Set Of Values Research Articles

Risk Factors Analysis and Nomogram Conduction for Major Adverse Events After Lumbar Fusion Surgery in Older Patients: A Prospective Cohort Study

This study aimed to identify risk factors for major adverse events (AEs) after lumbar fusion surgery in patients aged 75 and over and evaluate the role of several common geriatric comprehensive assessment items in predicting postoperative major AEs. This is a prospective cohort study of patients aged ≥75 years who underwent open lumbar fusion for degenerative spine disease from August 2019 to August 2022. The primary outcome measure was the incidence of major postoperative AEs within 90 days after surgery. Clavien-Dindo III-IV complications and unplanned readmission were defined as major AEs. Patients' characteristics, laboratory tests, assessment results, and surgery-related variables were compared between the major AEs and the non-major AEs groups. Multivariable logistic regression analysis was used to identify independent risk factors for major AEs. The logistic regression model was evaluated in another prospective cohort of patients from October 2022 to October 2023. A total of 301 patients (mean [SD] age, 79.7 [3.5] years; 60.5% male) were included in the study. Five features, including female (OR 1.99, p = 0.040), higher body mass index (BMI) (OR 1.090, p = 0.024), frailty (OR 2.043, p = 0.032), hypoalbuminemia (OR 2.489, p = 0.040), and higher Charlson comorbidity index (CCI) (OR 1.397, p = 0.024), were independently associated with major AEs and were selected to develop a predictive nomogram of major AEs. The area under the curve values for the development set and validation set were 0.75 and 0.71, respectively. Preoperative frailty, hypoalbuminemia, female sex, greater BMI, and higher CCI grade were risk factors for 90-day major AEs after lumbar fusion surgery in older patients. The predictive nomogram that we developed using this data can enhance preoperative risk counseling and optimization for older patients.

Development of a Frailty Prediction Model Among Older Adults in China: A Cross-Sectional Analysis Using the Chinese Longitudinal Healthy Longevity Survey.

To identify the risk factors associated with frailty among older adults in China and develop a predictive model for assessing their frailty risk. Secondary cross-sectional analysis. The 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) provided data for this study. A total of 9006 participants were included in the analysis. Their general demographic, socioeconomic status and health behaviour risk factors were collected in the CLHLS. Frailty was assessed using the Frailty Index. A visual nomogram model was constructed based on independent predictors identified using multivariate analysis. The nomogram's discrimination and calibration capabilities were evaluated using the C-statistics and calibration curves. A 1000-times resampling enhanced bootstrap method was performed for internal validation of the nomogram. The results showed that living in rural settings, having a primary education level, having a spouse, having basic living security, smoking, drinking, exercising and social activities were protective factors against frailty. Increasing age, being underweight or obese, adverse self-assessed economic status and poor sleep quality were risk factors of frailty. The AUC values of the internal validation set were 0.830. The calibration curve was close to ideal. The Brier score was 0.122. The above results showed that the nomogram model had a good predictive performance. A simple and fast frailty risk prediction model was developed in this study to help healthcare professionals screen older adults at high risk of frailty in China. The frailty risk prediction model will assist healthcare professionals in risk management and decision-making and provide targeted frailty prevention interventions. Screening high-risk older adults and early intervention can reduce the risk of adverse outcomes and save medical expenses for older adults and society, thereby realising cost-effective planning of health resources and healthy ageing. No patient or public contribution. This study was a cross-sectional, secondary analysis of the CLHLS data.

Current Clinical Utility of Circulating Tumor DNA Testing in Breast Cancer: A Practical Approach.

Circulating tumor DNA (ctDNA) refers to DNA fragments released from cancer cells into the bloodstream. Clinical utility of ctDNA in breast cancer has been explored in both metastatic breast cancer (MBC) and early-stage breast cancer (EBC) settings. In MBC, ctDNA can detect therapeutically targetable genomic alterations and has shown great potential in predicting treatment response or resistance. Accumulating data suggest that ctDNA might also have prognostic value in MBC. In EBC, emerging data have shown ctDNA's predictive and/or prognostic value in both neoadjuvant and adjuvant settings. Minimal residual disease (MRD) detection via ctDNA to detect clinical recurrence after curative therapy is a rapidly advancing field. In this review, we discuss the existing and emerging data regarding ctDNA utility in both MBC and EBC settings.

Rapid qualitative and quantitative detection for adulteration of Atractylodis Rhizoma using hyperspectral imaging combined with chemometric methods

In the field of traditional Chinese medicine, Atractylodis Rhizoma (AR) is commonly used for various diseases due to its excellent ability to dry dampness and strengthen the spleen, especially popular in East Asia. The aim of this study is to proposed Hyperspectral Imaging (HSI) in combination with chemometric methods for the rapid qualitative and quantitative detection of AR adulteration with other types of powder. Partial Least Squares Discriminant Analysis (PLS-DA) was used to construct the classification models the best, with the First-order Derivative (F-D) preprocessing method. The accuracy values of the test sets for classification models were above 99%. Furthermore, Partial Least Squares Regression (PLSR), Random Forest Regression (RFR), and BP Neural Network (BPNN) were used to quantitatively analyze the adulteration level. On the whole, the BPNN model has a relatively stable effect. The R-square (R2) values of different models were all greater than 0.97, the Root Mean Square Error (RMSE) values were all less than 0.0300, and the Relative Percentage Difference (RPD) values were over 6.00. After applying three characteristic wavelength selection algorithms, namely Iterative Retained Information Variable (IRIV), Successive Projections Algorithm (SPA), and Variable Iterative Space Shrinkage Approach (VISSA) algorithms, the classification accuracy values remained over 99.00% while the quantification models’ RPD values were over 4.00. These results demonstrate the reliability of using hyperspectral imaging combined with chemometrics methods for the adulteration problems in AR.

Identification of characteristics of conceptual prototype of microprocessor resource-saving relay protection system

The object of the study is the conceptual prototype of a microprocessor resource-saving relay protection system. Currently, relay protection ensures electrical networks reliable and efficient work, however, the traditional architecture is proprietary, not allowing to fix and replace damaged parts without a company specialist. Therefore, the open-architecture relay protection is a very pressing issue, but the problem lies in meeting the relay protection requirements. The data transmission protocols nRF and ESP-NOW, Hall sensors evaluation for AC current measurement determination and sensor accuracy improvement was implemented. Experimental validation demonstrated that nRF and ESP-NOW protocols meet the delay and reliability requirements, however, the nRF protocol is more suitable due to its flexibility and obstacle penetration. The data demonstrated that the most effective conditions are without obstacles at 15 meters from the modem and with obstacles 5 meters from the modem. The experiment of Hall sensors characteristics determination demonstrated the accuracy of current measurement with the set values of the opening and closing currents. Nevertheless, it is not accurate (12.45 %) for the relay protection application. Therefore, the application of the changing values of the opening and closing currents is more effective and accuracy reaches 6.92 %. As a result, the service life of the Hall sensor was determined, and even after 10 million openings, the open state time remained unchanged. Therefore, the approximation function for current amplitude determination depending on open state time was found. On the other hand, Hall sensors may suffer from temperature drift and require further optimization to be fully reliable. The study limitation is the current range from 0 to 800 A

Исследование характеристик комбинированных устройств глубокого охлаждения дымовых газов на водогрейных котлах системы ЖКХ

One of the ways to increase the efficiency of hot water boilers of the housing and communal services system is the deep cooling of combustion products to temperatures below the dew point temperature. Currently, there are a number of studies on the use of condensation economizers and air heaters of various types to solve this problem. The use of such devices makes it possible to reduce the temperature of combustion products and, thus, increase the heat utilization coefficient, reduce fuel consumption. The use of combined flue gas cooling devices seems particularly promising, but the parameters of their operation have not yet been studied. In this regard, the development and study of the parameters of such devices are relevant. Using the techniques to design heat exchangers, a set of thermal calculations has been performed to study the characteristics of a combined deep cooling system for combustion products after a hot water boiler of the housing and communal services system, represented by an air heater and a condensation economizer. It is considered that one part of the flue gases after the air heater is sent to the economizer, and the other part goes through the bypass, bypassing the economizer, and then meets the combustion products coming out of it. The distribution of the combustion product flow before the economizer is based on the need to ensure the temperature of the mixed flow after the economizer at 70 °C. For the most common hot water boiler in the housing and communal services system of the TVG-8M type, the authors have been established the dependence of the heat transfer coefficients, the surface area of the heat exchangers and other parameters of the deep cooling system of the exhaust gases on the set value of the temperature of the combustion products after the air heater. It has been established that the proposed scheme of a combined deep cooling system for combustion products makes it possible to improve the technical and economic performance of the boiler by reducing fuel consumption. It is proved that the smoke temperature after the air heater for this type of the boiler should not be very low (not lower than 115–130 °C), since it dramatically increases the heat flow with a decrease in the average logarithmic temperature difference and leads to an increase not only in the temperature of the heated air, but also in the surface area of the air heater.

The Cancer-Specific Health Economic Measure QLU-C10D is Valid and Responsive for Assessing Health Utility in Patients with Thyroid Cancer.

Background: Health economic appraisals often rely on the assessment of health utilities using preference-based measures (PBM). The cancer-specific PBM, European Organisation for Research and Treatment of Cancer Quality of Life Utility - Core 10 Dimensions (EORTC QLU-C10D), was developed recently, and now needs to be validated in various clinical populations. Methods: In a multicenter, multinational prospective cohort study, we longitudinally collected EORTC QLQ-C30 and EQ-5D-5L data from patients with thyroid cancer. We applied seven country-specific value sets to the QLQ-C30 data to derive country-specific utility values and used the EQ-5D-5L as a comparator PBM. Criterion validity was assessed by correlating index scores and Bland-Altman plots. Construct validity was investigated by correlating domain scores. Known-group comparisons and responsiveness were assessed using external clinical criteria. Results: A total of 181 patients with thyroid cancer from nine countries (three continents) provided analyzable data. Patients were included if they had differentiated, medullary, or anaplastic thyroid cancer. Mean utility values of both instruments were generally lower compared to general population norms. No floor or ceiling effects were present for the QLU-C10D. The intra-class correlation for EQ-5D-5L and QLU-C10D index values ranged from 0.761 to 0.901 across the measurement timepoints, supporting criterion validity. Spearman's correlation coefficients ranged from 0.289 to 0.716 for theoretically corresponding domain pairs. The QLU-C10D detected differences in 9 of 15 known-group comparisons, supporting sensitivity. Clinically important changes were detected by all QLU-C10D country specific value sets, supporting responsiveness. Further, the QLU-C10D had higher statistical efficiency than the EQ-5D-5L in 74.7% of comparisons. Conclusions: The QLU-C10D is a valid PBM for health economic evaluations in thyroid cancer studies. We recommend its use to estimate health utilities in economic evaluations of thyroid cancer therapies.

Exploring common biomarkers of ischemic stroke and obstructive sleep apnea through bioinformatics analysis.

Clinical observations have shown that many patients with ischemic stroke (IS) have a history of obstructive sleep apnea (OSA) both before and after the stroke's onset, suggesting potential underlying connections and shared comorbid mechanisms between the two conditions. The aim of this study is to identify the genetic characteristics of OSA patients who develop IS and to establish a reliable disease diagnostic model to assess the risk of IS in OSA patients. We selected IS and OSA datasets from the Gene Expression Omnibus (GEO) database as training sets. Core genes were identified using the Limma package, Weighted Gene Co-expression Network Analysis (WGCNA), and machine learning algorithms. Gene Set Variation Analysis (GSVA) was conducted for pathway enrichment analysis, while single-sample gene set enrichment analysis (ssGSEA) was employed for immune infiltration analysis. Finally, a diagnostic model was developed using Least Absolute Shrinkage and Selection Operator (LASSO) regression, with its diagnostic efficacy validated using receiver operating characteristic (ROC) curves across two independent validation sets. The results revealed that differential analysis and machine learning identified two common genes, TM9SF2 and CCL8, shared between IS and OSA. Additionally, seven signaling pathways were found to be commonly upregulated in both conditions. Immune infiltration analysis demonstrated a significant decrease in monocyte levels, with TM9SF2 showing a negative correlation and CCL8 showing a positive correlation with monocytes. The diagnostic model we developed exhibited excellent predictive value in the validation set. In summary, two immune-related core genes, TM9SF2 and CCL8, were identified as common to both IS and OSA. The diagnostic model developed based on these genes may be used to predict the risk of IS in OSA patients.

Identifying the parameters and operation modes of the cavitation apparatus taking into account the influence of the processing material

The object of this study is dynamic pressure that takes into account the main parameters of technological process. Under real conditions of cavitation apparatus operation, a discrepancy between actual and calculated parameters of 30–50 % was found, which significantly reduces the efficiency and quality of material processing. The problem was solved through a joint study of the movement of the acoustic apparatus and the technological environment as a single structured system taking into account the influence of materials. This is a peculiarity of the approach and distinctive features of the results in comparison with existing ones, in which the research was conducted separately for the processing material and the cavitation apparatus. The model proposed in the work reflects the elastic, inertial, and dissipative parameters in the equations of motion, provided that their changes are taken into account, both in the acoustic apparatus and in the technological material. This approach has made it possible to reveal the physical essence of the interaction and analytically describe their joint movement. The resulting analytical dependences made it possible to calculate and propose numerical values of vibration amplitudes in the range of 4.0...20.0 μm, sound pressure values in the range of 5.0...30.0∙105 Pa for media with a viscosity of (10–200)∙10-3 Pa∙s. With the set value of the amplitude, it is possible to assign the necessary parameters for the implementation of the cavitation process. The developed calculation algorithm ensures the reliability of the accepted models and parameters of the cavitation apparatus. The proposed approach of joint study of the movement of the acoustic apparatus and the environment is expedient to use for the practical implementation of ultrasonic treatment. In particular, such processes as dispersion, emulsification, mixing, extraction, and others, in order to increase their efficiency

Optimal Control of Air-Side Economizer

The economizer system is a method of improving energy efficiency through the operating method, which introduces outdoor air through dampers when the outdoor air temperature or enthalpy is lower than the that of the indoor air. The set values used for economizer control include the mixed air temperature and high and low limits. The set values are presented as fixed values in the relevant standards and are controlled to be fixed during actual operation, which may lead to issues such as indoor discomfort, poor indoor air quality, and energy wastage. Therefore, it is necessary to optimize economizer control by determining appropriate set values considering the indoor and outdoor environments. To this end, this paper reviewed the economizer system, control method, control set values, and prediction models in buildings. As a result, it was concluded that optimal economizer control is possible by utilizing a prediction model.

A predictive model of treatment effectiveness of refractory peritoneal dialysis-related peritonitis in patients with peritoneal dialysis: a single-center observational study in South China

Abstract Background To prevent loss of peritoneal function caused by persistent abdominal inflammation, the guidelines recommend early extubation in patients with refractory peritoneal dialysis-associated peritonitis (rPDAP). In attempt to pinpoint high-risk patient cohorts that did not respond to treatment for refractory peritonitis, we created a model to predict the effectiveness of peritonitis treatment. Methods This observational cohort study included peritoneal dialysis (PD) patients from January 1, 2011 to December 31, 2020. Multivariate logistic regression analysis was used to explore the factors affecting the occurrence and prognosis of rPDAP, and to construct a predictive model for the success of rPDAP treatment. Receiver operator characteristic (ROC) curve, calibration and decision curve were drawn to evaluate the predictive performance of the model. Results A total of 1, 397 cases of peritoneal dialysis-associated peritonitis (PDAP) occurred in our center during the study period, of which 558 cases were diagnosed as rPDAP. The incidence of refractory peritonitis was 0.047 cases/patient-year. In the study, 440 cases with rPDAP were included. Among them 304 cases (69.1%) had been successfully cured, while 136 cases (30.9%) were treatment failure, of which 19 cases (4.3%) died, 85 (19.3%) cases transferred to hemodialysis and 32 cases (7.2%) were relapse/recurrent peritonitis. Dialysate culture results showed 132 (30.0%) cases were infected with gram positive bacteria, 161 (36.6%) gram negative bacteria. Multivariate Logistic regression analysis showed that episodes of peritonitis previously ≤ 3 times were correlated with the better prognosis of rPDAP, but white blood cell (WBC) counts in peritoneal dialysate on the 3rd day of peritonitis or WBC counts on the 5th day ≥ 300 × 106/L, the pathogenic microorganism with gram-negative bacteria, as well as longer duration of PD were associated with poor outcomes. The C-statistical value of the training data set was 0.870 (95%CI: 0.821–0.918). The calibration curve and clinical decision-making curve also proved that this nomogram could accurately predict the success of treatment in patients with refractory peritonitis. Conclusion The nomogram model created through internal verification indicated a strong clinical application value and a high prognostic prediction accuracy for rPDAP.

Utility analysis of outpatient hypertensive patients with and without comorbidities using the EQ-5D-5L instrument: A study at UPTD Puskesmas Pagerageung, Tasikmalaya Regency, West Java

Hypertension is a chronic condition often requiring lifelong treatment, which can impact patients’ quality of life (QoL) in physical, psychological, and social domains. The presence of comorbid conditions alongside hypertension can further deteriorate QoL. Health utility measurement, particularly in hypertensive patients with comorbidities, is crucial for understanding these compounded effects. This study aims to evaluate and compare the quality of life utility in hypertensive patients with and without comorbidities using the EQ-5D-5L instrument, focusing on how comorbid conditions influence overall QoL. A descriptive observational study with a cross-sectional design was conducted among 100 hypertensive patients treated at UPTD Puskesmas Pagerageung, Tasikmalaya, from January to March 2024. Participants were selected through purposive sampling. The EQ-5D-5L questionnaire was used to assess utility scores, which were calculated using an Indonesian-specific value set. Chi-square and Post Hoc LSD analyses were applied to explore relationships between utility scores and demographic factors such as age, gender, and occupation. The average utility score for hypertensive patients without comorbidities was 0.669, higher than that of patients with comorbid conditions. Specifically, patients with diabetes mellitus, osteoarthritis, gastric conditions, heart disease, and severe comorbidities (e.g., kidney disease, cataracts, stroke) had average scores of 0.578, 0.640, 0.651, 0.537, and 0.148, respectively. Age was significantly associated with utility scores (p = 0.014), whereas gender and occupation showed no significant impact. Hypertensive patients without comorbidities had a better quality of life utility than those with additional health issues. Targeted management of comorbidities is essential to improve the quality of life among hypertensive patients, especially in those facing compounded health challenges.

Quality of life in people with multiple sclerosis vs general population: differences increase by age

Abstract Background To enhance health care for chronically ill people, it is crucial to understand the impact of their disease on health-related quality of life (HRQoL). More than 240,000 people in Germany live with multiple sclerosis (PwMS), the most common immune-mediated neurodegenerative disease of the central nervous system. Little is known about HRQoL in PwMS in comparison to the general population and by subgroups. Methods In 2021, 6,928 statutorily-insured PwMS aged ≥18 years and living in the federal state of Lower Saxony, Germany, were invited to take part in an online survey. The German EQ-5D-5L value set was used to analyse HRQoL by index values. Descriptive subgroup analyses were conducted (age, sex) and compared to a general German reference population (Grochtdreis et al. 2019, DOI: 10.1007/s10198-019-01054-1). Mann-Whitney-U- or Kruskal-Wallis-tests were performed as appropriate. Results Of 1,935 respondents (response rate 27.9%), 1,916 PwMS were included in the current preliminary complete case analysis. HRQoL is reduced in PwMS compared to the general population: Mean (M) 0.67 vs. M 0.88, respectively. While no significant differences by sex were found in PwMS (male: M 0.66 vs. female: M 0.68, p = 0.1), HRQoL decreased with increasing age (p < 0.001). The reduction in HRQoL is more pronounced in PwMS than in the general population (difference between means 0.53 in 18-24 years old to ≥ 75 years old PwMS vs. 0.14 in the reference population, respectively). Conclusions PwMS report an overall lower level of HRQoL compared to the general population. Increasing age correlates with a substantial decrease of HRQoL in PwMS. Targeted research is needed to improve HRQoL of this vulnerable population. Key messages • The decline in HRQoL with increasing age is more pronounced in PwMS than in the general population in Germany. • Further research should focus particularly on the extent to which MS-related factors are solely attributable for the considerable decline of HRQoL in PwMS.

Up-titration of Guideline Directed Medical Therapy (GDMT) and the occurrence of side effects in Heart Failure with reduced Ejection Fraction (HFrEF)

Abstract Background The ESC Guidelines recommend early, full-dose use of heart failure (HF) medications to enhance survival, but real-world application often faces delays and inconsistencies. Clinicians often fear side effects during up-titration to the recommended target dose (TD), i.e. hypotension, bradycardia, renal impairment, and hyperkalemia (HK). The dependency of side effects during dose escalation from the severity of HF remains unclear. Purpose This study aimed to evaluate the relationship between the occurrence of side effects during up-titration of HF medication and HF severity reflected by N-terminal pro B-type natriuretic peptide (NT-proBNP). Methods 425 patients with HFrEF and a complete data set of patient characteristics, medications and laboratory values at baseline (BL), 2 months (2M), and 6 months (6M) were included from our outpatient HF unit's prospective registry. Significant side effects were defined as: systolic blood pressure (SBP) <90mmHg, heart rate (HR) <50 beats per minute (bpm), potassium (K) >5.0mmol/l or K >5,5mmol/l and estimated glomerular filtration rate (eGFR) <30ml/min/1.73m2. Patients were categorized into three risk groups based on their NT-proBNP levels, i.e. low-risk with NT-proBNP <1000pg/ml, medium-risk with NT-proBNP 1000-2000pg/ml or high-risk with NT-proBNP >2000pg/ml. The occurrence of side effects was recorded and the development compared among the HF risk groups. Results Figure 1 shows up-titration of HF medication. Mean daily dosages of betablockers (BB), mineralocorticoid receptor antagonists (MRA) and renin-angiotensin-system inhibitors (RASi) increased significantly during follow-up (BL vs 2M and BL vs 6M, p<0.001 for all). The majority of patients received ≥50% of the recommended TDs at 6M (89% for BB, 83% for MRA, 88% for RASi and 91% for total mean TDs ≥50%), and the achieved daily dosages at 6M were largely comparable across the HF risk groups at 6M, except for RASi (p=0.030). Figure 2 depicts the side effects. Side effects developed almost exclusively at short-term within 2M except for lower SBP (Figure 2A). Newly developed side effects occurring after up-titration (2B) were even more rare and predominantly occurred within the highest NT-proBNP group. The occurrence of hypotension and bradycardia was infrequent and comparable within the HF risk groups. Renal dysfunction (at 6M p=0,041) and HK occurred predominantly in higher risk patients (HK at 2M p=0,001 and at 6M p<0,001). Conclusions Up-titration of HF medications is highly feasible, particularly in low- and medium-risk patients. Despite rare side effects such as hyperkalemia and renal impairment, up-titration remains unimpeded, especially in patients with NT-proBNP levels below 2000pg/ml. These findings emphasize the safety of up-titration in HF.

Circulating Amyloid beta 1-40 is independently associated with statin treatment and LDL cholesterol reduction: a prospective cohort study

Abstract Background Accumulating evidence suggests that circulating amyloid beta 1-40 (Aβ40), a pro-inflammatory and pro-atherogenic peptide, is associated with atherosclerotic cardiovascular disease (ASCVD), providing incremental prognostic value and risk stratification refinement in primary and secondary prevention settings. Existing evidence supports conflicting off-target effects of statins on plasma Aβ40. We aim to explore the impact of cardiovascular risk reduction through statin therapy on Aβ40 plasma levels in subjects with dyslipidemia and with/without ASCVD. Methods In this prospective study, patients with dyslipidemia who visited for the first time our lipid clinic for risk stratification and treatment plan assessment (n=146) were consecutively recruited. Αβ40 was measured in plasma samples by enzyme-linked immunosorbent assay at baseline and after a mean follow-up of 5.2 and 15 months. Patients in whom statin treatment was initiated or intensified in terms of dose or regimen (n= 68) were compared against patients not treated with statins or with unchanged statin intensity (n = 78). Statin intensity treatment was defined based on the European Society of Cardiology (ESC) guidelines. Results Increased Aβ40 plasma levels at baseline were associated with ASCVD presence, decreased glomerular filtration rate (GFR), and history of heart failure (p<0.05 for all). An increase in Aβ40 circulating levels between baseline and follow-up 1 was observed in patients in whom statin treatment was initiated or intensified (p=0.041). However, in patients not treated with statins or treated with unchanged statin intensity, an increase in Aβ40 circulating levels was observed between follow-up 1 and follow-up 2 (p=0.05, Figure 1A). These changes in Aβ40 were significantly different between the two groups during the short follow-up period (β=0.226, p for interaction =0.025) independently from age and changes in GFR, systolic blood pressure, and LDL-C. Additionally, patients who achieved a reduction in low-density lipoprotein cholesterol (LDL-C) ≥ 50% in follow-up 2 have unchanged Aβ40 levels during the long follow-up period, while an increase in Aβ40 was observed in the rest population (p=0.012, Figure 1B). These changes were significantly different between the two LDL-C groups independently of statin treatment and changes in high sensitive C-reactive protein (hs-CRP) (β= -0.231, p for interaction=0.035). Conclusion In a dyslipidemic population, statin initiation or intensification and LDL-C decrease showed a short-term increase and a long-term return to initial levels, respectively, in circulating Aβ40 levels. From a mechanistic point of view, our findings suggest that statins have an impact on Aβ40, possibly through an LDL-C-dependent and a non-LDL-C-dependent pathway. Further studies are needed to evaluate the utility of circulating Aβ40 as a novel biomarker in ASCVD risk reduction assessment.

Prevalence of cardiomyopathies and myocardial scar in patients with non-complicated premature ventricular beats: a CMR study

Abstract Introduction Frequent or symptomatic premature ventricular beats (PVBs) in subjects with no personal or family history of cardiac disease or sudden death is a recurrent motive for cardiac magnetic resonance (CMR) prescriptions. This represents a significant burden on healthcare services, given the low availability of CMR technique. If CMR is a recommended imaging modality in patients with history of cardiac arrest due to ventricular arrhythmia, sustained ventricular arrhythmias or when first-line tests are abnormal, its diagnostic value in this specific setting has not been evaluated. Purpose To determine the prevalence of significant CMR abnormalities (myocardial fibrosis, arrhythmogenic cardiomyopathies) in patients with no personal nor family history of cardiac disease and non-complicated PVBs. Methods Between September 2010 and July 2021, 416 healthy adults with no personal nor family cardiac disease history underwent CMR at our institution to explore non complicated PVBs, and were retrospectively included (Figure 1). Right and left ventricular (RV/LV) function and dimensions were systematically evaluated on CMR, as the presence of myocardial late gadolinium enhancement (LGE). Criteria for cardiomyopathies (hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), ARVD), the presence and location of myocardial fibrosis were looked after. Results A total of 605 patients were referred for CMR to explore frequent PVBs, representing 14% of all tests performed during this period. Among them, 12 patients (3%) presented significant myocardial abnormalities possibly related to PVBs: 2 patients had sequelae of myocardial infarction and 3 of myocarditis, 1 patient had criteria of HCM and 1 of ARVD, finally 5 presented non-specific myocardial fibrosis (septal mid-wall LGE). In addition, after a mean follow-up of 5 years, there was no death in patients with abnormal CMR, and only 2 patients underwent transcatheter ablation for focal non complicated but symptomatic PVBs. There was no hospitalization for heart failure. Conclusion In patients with non-complicated PVBs and no history of cardiac disease, the rate of cardiomyopathy pattern or myocardial scar on CMR is very low (3%). In this specific population, events were very rare: frequent isolated PVBs, even when associated with myocardial abnormalities, were a benign condition in our study. Given the high volume of patients referred for this indication in daily practice (14% of total CMRs in our center), the limited availability and high costs of CMR, and the difficulties of CMR sequences acquisition in the context of frequent PVBs (possibly leading to misdiagnosis), these data suggest that we should refine the selection of patients undergoing CMR for PVBs exploration.

Application of microencapsulated phase change materials for controlling exothermic reactions

Abstract Thermal runaway is a frequent source of process safety issues, and the uncontrolled release of chemical energy puts reactors at risk. The design of the exothermic reactor faces challenges due to the selective sensitivity of the product to high temperatures and the need to increase the lifetime of the catalyst, optimize the product distribution, and improve the thermodynamic properties. Phase change material (PCM) encapsulation is recommended to reduce leakage, phase separation, and volume change problems. This work introduces encapsulated PCMs to improve reactor temperature control and minimize thermal runaway in exothermic processes. The warning temperature value setting effectively inhibits fugitive exothermic reactions and enhances heat transfer. When a sufficient quantity of encapsulated PCMs is input, the response speed will automatically accelerate. Spontaneous acceleration of the reaction rate due to thermal runaway of the reaction may be completely avoided by adding a sufficient amount of encapsulated PCM. Microencapsulation is used to control volume changes and inhibit thermal reactions. Preventive strategies include cooling, depressurization, safety release, emergency resources, and reaction containment. Encapsulated PCMs improve mechanical and thermal properties, surface-to-volume ratio, heat transfer surface, thermal capacity, and efficiency.

Indigenous Experiences and Contributions to Western Scientific Knowledge Systems: An Ethnographic Exploration

Knowledge systems are embedded in sets of values, worldviews, and cosmologies that affect the whole process of knowledge production. Employing an ethnographic method that integrates participant observation, interviews, and focus groups, I explore the contributions, ideas, points of view, and metaphors that individuals of Indigenous origins introduce to the scientific method when they enter Western scientific knowledge systems. This ethnographic exploration focuses on a group of students with a variety of Indigenous backgrounds participating in a field course on introduction to Ecology. Native-born students contribute innovations to the knowledge production process by shaping research questions, methodologies, and result interpretations. These innovations stem from diverse worldviews and epistemologies, and while they could significantly impact scientific knowledge production, the students may not fully appreciate their own relevance. This work may serve as a testimony of the processes of reflection and negotiation with the scientific methods, practices, and values that native students undergo when participating in a Western scientific context.

High‐precision numerical simulation method for thermal–mechanical coupling in rubbers

AbstractImproving the precision of numerical simulations in thermal–mechanical coupling for amorphous polymer materials is crucial for their effective utilization. To enhance the precision of rubber numerical simulations, this study proposed a method considering the temperature and strain rate to establish tensile testing conditions based on the principle of time–temperature equivalence. Additionally, to obtain more precise parameters for hyperelastic constitutive equations, stress relaxation experiments were conducted to determine a set of stress values under complete rubber stress relaxation, which were used to fit the hyperelastic components of the hyper‐viscoelastic algorithm. A finite element model of rubber rebound was established, and a hyperelastic model based on loss factor and a hyperelastic model based on Prony series (hyper‐viscoelastic) were used to calculate the temperature changes caused by rubber rebound coefficient and energy dissipation during the rebound process at 110, 120, and 130°C. We compared the calculation results of these two algorithms with experimental data to verify their accuracy. The research results show that the average error of the rebound coefficient of the hyperelastic algorithm at three temperatures is 3.63%, and the average error of the rebound coefficient of the hyper‐viscoelastic algorithm at these three temperatures is 0.93%. The comparison with the rebound test results shows that the hyper‐viscoelastic method is more accurate and better captures the viscoelastic hysteresis of rubber, but the model calculation time is longer. In addition, at the moment of rebound sample impact, the maximum temperature rise amplitude of the hyperelastic algorithm sample impact position is 2.60, 1.75, and 0.91°C, which are 110, 120, and 130°C, respectively; The maximum heating amplitudes of the hyper‐viscoelastic algorithm are 2.05, 1.35, and 0.61°C. The hyper‐viscoelastic algorithm is closer to the actual test results.Highlights Applied the principle of time–temperature equivalence. Determination of material parameters using the hyper‐viscoelastic algorithm. Calculated the temperature change during the rubber rebound process.

Introducing listening as a weak method for advancing sustainability and interdisciplinary scholarship

AbstractThere is now widespread recognition of the need for inter/transdisciplinary (I/TD) approaches to solving global problems like climate change and biodiversity. Yet methods for successfully integrating knowledge across disciplines, and between research and practice, are in need of further development, particularly approaches that can ameliorate epistemological and ontological divides. Here we propose a framework for good listening as a ‘weak method’ that can provide guidance and structure to I/TD collaborations, but does not assume the form and goals a given collaboration will take. Synthesising the results of a scoping, interdisciplinary literature review, we highlight four key components of listening—receiving, processing, interpretation, and feedback/response—and provide a set of normative values regarding ‘good listening’ for each. Our goal is to provide a framework that is grounded in detailed scholarly discussions of listening politics and practice, but that is specifically formulated in response to the needs and concerns of I/TD researchers. We then apply our framework to four commonly encountered challenges in sustainability science, drawing on our collective experience in the field to explore how good listening can aid I/TD collaboration in regards to inclusion, group dynamics, format and pace. In doing so, we hope to inspire those working in sustainability science to approach I/TD collaboration in a new way and provide a tool for facilitating caring and transformational approaches to solving the world’s most pressing sustainability crises.