Wall Thickness Research Articles

Normative values for lung, bronchial sizes, and bronchus-artery ratios in chest CT scans: from infancy into young adulthood.

To estimate the developmental trends of quantitative parameters obtained from chest computed tomography (CT) and to provide normative values on dimensions of bronchi and arteries, as well as bronchus-artery (BA) ratios from preschool age to young adulthood. Two independent radiologists screened a dataset of 1160 chest CT scans, initially reported as normal, from participants aged 0 to 24 years. Using an automated deep learning-based algorithm, we computed the following bronchus and artery parameters: bronchial outer diameter (Bout), bronchial inner diameter (Bin), adjacent pulmonary artery diameter (A), bronchial wall thickness (Bwt), bronchial wall area (BWA), and bronchial outer area (BOA). From these parameters, we computed the following ratios: Bout/A, Bin/A, Bwt/A, Bwt/Bout, and BWA/BOA. Furthermore, mean lung density, total lung volume, and the square root of wall area of bronchi with a 10-mm lumen perimeter (Pi10) were obtained. The effects on CT parameters of age, sex, and iodine contrast were investigated using mixed-effects or regression model analyses. 375 normal inspiratory chest CT scans (females / males = 156 / 219; mean age [SD] 12.7 [5.0] years) met the inclusion criteria. Bout and Bin progressively increased with age (all p < 0.05), but Bwt, Bout/A, Bin/A, Bwt/A, Bwt/Bout, or BWA/BOA did not. Total lung volume and mean lung density continuously increased with age (both p < 0.001), while Pi10 did not exhibit such a trend. Bout, total lung volume, and mean lung density were the only parameters that differed between males and females, all higher in males than females (all p < 0.03). The presence of iodinated contrast led to greater values for Bwt, Bwt/Bout, and BWA/BOA, but lower values for Bin, Bout/A, Bin/A, and Bwt/A (all p < 0.01). Quantitative CT parameters of both lung parenchyma and bronchi exhibit growth-related changes, but from 6 to 24 years ratios between bronchus and artery dimensions remain constant. Contrast-enhanced CT scans affect the assessment of lung parenchyma and bronchial size. We propose age and technique-dependent normative values for bronchial dimensions and wall thickness. Question What are the developmental trends of quantitative lung CT parameters in patients from childhood into young adulthood? Findings The ratio between bronchus and pulmonary artery dimensions demonstrates consistent values across age groups, indicating synchronized growth between bronchi and paired pulmonary arteries. Clinical relevance Our findings highlight the importance of standardized CT protocol and volume acquisition, and emphasize the need for ongoing collection of normal chest CT scans to refine the proposed reference values.

Alleviation of cadmium toxicity and minimizing its accumulation in rice plants by methyl jasmonate: Performance and mechanisms.

Heavy metal pollution is a worldwide problem that threaten agricultural production and human health. Methyl jasmonate (MeJA) is a phytohormone that could enhance plant resistance against various stresses. However, the mechanism of MeJA in cadmium (Cd) uptake, distribution, and translocation in rice plants remains elusive. In this study, we found that the Cd induced-growth inhibition was ameliorated by MeJA. Upon MeJA application, Cd content in root and shoot was decreased by 10.15 % and 36.39 %, which paralleled with less Cd2 + influx of rice roots and depressed expression of the cation transporters (OsNramp1 and OsNramp5). The subcellular distribution revealed that MeJA enriched Cd distribution in cell wall, which was accompanied by increased cell wall thickness and altered cell wall polysaccharide (pectin, cellulose, hemicellulose) content, meanwhile, the Cd content in pectin, cellulose, hemicellulose was increased, the FTIR analysis implied that functional groups (especially -OH and COO-) on cell wall were involved in Cd fixation. The root to shoot translocation of Cd was hindered by exogenous MeJA, this was validated by the decreased expression of OsHMA2 in root and declined Cd level in xylem sap. Overall, our results revealed that MeJA could act as a foliar resistance control substance to reduce Cd accumulation in rice plants. The detailed molecular mechanisms of MeJA in Cd detoxification in plants still need further investigation.

Interpretation, Reporting, Imaging-Based Workups, and Surveillance of Incidentally Detected Gallbladder Polyps and Gallbladder Wall Thickening: 2025 Recommendations From the Korean Society of Abdominal Radiology.

Incidentally detected gallbladder polyps (GBPs) and gallbladder wall thickening (GBWT) are frequently encountered in clinical practice. However, characterizing GBPs and GBWT in asymptomatic patients can be challenging and may result in overtreatment, including unnecessary follow-ups or surgeries. The Korean Society of Abdominal Radiology (KSAR) Clinical Practice Guideline Committee has developed expert recommendations that focus on standardized imaging interpretation and follow-up strategies for both GBPs and GBWT, with support from the Korean Society of Radiology and KSAR. These guidelines, which address 24 key questions, aim to standardize the approach for the interpretation of imaging findings, reporting, imaging-based workups, and surveillance of incidentally detected GBPs and GBWT. This recommendation promotes evidence-based practice, facilitates communication between radiologists and referring physicians, and reduces unnecessary interventions.

Black phosphorus nanomaterials mediate size-dependent acute lung injury by promoting macrophage polarization.

Black phosphorus nanomaterials (BPNM) exhibit excellent properties and potential applications in electronics, but workers may face inhalation exposure during BPNM production. In addition, there is a lack of biosafety assessments regarding respiratory exposure to BPNM of different sizes. In this study, we investigated the lung toxicity in mice exposed to 5, 50, 500μg/kg of black phosphorus quantum dots (BPQDs) and black phosphorus nanosheet (BPNS) via single tracheal instillation. The average diameter of the BPQDs and BPNS were 13.48±4.82nm and 325.53±165.17nm, respectively. Twenty-four hours after exposure, both BPQDs and BPNS caused acute lung injury, characterized by bronchial wall thickening, alveolar collapse, increased lamellar bodies, and immune cell infiltration. BPNS exposure resulted in reduced gene expression of pulmonary surfactant proteins Spb and Spc. Additionally, both BPQDs and BPNS increased inflammatory factors gene expression and induced lung macrophages polarization, with BPNS demonstrating a more significant effect. This study is the first to show that BPQDs and BPNS induced acute lung injury and inflammation in mice, with BPNS being more toxic. These findings are crucial for enhancing the biosafety assessment of BPNM and advancing technologies to improve the safety of nanomaterials.

Left ventricular wall thickness discrepancies at end-diastole and mid-diastole: Reference values for cardiac CT.

To investigate differences in left ventricular wall thickness (LVWT) measurements between end-diastole and mid-diastole using cardiac computed tomography (CCT) and establish LVWT reference values stratified by phase, sex, and region. Subjects who underwent CCT without a history of cardiovascular disease or risk factors were retrospectively included between 2021 and 2024. LVWT was manually measured in each segment according to the American Heart Association's 17-segment model at end-diastole and mid-diastole. Regional LVWT was calculated as the average value of relevant segments. The study included 187 subjects with a mean age of 51±11years, including 77 (41%) men. Global LVWT was lower at end-diastole than at mid-diastole (5.7±0.8 vs. 6.5±0.9mm, P<0.001). Each segmental LVWT correlated significantly between end-diastole and mid-diastole (Pearson's correlation coefficient: 0.79-0.87). Segment 2 was thickest (8.1±1.5mm at end-diastole and 9.1±1.7mm at mid-diastole). LVWT was greater in men than in women (all P<0.001). The upper limits of LVWT were 9.9mm for women and 11.7mm for men at end-diastole, and 11.8mm for women and 13.1mm for men at mid-diastole. LVWT progressively thinned from the base to the apex. Apical LVWT measured on short-axis and long-axis showed a small but statistically significant difference, particularly in Segment 16. This study provides CCT reference values for LVWT at end-diastole and mid-diastole. Mid-diastolic LVWT was slightly greater than end-diastolic LVWT, with a statistically significant difference. Normal LVWT was greater in men than in women, with regional variations observed in both phases.

Bruton tyrosine kinase promotes wound healing after myocardial infarction by inhibiting the transcription of u-PA

BackgroundsBruton tyrosine kinase (BTK), which is highly expressed in immune cells, plays a critical role in regulating the function of macrophages. A growing body of evidence has demonstrated that the accumulation of macrophages in cardiac tissue after myocardial infarction (MI) significantly affects wound healing and ventricular remodeling during the early phase of repair after MI. However, the role of BTK in cardiac repair post-MI, especially in macrophage-mediated repair, remains unclear. MethodsMI was induced by permanent left anterior descending (LAD) artery ligation in wild-type (WT) mice and macrophage-specific BTK-knockout (BTKMAC-KO) mice. Expression of BTK and phosphorylated BTK were assessed by western blotting. Then, RNA sequencing and ChIP-qPCR assay were performed to explore potential BTK targets and transcriptional regulatory sites. ResultsBTK, which was mainly expressed in macrophages, was upregulated in mice after MI. Compared with WT mice, BTKMAC-KO mice had significantly greater mortality due to heart rupture, reduced wall thickness and severe impairment of left ventricular (LV) function after MI. In addition, increased matrix metalloproteinase-9 (MMP-9) expression and decreased α-SMA and collagen expression were observed in BTKMAC-KO mice after MI. Further experiments revealed that BTK deficiency in macrophages reduces the expression of VEGF and impairs angiogenesis after MI. By RNA sequencing, we found that Nf-kB family genes, as well as the urokinase-type plasminogen activator (uPA), were significantly upregulated in BTK-deficient macrophages. By ChIP-qPCR analysis, we confirmed that uPA was transcriptionally activated by the Nf-kB p65 subunit. Finally, the application of plasminogen activator inhibitor-1 (PAI-1), an uPA inhibitor, markedly protected against cardiac rupture, lowered the mortality rate, and improved cardiac function by increasing collagen deposition and promoting tissue healing in BTKMAC-KO mice after MI. ConclusionsThe present study identifies PAI-1 as a novel cardioprotective agent for cardiac repair post-MI that increases collagen deposition and promotes tissue healing. A therapeutic strategy targeting BTK may be a promising treatment for cardiac repair post-MI.

Role of putative APSES family transcription factor Swi6 in cell wall synthesis regulation in the agaricomycete Pleurotus ostreatus.

Clade A APSES family transcription factor Swi6 functions alongside Mbp1 to form the MBF (MluI cell cycle box-binding factor) complex in ascomycetes. In the agaricomycete Pleurotus ostreatus, Mbp1 plays a crucial role in regulating β-glucan and chitin synthesis; however, the role of Swi6 has not been explored in this fungus. In this study, its involvement in cell wall synthesis regulation was analysed using swi6 disruption strains in P. ostreatus. The Δswi6 strains exhibited reduced growth rates and shorter aerial hyphae formation in both agar and liquid media, suggesting an essential role of Swi6 in normal vegetative growth. Furthermore, swi6 disruption affected cell wall thickness distribution, the expression of specific chitin synthase genes, the relative percentage of chitin, and sensitivity to calcofluor white, suggesting that Swi6 is required for normal chitin synthesis regulation in P. ostreatus. In contrast, no significant differences were observed between the wild-type and Δswi6 strains in the relative percentage of α- and β-glucan and the expression of α- and β-glucan synthase genes, suggesting its unimportant role in α- and β-glucan synthesis regulation. In conclusion, Swi6 is necessary for normal mycelial growth and chitin synthesis regulation in P. ostreatus. To the best of our knowledge, this study is the first report on the functional differences and overlaps between Mbp1 and Swi6 in the regulation of cell wall synthesis in agaricomycetes.

The Impact of Active Ascertainment on Sex-Specific Differences in the Prevalence and Phenotype of Transthyretin Cardiac Amyloidosis: The SCAN-MP Study

Transthyretin cardiac amyloidosis (ATTR-CA) is disproportionately diagnosed in older adult men. However, studies suggest that the true prevalence of ATTR-CA in women may be higher than previously reported. The Screening for Cardiac Amyloidosis with Nuclear Imaging in Minority Populations (SCAN-MP) study utilizes nuclear scintigraphy to identify ATTR-CA in self-identified Black and Caribbean Hispanic participants ≥60 years old with heart failure and left-ventricular hypertrophy. We characterized the sex distribution and phenotypic characteristics of ATTR-CA in this active ascertainment cohort in comparison to a population of ATTR-CA patients who were referred to a tertiary care academic center outpatient clinic. Compared to the referral clinic cohort, the active ascertainment SCAN-MP cohort had a greater proportion of women (31.3% vs 13.3%, p=0.016). This was mainly attributed to the higher proportion of women with wild-type disease [ATTRwt-CA] (27.8% vs 7.1%, p=0.012). Women with ATTR-CA in the active ascertainment cohort exhibited higher left ventricular ejection fraction than those in the referral cohort (61% vs 50%, p = 0.011); lower left ventricular mass index (110 g/m2 vs 148 g/m2, p = 0.014); and lower posterior wall thickness (1.4 cm vs 1.6 cm, p = 0.01). An active ascertainment strategy for ATTR-CA identification demonstrated a greater proportion of women than did a referral cohort, driven predominantly by the greater proportion of women with ATTRwt-CA, and echocardiographic evidence of a less severe phenotype. In conclusion, efforts for early identification of ATTR-CA in women are critical for reducing sex disparities in this clinically treatable disease.

Proteomic reprogramming underlying anatomical and physiological characteristics of poplar wood in acclimation to changing light and nitrogen availabilities.

To explore the proteomic regulation that underlies the physiological, anatomical, and chemical characteristics of wood in acclimation to changing light and nitrogen (N), saplings of Populus × canescens were treated with control or high irradiance in combination with low, control or high N for 4 months. High irradiance led to elevated levels of starch, sucrose, glucose, and fructose, decreased concentrations of ammonium, nitrate, most amino acids and total N, wider xylem, more xylem cell layers, narrower vessel lumina, longer fiber cells, greater fiber wall thickness, and more cellulose and hemicellulose but less lignin deposition in poplar wood. Limiting N resulted in increased levels of starch and sucrose, reduced levels of glucose, fructose, ammonium, nitrate, amino acids and total N, narrower xylem, fewer xylem cell layers, reduced vessel lumen diameter, thicker fiber walls, and less cellulose and more hemicellulose and lignin accumulation, whereas high N had the opposite effects on poplar wood. Correspondingly, numerous differentially abundant proteins, which are related mainly to the metabolism of carbohydrates and amino acids, cell division and expansion,and deposition of secondary cell walls, such as sucrose synthase 6 (SUS6), cell division cycle protein 48 (CDC48) and laccases (LACs), were identified in poplar cambiums in response to changes in light intensity and N availability. These results suggest that proteomic relays play essential roles in regulating the physiological characteristics and anatomical and chemical properties of poplar wood in acclimation to changing light and N availabilities.

Fecal calprotectin, intestinal ultrasound, and their combination for the diagnosis of inflammatory bowel disease.

We aimed to evaluate the diagnostic accuracy of fecal calprotectin (FC) and intestinal ultrasound (IUS), independently and in combination, as screening tools for adults with suspected IBD to reduce the number of unnecessary endoscopic procedures. We conducted a retrospective monocentric study that included consecutive adult patients with (i) ileocolonoscopy for suspected IBD between January 2021 and June 2023 who had either (ii) IUS and/or (iii) a FC test within 6 weeks. Bowel wall thickness (BWT) and the color Doppler signal (CDS) were evaluated for all segments. The presence of lymphadenopathy, loss of stratification, stricture, and fistula were also recorded. In total, 119 patients with a median age of 32 years (IQR, 24.0-41.0) were included. The most common symptoms were abdominal pain (n=88, 75%) and chronic diarrhea (n=89, 75%). Among the 119 patients, 74 (62%) had IUS, 101 (82%) had a FC test, and 56 (47%) had both. Forty patients (34%) had a diagnosis of IBD, including 31 (26%) with CD and 9 (8%) with UC. By ROC curve analysis, the best threshold of FC to diagnose IBD was 117 ug/g (Se 97%, Sp 73%, PPV 67%, NPV 98%, AUC 0.88, 95%CI [0.81; 0.94], p=0.006). Using this threshold, only 3% of patients were misclassified as non-IBD. Screening by measuring FC levels would result in a 48% reduction in the number of adults requiring endoscopy. Abnomal IUS was significantly associated with a diagnosis of IBD (OR 5.6, 95%IC [2.1;16.2], P=0.0008). The association of a BWT>3 mm and a positive CDS was associated with a Se, Sp, PPV, and NPV of 48%, 100%, 100%, and 75%, respectively, but 52% of patients were misclassified as non-IBD. The combination of a BWT>3 mm, CDS, and FC>117 ug/g had a Se, Sp, PPV, and NPV of 44%, 100%, 100%, and 69%, respectively. For patients with a normal IUS and FC<117 ug/g, 4% were misclassified as non-IBD. The combination of FC and IUS is a useful screening strategy to identify patients who truly require endoscopy for suspected IBD. Calprotectin is a highly effective test for ruling out IBD. Conversely, relying solely on IUS lacks the discriminative power to safely rule out IBD. However, it shows a high PPV and is a potent tool for diagnosing IBD.

Investigation of uni- and bi-directional soft pneumatic actuators and its implication using rapid prototyping

Abstract In the age of automation and robotics, pneumatic grippers play a crucial role in material handling across diverse industrial sectors. This study explores the design and performance of uni- and bi-directional pneumatic grippers, which provide enhanced versatility and multi-directional gripping capabilities, using a rapid prototyping approach to address modern manufacturing needs. Through finite element analysis and experimental testing, the functionality of the gripper is evaluated, with a focus on hyperelastic materials like thermoplastic polyurethane. Three mesh techniques—automatic, tetrahedral, and hex-dominant—are analyzed, with the hex-dominant mesh proving the most effective for all models. Pressures up to 100 kPa, applied in 25 kPa increments to simulate real-world conditions, assessing deformation in both the uni- and bi-directional gripper mechanisms. Key design optimizations based on FE analysis include: a 1 mm gap between the chambers, which has shown an optimal deformation improvement of 109%, and a wall thickness ranging from 0.5 to 1 mm, which balances flexibility while minimizing deformation. In the bi-directional configuration, a chamber height of 4 mm achieves faster deformation with a maximum of 387.86%. Additionally, a 1 mm mid-layer deforms more rapidly, indicating that a thinner mid-layer enhances deformation and increases flexibility. The optimized Model-5, with refined geometry, successfully resolved issues of air leakage and printing defects, demonstrating effective bi-directional gripping capabilities and improved flexibility. The results validate the effectiveness of the design and analysis approach used in this study. These findings underscore the potential of bi-directional pneumatic grippers to transform material handling into industrial applications, offering significant improvements in adaptability and efficiency.

Cardiac amyloidosis: when to suspect and how to confirm.

Diagnosing cardiac amyloidosis (CA) is challenging because of its phenotypic heterogeneity, multiorgan involvement requiring interaction among experts in different specialties and subspecialties, lack of a single noninvasive diagnostic tool, and still limited awareness in the medical community. Missing or delaying the diagnosis of CA may profoundly impact on patients' outcomes, as potentially life-saving treatments may be omitted or delayed. The suspicion of CA should arise when "red flags" for this condition are present, together with increased left ventricular wall thickness. The diagnosis of CA requires amyloid typing and differentiation between the two most common forms, light chain (AL) and either mutated or wild-type transthyretin cardiac amyloidosis (ATTR-CA), which is critical to guide a specific treatment. Scientific societies worldwide focus on the importance of red flags, and on the prompt initiation of the diagnostic process with bone tracer uptake and the search of a monoclonal protein. An extra-cardiac or endomyocardial tissue biopsy is needed when a monoclonal protein has been detected and/or cardiac bone tracer uptake is absent or weak. Finally, all patients diagnosed with ATTR-CA should undergo genetic testing to search for TTR gene mutations.

Higher Aircraft Noise Exposure Is Linked to Worse Heart Structure and Function by Cardiovascular MRI.

Aircraft noise is a growing concern for communities living near airports. This study aimed to explore the impact of aircraft noise on heart structure and function. Nighttime aircraft noise levels (Lnight) and weighted 24-hour day-evening-night aircraft noise levels (Lden) were provided by the UK Civil Aviation Authority for 2011. Health data came from UK Biobank (UKB) participants living near 4 UK major airports (London Heathrow, London Gatwick, Manchester, and Birmingham) who had cardiovascular magnetic resonance (CMR) imaging starting from 2014 and self-reported no hearing difficulties. Generalized linear models investigated the associations between aircraft noise exposure and CMR metrics (derived using a validated convolutional neural network to ensure consistent image segmentations), after adjustment for demographic, socioeconomic, lifestyle, and environmental confounders. Mediation by cardiovascular risk factors was also explored. Downstream associations between CMR metrics and major adverse cardiac events (MACE) were tested in a separate prospective UKB subcohort (n = 21,360), to understand the potential clinical impact of any noise-associated heart remodeling. Of the 3,635 UKB participants included, 3% experienced higher Lnight (≥45 dB) and 8% higher Lden (≥50 dB). Participants exposed to higher Lnight had 7% (95%CI: 4%-10%) greater left ventricular (LV) mass and 4% (95%CI: 2%-5%) thicker LV walls with a normal septal-to-lateral wall thickness ratio. This concentric LV remodeling is relevant because a 7% greater LV mass associates with a 32% greater risk of MACE. They also had worse LV myocardial dynamics (eg, an 8% [95%CI: 4%-12%] lower global circumferential strain which associates with a 27% higher risk of MACE). Overall, a hypothetical individual experiencing the typical CMR abnormalities associated with a higher Lnight exposure may have a 4 times higher risk of MACE. Findings were clearest for Lnight but were broadly similar in analyses using Lden. Body mass index and hypertension appeared to mediate 10% to 50% of the observed associations. Participants who did not move home during follow-up and were continuously exposed to higher aircraft noise levels had the worst CMR phenotype. Higher aircraft noise exposure associates with adverse LV remodeling, potentially due to noise increasing the risk of obesity and hypertension. Findings are consistent with the existing literature on aircraft noise and cardiovascular disease, and need to be considered by policymakers and the aviation industry.

Sex-specific effects on the heart from combined exposure to simulated galactic cosmic radiation and hindlimb unloading.

Future long duration space missions will expose astronauts to higher doses of galactic cosmic radiation (GCR) than those experienced on the international space station. Recent studies have demonstrated astronauts may be at risk for cardiovascular complications due to increased radiation exposure and fluid shift from microgravity. However, there is a lack of direct evidence on how the cardiovascular system is affected by GCR and microgravity since no astronauts have been exposed to exploratory mission relevant GCR doses. Therefore, we utilized a ground-based mouse model to determine the cardiovascular risks for space radiation exposure while the mice were simultaneously hindlimb suspended to mimic microgravity. 6-month-old male and female C57BL/6 mice were exposed to an absorbed dose of 0 Gy, 0.5 Gy, or 1.5 Gy simulated GCR (GCRsim) that comprised beams of 5 ions at NASA's Space Radiation Laboratory. Subcohorts of mice were hindlimb unloaded (HLU), starting 5 days before GCRsim until the completion of radiation exposure. GCRsim + HLU was performed over 8 hours (0.5 Gy) or 24 hours (1.5 Gy). After completion of GCRsim and HLU, mice were shipped to UAMS for long-term observation. Cardiac function was measured using high resolution ultrasound at 6 and 9 months after exposure. Tissues were collected after the final ultrasound and prepared for further analysis. Female mice exposed to 1.5 Gy + HLU demonstrated a significant increase in body weight compared to ground controls months after GCR exposure; however, there was no change in male body weights. Cardiac ultrasound revealed 0.5 Gy GCRsim decreased left ventricular (LV) mass, LV posterior wall thickness in diastole, and systole in males 6 months after exposure. In females, 1.5 Gy + HLU significantly increased LV posterior wall thickness in diastole and systole at 6 months. These changes in ultrasound measurements were no longer seen at 9 months. Moreover, at 9 months there was no change in total collagen content or density of the capillary network in the heart. Lastly, the combination of GCRsim and HLU influenced immune cell markers in the heart of female mice. These data suggest that combined simulated GCR and microgravity result in minor, yet statistically significant sex-dependent changes to body weight and cardiac structure.

A soft receiving platform for coaxial bioprinting cell-laden microtubes with uniform wall thickness

A soft receiving platform for coaxial bioprinting cell-laden microtubes with uniform wall thickness

Diagnostic Utility of Relative Apical Sparing Index in Cardiac Amyloidosis Subtypes: A Comparative Study of Immunoglobulin Light Chain and Transthyretin Amyloid Cardiomyopathy.

Speckles tracking echocardiography imaging enables clinicians to detect subtle systolic dysfunction. The aim of the present study was to elucidate the differences in speckle tracking echocardiographic findings between immunoglobulin light chain amyloid cardiomyopathy (AL-CM) and transthyretin amyloid cardiomyopathy (TTR-CM). The patients with a confirmed diagnosis of cardiac amyloidosis through cardiac biopsy from March 2013 to October 2022 were included. The relative apical sparing index (RASI) was calculated using speckle tracking echocardiography by the following equation; average apical strain/(average basal strain+mid strain). The final study population consisted of 35 patients with cardiac amyloidosis (AL-CM: 10 patients, TTR-CM: 25 patients). The mean age was 74±12years. Although both subgroups had a gradual change of strain values from basal to apical segments, RASI was significantly lower in AL-CM compared to TTR-CM (0.92±0.29 vs. 1.46±0.53, p=0.001). A RASI cutoff value of <1.0 proved useful in differentiating the diagnosis of AL-CM from TTR-CM (sensitivity: 81%, specificity: 70%, AUC: 0.82). A significant positive correlation with left ventricular mass index and RASI was found in AL-CM, but not in TTR-CM. The apical sparing phenomenon was more remarkable in TTR-CM compared with AL-CM. RASI might be useful for the discrimination of cardiac amyloidosis subtypes. There was a difference in the relationship of RASI with left ventricular wall thickness between the cardiac amyloidosis subtypes.

Closed-cell Polyurethane In-situ Foaming Hofneycomb for Enhanced Energy Absorption and Water Intrusion Resistance

To achieve novel core with high energy absorption and strong water intrusion resistance, a composite structure was created by employing in-situ foaming of closed-cell polyurethane (PU) in a honeycomb structure. Experimental, theoretical, and finite element analyses revealed that the in-situ foaming technique increased the honeycomb's energy absorption by 312.84% and improved impact efficiency by 61.45% while maintaining specific energy absorption (SEA). Remarkably, this composite structure surpassed the energy absorption capacity of individual honeycomb and foam. The coupling gain ratio introduced by the foam increases within a certain range as the honeycomb cell size decreases and wall thickness increases, with little influence from the foam's mechanical properties. Water intrusion, leading to ice formation at low temperatures, drastically reduced honeycomb SEA by 94.61% and impaired mechanical properties significantly. Closed-cell PU in-situ foaming provided exceptional water intrusion resistance, preserving the honeycomb's mechanical performance, including energy absorption and SEA.

Prognostic impact of hypertension and diabetes in patients with cardiac amyloidosis.

Hypertension and diabetes may increase the risk of adverse events in the general population and patients with cardiomyopathies, however, their role in patients with cardiac amyloidosis (CA) is still unclarified. to evaluate the effect on phenotype and clinical outcomes of hypertension and diabetes in patients with CA. Data from 5 Italian Amyloidosis Referral Centres were used to describe clinical characteristics and outcomes of patients with CA based on the presence of a history of hypertension and diabetes. The study includes 887 patients with CA (311 light chain CA, 87 hereditary transthyretin CA, 489 wild-type transthyretin CA). Median age was 75 years (67-81), and 692 (78 %) were men. Five hundred-seven (57 %) patients had hypertension, 127 (14 %) had diabetes. In multivariable linear regression analysis, hypertension was associated with an increased interventricular septal thickness (coefficient 0.63,95 % CI 0.2-1.06), and augmented E/e' ratio (1.92,95 % CI 0.55-3.29). On Cox regression, diabetes was independently associated with death and heart failure hospitalizations (HR 1.45,95 % CI 1.05-1.99, p = 0.02). Patients with hypertension present a more severe phenotype with increased LV wall thickness and more severe diastolic dysfunction compared to non-hypertensive. The presence of diabetes in this cohort is associated with an increased risk of adverse outcomes.

Renal scarring in children with febrile urinary tract infection.

The authors aim to evaluate characteristics of children with fUTI and results of renal bladder ultrasonography (RBUS) and late dimercaptosuccinicacid (DMSA) scan. This study is designed as retrospective analysis of RBUS and DMSA reports of children with fUTI. Age, gender, number of fUTI, presence of constipation and vesicouretheral reflux (VUR) were recorded. The study included 160 children with fUTI with a median age of 7 years (6 months 18 years old). The majority of children in this study were girls (86.3 %), older than 60 months (73.1 %) and had one episode of fUTI. The recurrence rates of UTI were similar in both girls and boys. The total rate of constipation was 21.9 %. The rate of renal scarring on DMSA was 16.9 %. The rates of renal scarring were similar at three age groups and both genders. The rate of renal scarring was higher in children with recurrent UTI compared to those with one episode of fUTI (26.4 % and 12.5 %, respectively; p = 0.04). The rate of constipation in children with renal scarring and normal DMSA was similar (p = 0.07). The rate of trabeculation and thick bladder wall was higher in children with renal scarring at DMSA than children with no renal scarring (p = 0.03). The present study demonstrated that 16.9 % of children with fUTI had renal scarring. The rates of renal scarring were similar in both gender and age groups. Children with recurrent UTI and abnormal bladder results at RBUS had higher rates of renal scarring.

Performance of the modified 2022 ACR/EULAR giant cell arteritis classification criteria without age restriction for discriminating from Takayasu arteritis

ObjectiveTo evaluate the ability to discriminate giant cell arteritis (GCA) from Takayasu arteritis (TAK) according to the modified 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) GCA classification criteria.MethodsPatients enrolled in the Japanese nationwide retrospective registry were evaluated using the criteria with partial modification; wall thickening of descending thoracic-abdominal aorta were mainly diagnosed by contrast-enhanced computed tomography (CT) or magnetic resonance imaging instead of evaluating with positron emission tomography (PET)-CT. The discriminability of the criteria was evaluated using C-statistic (> 0.7: good ability).ResultsNewly diagnosed patients with GCA (n = 139) and TAK (n = 129) were assessed, and 23.3% of TAK were aged 50 years or older at onset. The sensitivity of the modified 2022 ACR/EULAR GCA classification criteria with a score ≥ 6 was 82.0%, 68.5%, and 32.1% in all GCA, GCA with large-vessel involvement, and GCA without cranial arteritis, respectively. The specificity of the modified criteria was 96.1% for the 129 TAK as controls. Five patients with late-onset TAK met the modified criteria, and four had cranial signs and symptoms, two had bilateral axillary artery involvement, and four had descending thoracic-abdominal aorta involvement. The discriminability of the criteria was good (C-statistic: 0.986, 95% confidence interval [CI]: 0.976–0.996) and remained good after excluding age (C-statistic: 0.927, 95% CI: 0.894–0.961). The discriminability of a set of large-vessel lesions (bilateral axillary artery and descending thoracic-abdominal aorta) and inflammatory markers was markedly decreased with poor C-statistic value (C-statistic: 0.598, 95% CI: 0.530–0.667). Discriminability was improved after adding polymyalgia rheumatica (PMR) (C-statistic: 0.757, 95% CI: 0.700–0.813) or age (C-statistic: 0.913, 95%CI: 0.874–0.951) to the set of large-vessel lesions. In GCA patients with a score ≤ 5, 52% had bilateral subclavian and/or axillary artery involvement.ConclusionThe modified 2022 ACR/EULAR GCA classification criteria well performed in classifying GCA and TAK without PET-CT in routine clinical practice. A set of items included in the modified GCA classification criteria had good discriminative ability for GCA and TAK, even when age was excluded. However, age restriction or PMR was required to distinguish GCA without cranial lesions from TAK.