Fractional Volume Research Articles

Effects of sodium-glucose cotransporter-2 inhibitors in myocardial infarction patients: A systematic review and meta-analysis.

Sodium-glucose cotransporter-2 (SGLT2) inhibitors are known to improve cardiovascular outcomes in individuals with heart failure (HF), type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). However, their efficacy following myocardial infarction (MI) remains unclear. A systematic search was conducted using PubMed, Embase, Cochrane Library, Web of Science and ClinicalTrials.gov. Primary outcomes included hospitalization for heart failure (HHF), cardiovascular (CV) death, a composite of HHF or CV death, all-cause death, major cardiovascular events (MACE), recurrent MI, severe arrhythmia, renal injury and stroke. Secondary outcomes targeted improvements in left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume (LVEDV). Thirteen studies comprising 22 370 patients were included. Meta-analysis revealed that SGLT2 inhibitors reduced HHF (RR 0.69, 95% CI 0.61 to 0.78, p < 0.001), combined HHF or CV death (RR 0.87, 95% CI 0.77 to 0.99, p = 0.028), all-cause mortality (RR 0.82, 95% CI 0.73 to 0.93, p = 0.002), MACE (RR 0.68, 95% CI 0.53 to 0.88, p = 0.004), recurrent MI (RR 0.81, 95% CI 0.69 to 0.94, p = 0.007), severe arrhythmia (RR 0.54, 95% CI 0.34 to 0.85, p = 0.009) and renal injury (RR 0.68, 95% CI 0.53 to 0.87, p = 0.002). Improvement in LVEF (MD 3.96%, 95% CI 2.52 to 5.40; p < 0.001) and LVEDV (MD -5.52 mL, 95% CI -10.21 to -0.83; p = 0.021) was notably greater in the SGLT2 inhibitors group. In post-MI patients, we first found that SGLT2 inhibitors significantly lowered the risk of HHF, combined CV death or HHF, all-cause death, MACE, recurrent MI, severe arrhythmias and renal injury. Additionally, SGLT2 inhibitors improved LVEF and LVEDV.

Assessment of water diffusion in epoxy composites: a novel approach towards holistic understanding

Performance of insulating polymers is seriously impacted by water absorption. Hence, its assessment using Fick’s law and 3-core water shell model are used for a holistic understanding of water diffusion. Epoxy with organically modified montmorillonite clay of 2, 5 and 7 weight percent (wt.%) are fabricated and water diffusion is carried out for 240 hours. The results are analysed by dielectric and gravimetric approaches. The weight gain in epoxy after 240 hours is 0.42% and 0.19% at 5 wt.% of the filler. The weight gain peaks after 120 hours in all the composites and the variations from 120 to 240 hours are minimal. The weight gain rate is lowest at 96 hours, and it peaks at 120 hours and is highest at 0.00033%/hour in epoxy, and reduces to 0.0023%/hour with filler of 7 wt.%. The weight gain and weight gain rate are characteristics of the epoxy and the filler controls the magnitude. Diffusion coefficient is lowest at 5 wt.% but the differences in the other composites are limited. The effect of fillers on free volume, free volume rate and fractional free volume are correlated to the dielectric parameters. Water uptake increases the DC conductivity from 10−14 to 10−12 S/m after 240 hours and the relative permittivity increases by 40%. The water shell model, diffusion parameters and the free volume parameters are correlated to the results of DC conductivity and relative permittivity. Subtle changes induced by absorbed water is identified by the method adopted.

Cognitive Impairment, Associated Clinical Factors, and MR Volumetric Measures in Myelin Oligodendrocyte Glycoprotein-IgG-Associated Disease.

Cognitive impairment is a common and challenging symptom in multiple sclerosis and neuromyelitis optica spectrum disease; however, data in myelin oligodendrocyte glycoprotein-IgG-associated disease (MOGAD) remain scarce. In this cross-sectional study, we investigated the frequency of cognitive impairment, associated clinical factors, and MRI volumetric measures in MOGAD. Participants were investigated in a single center by certified psychologists and underwent a standardized 3-T-MRI protocol. MRI data were processed with FreeSurfer for gray and white matter volume estimation, presented as a fraction of total intracranial volume. Sera screening for antineural antibodies has been conducted using cell-based assays. The following clinical factors were included in the multivariate logistic regression analysis: sex, age, overall number of previous relapses, and specifically the history of acute disseminated encephalomyelitis (ADEM)/ADEM-like episodes and other brain relapses. Thirty-two patients with MOGAD (19 female, median age 29.4 years) after a median of 2 relapses with a median EDSS of 1.0 were recruited. Seven patients (21.9%) demonstrated cognitive impairment with the most prevalent deficits in mental flexibility (16.7%), attention (11.1%-14.8%), and verbal working memory (10.3%). 72.4% suffered from fatigue and 42.9% from signs of depression, moderate to severe in 28.6%. The overall number of previous relapses (odds ratio [OR] 1.789, 95% CI 1.041-3.074) and specifically ADEM/ADEM-like episodes (OR 16.929, 95% CI 1.228-233.427) were the only clinical factors associated with cognitive impairment in a multivariate logistic regression model. Screening for antineuronal antibodies remained negative. Cerebral white matter (WM) (0.300 vs 0.317, p = 0.003) and deep gray matter (DGM) (0.036 vs 0.038, p = 0.002) volumes were reduced in patients with MOGAD compared with healthy controls (n = 32). Both cognitive impairment (0.031 vs 0.036, p = 0.003) and history of ADEM/ADEM-like episodes (0.032 vs 0.036, p = 0.006) were associated with reduced DGM volume compared with unaffected patients with MOGAD. Despite a low overall disability, every 5th patient with MOGAD experiences cognitive impairment. Cognitive impairment is associated with a higher number of relapses and particularly ADEM/ADEM-like attacks. Although both WM and DGM atrophies are apparent in MOGAD, the latter only seems to have an association with cognitive impairment.

Cerebral, Splanchnic, and Renal Transit Time Measurement and Blood Volume Estimation Using Contrast-Enhanced Ultrasonography.

We aimed to measure cerebral, splanchnic, and renal transit times and the associated blood volumes using contrast ultrasound. In healthy individuals, regional transit times were calculated from time-intensity curves generated as ultrasound contrast passed through the associated inflow and outflow vessels. These included the internal carotid artery and internal jugular vein (brain), the superior mesenteric artery and portal vein (intestines), and the renal artery and renal vein (kidney). An organ's blood volume relative to the stroke volume delivered to that organ with each cardiac cycle was calculated from the product of heart rate and transit time of contrast passage through the associated vascular bed. The fraction of systemic stroke volume received by each organ was calculated from the respective velocity-time integral and inflow vessel cross-sectional area and used to estimate absolute organ blood volume. The cohort consisted of 16 participants (age: 42 ± 13 years; 5 female) without known cerebrovascular, gastrointestinal, or renal disease. Cerebral, splanchnic, and renal transit times were obtained for 15, 14, and 8 individuals, respectively. Anatomic variability of the renal vessels confounded the acquisition of renal transit times. For all organs, transit times were reproducible and the associated blood volumes were generally comparable to reference values. Cerebral, gastrointestinal, and renal transit times/blood volumes can be reasonably acquired from contrast ultrasound, although the latter is less reliably available. Assessment of the impact on regional blood volumes of pharmacologic or other interventions is a next step toward clinical application of this technique.

Myelin measurement in amyotrophic lateral sclerosis with synthetic MRI: A potential diagnostic and predictive method

Background: Myelin damage has recently been highlighted as a major causative factor of amyotrophic lateral sclerosis (ALS). Although myelin damage has been pathologically identified in ALS, it has not been clinically evaluated. This study aimed to quantify myelin volume using synthetic MRI to evaluate myelin damage in patients with ALS, and determine its association with clinical parameters.Methods: We evaluated patients with ALS (n = 35) and individuals (n = 16) without intracranial disease using synthetic magnetic resonance imaging (MRI) and measured total myelin volume (TMV), myelin fraction (MYF), and myelin partial volume (VMY) in the cerebral peduncle and the posterior limb of the internal capsule (PLIC). We also investigated factors associated with acquired quantitative values.Results: The TMV was significantly lower in the patients with ALS than in the control group (P = 0.045). The TMV (r = 0.42, P = 0.013) and MYF (r = 0.34, P = 0.047) significantly correlated with Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) scores in the patients, and MYF was independent of the traditional white matter lesion grading score. The VMY of the PLIC was significantly lower in the ALS than the control group (P = 0.018), and the ALS group significantly correlated with ALSFRS-R scores (r = 0.36, P = 0.033).Conclusions: Myelin damage can be quantified by synthetic MRI as reduced myelin volume, with the possibility of predicting prognoses in patients with ALS. Furthermore, myelin measurements in the PLIC might be a novel diagnostic marker for ALS.

High‐Performance and Scalable Organosilicon Membranes for Energy‐Efficient Alcohol Purification

AbstractThe production of bio‐alcohol is increasingly gaining international attention due to its potential as a viable alternative to fossil fuels and its ability to mitigate carbon dioxide emissions. However, the cost of bio‐alcohol production is almost double that of fossil fuels, primarily because of the low yield of the purification process. Herein, a high‐performance and scalable organosilicon membrane with high chain flexibility and controllable crosslinking density is developed for energy‐efficient alcohol purification. The synthesized organosilicon membrane achieves an ultrahigh total flux (5.8 kg·m−2·h−1) with a comparable separation factor (8.7) for ethanol/water separation, outperforming most state‐of‐the‐art polymer‐based membranes. Integrated experiments and molecular dynamics simulations confirm that the ultrafast alcohol permeation of the membrane originates from its high chain flexibility, large fractional free volume, and weak interactions between feed molecules and membranes. The universal applicability of the low‐crosslinking mechanism for the formation of high‐performance organosilicon membranes is also validated. Moreover, its high efficiency and scalability in membrane production, along with the stability of the casting solution, offer promising prospects for industrial applications.

Designing an efficient set-aside policy for advancing human rights goals through public procurement

Set-aside policy is one of the mechanisms in public procurement adopted for implementing social goals of the State. Set-asides refer to the arrangement of keeping a fraction of the procurement volume, also termed the quantum of set-aside, reserved for vendors of a targeted group. The targeted group can either be a traditionally disadvantaged group that merits government support or, alternatively, a group that complies with certain desirable practices in its operations.Government has at its disposal many design choices like the fraction of procurement quantity to be reserved for the targeted group etc, that it can adjust to maximise the desired social benefits that accrue. However, there is little insight into how these choices are made, and to what extent, they can impact the ultimate outcome. This paper seeks to address this gap by developing an economic model for set-aside policy and carrying out a game theoretic analysis to identify the economic incentives to vendors arising out of set aside benefits that can drive a change in their operations.The insights from this economic model are then used to understand how government policy choices can impact these incentives and thereby the level of change that the policy can bring about. The paper focusses on the specific case where set-asides are proposed to be used for promoting human rights goals. This allows the researcher to suggest some practical measures that States can adopt for ensuring universal compliance of desired human rights standards by vendors using set-aside policy. This analysis also enables the researcher to quantify the connection between the State's “leverage” and its concomitant responsibility for promoting human rights in its business connections.

Associations Between Plasma Levels of NLRP3 Protein, Interleukin-1 Beta and Features of Acute ST-Elevation Myocardial Infarction.

Phenotyping inflammation in ST-elevation myocardial infarction (STEMI) is a challenge for modern cardiology. NLRP3 inflammasome is a proven predictor of adverse outcomes in cardiovascular disease, but its specificity in stratifying inflammatory activity in patients with myocardial infarction (MI) has not been demonstrated. The aim of this paper is to describe the levels of NLRP3 protein and IL-1β concentrations and their changes in dynamics and associations with clinical, laboratory and instrumental characteristics of patients with STEMI. A total of 45 patients with STEMI were enrolled. Concentrations of NLRP3 and IL-1β were evaluated in arterial and venous EDTA blood from the infarct-related coronary and peripheral arteries and veins on days 1, 3 and 7 after MI. The concentrations of markers were higher on the first day after MI with a maximum decrease on the third day. The levels of both markers in venous plasma correlated with those in arterial blood, allowing their routine determination in venous plasma on the first day after MI. IL-1β levels correlated directly with the wall motion index and inversely with left ventricular ejection fraction and stroke volume, which characterize the potential contribution to adverse myocardial remodeling. There were two multidirectional trends in changes in NLRP3 and IL-1β levels during hospitalization. Initially higher levels with a gradual decrease by day 7 were associated with a longer duration of myocardial ischemia and higher plasma troponin I levels. Further evaluation of the long-term outcomes of MI will allow identifying inflammatory factors that input to the development of secondary major adverse cardiac events and will provide a new step in the understanding of inflammatory phenotyping.

Abstract 4119052: Redefining the phenotypic continuum of cardiovascular disease using machine learning

Background: Current approaches that define cardiovascular disease rely on assignment of traditional diagnostic labels which may not reflect the natural continuum of phenotypic expression, influenced by genetic and environmental modifiers, or adequately identify groups with shared molecular mechanisms. Machine learning can leverage advances in genetic and imaging characterisation to reclassify phenotypic diversity along a continuum, from health to disease. Research Aims: Our study aims to build a tree-like classification of cardiovascular phenotypes in the community where branches represent subjects with shared features, ordered by their severity. Using dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) as exemplar conditions with opposing phenotypes, we aim to demonstrate the interaction between genetic and environmental modifiers of disease expression. Methods: We analysed cardiovascular magnetic resonance (CMR) imaging, electrocardiogram (ECG), biomarkers and clinical data from participants in the UK Biobank. Using unsupervised learning of multiparametric data, we built a tree of phenotypic expression. We projected the risk of DCM and HCM cases, and associated rare and common variant risk, onto the tree structure. Results: Ten main branches were discovered, using data from 41,525 participants (51.7 % female, median age 65 yrs [IQR: 58, 70]). The extremities of branches 1 and 6 were enriched for DCM cases (p &lt;0.05) and participants with reduced ejection fraction and high left ventricular volumes (p &lt;0.05). Compared with subjects at the tree centre, distal participants in branch 1 had increased blood pressure (BP) and body mass index (BMI), whilst those in branch 6 were more likely to have high HbA1c levels and carry a pathogenic DCM variant (p &lt;0.05). The extremity of branch 5 was enriched for HCM cases, rare sarcomeric variants (p = 0.004) and high polygenic risk (p &lt;0.001). Whilst the ends of branches 3 and 9 had high polygenic risk for HCM, they were less likely to have elevated BP and BMI, and had reduced likelihood of HCM expression, compared with branch 5. A phenomapping model was trained to accurately project unseen subjects onto the tree (R 2 0.98). Conclusions: We present a tree-like continuum of cardiovascular phenotypes, providing a novel framework for mechanistic discovery and exploration of genotype-phenotype associations. Phenomapping of unseen subjects enables personalised estimation of genetic and cardiovascular risk.

Abstract 4135465: Efficacy of SGLT-2 inhibitors combined with percutaneous coronary intervention on clinical and echocardiographic parameters in patients with acute myocardial infarction: A systematic review and meta-analysis

Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have shown benefits in improving cardiovascular outcomes in heart failure (HF) patients and may mitigate symptom progression in myocardial infarction (MI). However, their efficacy in acute MI patients undergoing percutaneous coronary intervention (PCI) is unclear. This study aims to evaluate whether SGLT2i combined with PCI improves clinical and echocardiographic outcomes. Methods: A comprehensive search of electronic databases, PubMed, Cochrane Central and SCOPUS was conducted from inception till May 2024. The study was conducted adhering to the PRISMA guidelines. The clinical benefit of PCI plus SGLT2i was assessed through risk reduction of acute kidney injury (AKI), CV death (CVD), hospitalization due to HF (hHF), all-cause mortality (ACM), and revascularization. Echocardiographic outcomes assessed were change in left ventricular ejection fraction (LVEF) and LV end-diastolic volume (LVEDV). Results were presented as risk ratios (RR) along with their 95% CI for dichotomous data while weighted mean difference (WMD) were reported for continuous outcomes. The data was aggregated using a random effects model. Results: Our analysis included eleven records comprising 6,411 participants. The results indicated that PCI plus SGLT2i significantly reduced the risk of AKI (RR: 0.66, 95% CI: [0.52, 0.83], p&lt;0.01) and ACM (RR: 0.54, 95% CI: [0.4, 0.7], p&lt;0.01) compared to PCI alone. However, the reduction in risk for CVD was not statistically significant (RR: 0.56, 95% CI: [0.2, 1.1], p=0.09), as was the case for hHF (RR: 0.65, 95% CI: [0.3, 1], p=0.07). Additionally, there was no significant difference in the risk of revascularization between the two groups (RR: 2.9, 95% CI: [0.62, 14.39], p=0.17). PCI plus SGLT2i was also significantly associated with an increase in LVEF (WMD: 2.73, 95% CI: [1.09, 4.36], p&lt;0.01) and decrease in LVEDV (WMD: -8.0, 95% CI: [-13.17, -2.90], p&lt;0.02). Conclusion: Our study demonstrates that SGLT2i administration in MI patients undergoing PCI leads to improved renal and mortality outcomes, along with enhanced cardiac function. These benefits are hypothesized to result from kidney-mediated natriuretic effects, improved blood flow regulation, reduced endothelial dysfunction, and decreased arterial stiffness, which optimize cardiac function. We recommend future studies with larger sample sizes and longer follow-ups to assess the long-term benefits of SGLT2i combined with PCI.

Structure and properties of the boride layer of steel using the plasma alloying method

Boration is one of the promising methods for increasing surface hardness and wear resistance, resistance to oxidation and corrosion of mechanical engineering parts. The diffusion saturation process is characterized by a long duration, as well as a shallow depth of the hardened layer. The use of concentrated heating sources can solve these problems. Among the methods of high-energy exposure, the technology of plasma surface alloying should be highlighted. In this paper, the study of the microstructure and properties of the boride layer obtained on steel by plasma alloying is carried out. It is noted that the boron-doped layer has a heterogeneous structure and high hardness. It is noted that the layer obtained after alloying with a current of 120 A has the highest microhardness value and amounts to 859–1265 HV. With an increase in current to 140 A, the microhardness of the alloyed layer decreases and amounts to 761–1048 HV. Increasing the current to 160 A leads to a significant decrease in the microhardness of the surface layer and it is 452–747 HV. It is known that the volume of iron boride fractions determines the degree of hardening of the steel surface. An increase in the plasma arc current leads to a decrease in the proportion of primary borides in the surface layer after alloying, and therefore leads to a decrease in microhardness. The alloyed layer has characteristic zones: hypereutectic, eutectic and hypoeutectic. An increase in current leads to a significant change in the microstructure of the surface layer and a decrease in the microhardness of the alloyed layer. The surface layer after plasma alloying with a current of 120 A has the highest microhardness (1265 HV). It has been established that it is possible to obtain a boride layer using the technology of plasma surface doping with boron. After processing, the alloyed layer is characterized by a heterogeneous structure and has high hardness.

The Impact of Different Revascularization Strategies Implemented in Acute Myocardial Infarction on the Recovery of Left Ventricular Functional and Deformational Parameters

Background: Despite well-established therapeutic techniques, such as direct revascularization through percutaneous coronary intervention (PCI), acute myocardial infarction (AMI) remains a leading cause of mortality and morbidity. Objectives: To determine if two-dimensional speckle tracking echocardiography (STE) deformation parameters and the early recovery of left ventricular (LV) functions are affected by the timing of PCI in AMI. Methods: A total of 200 cases with newly-onset acute myocardial infarction (AMI) who had a baseline left ventricular ejection fraction (LVEF) higher than 40% and received effective therapy with percutaneous coronary intervention (PCI) were included in this investigation. cases were categorized as either ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI). cases were grouped into four groups according to the time between presentation and PCI. Using standard echocardiography and two-dimensional (2D) ST-elevation STE, individuals were re-evaluated three months later to find out if remodeling had taken place or if the LV function had returned. Results: Of the 200 AMI patients, including 140 males (70%), improvement in global longitudinal strain (GLS) and harmed longitudinal strain (HLS) were better in STEMI and NSTEMI patients received urgent revascularization with PCI (groups I and III) versus patients with pharmacoinvasive strategy or routine invasive strategy (Groups II and IV) (P &lt; 0.05) while there was an insignificant difference between group I and III (P = 0.79). Of the 200 patients, 47 patients (23.5%) presented signs of LV remodeling at 3 months follow up. Age, smoking history, hypertension, dyslipidemia, Killip class, peak creatine phosphokinase - MB level, baseline left ventricular end diastolic volume (LVEDV), HLS, and harmed longitudinal strain rate (HLSR) were all factors that were found to be significantly associated with left ventricular remodeling (P&lt;0.05) in the univariate logistic regression analysis. The following factors were identified as independent predictors of left ventricular remodeling in multivariate logistic regression analysis: damaged left ventricular ejection fraction (EF) and end-systolic volume, peak troponin I, Killip class, culprit left anterior descending (LAD), 2 and 3-vessel coronary artery disease (CAD), and wall motion score index (WMSI). Conclusion: Earlier PCI in AMI helps earlier improvement in myocardial strain parameters. HLS and HLSR are excellent predictors for LV remodeling and may do better than global parameters.

Liquid Crystal Ordering in Densely Packed Colloidal Suspensions of Highly Anisotropic Monolayer Nanosheets

Monolayer nanosheets of zirconium phosphate in aqueous suspension exhibit short-range repulsion and long-range attraction, producing, at overall volume fractions larger than about half a percent, phase separation into higher-concentration liquid crystal and lower-concentration isotropic regions. At high concentrations, this phase separation takes the form of an emulsion of condensed, liquid-crystalline droplets, which anneal to form lens-shaped tactoids. These tactoids provide an opportunity to study the liquid crystal ordering of inorganic nanosheets in the limit of large shape anisotropy (diameter/thickness~400) and high packing fraction (volume fraction ≳ 70%). The internal liquid crystal structure of the tactoids remains nematic even under conditions that would usually favor ordering into lamellar smectics. Local lamellar ordering is suggested by short-range, smectic-like layer correlations, but a full transition into a smectic phase appears to be inhibited by the nanosheet edges, which act as a perturbative population of dislocation loops in the system of layers. Under conditions of thermal equilibrium, the nanoplates organize positionally to enable bend deformation of the director, a hallmark of the nematic phase and its principal distinction from the smectic, where bend must be expelled.

Parametric Instability of Alfvén Waves and Wave Packets in Periodic and Open Systems

The parametric decay instability of Alfvén waves has been widely studied, but few investigations have examined wave packets of finite size and the effect of different boundary conditions on the growth rate. In this paper, we perform a linear analysis of circular and arc-polarized wave trains and wave packets in periodic and open boundary systems in a low-β plasma. We find that both types of wave are 3–5 times more stable in open boundary conditions compared to periodic. Additionally, once the wave packet width ℓ becomes smaller than the system size L, the growth rate decreases nearly with a power law γ ∝ ℓ/L. This study demonstrates that the stability of a pump wave cannot be separated from the laboratory settings, and that the growth rate of daughter waves depends on the conditions downstream and upstream of the pump wave and on the fraction of volume it fills. Our results can explain simulations and experiments of localized Alfvén waves. They also suggest that Alfvénic fluctuations in the solar wind, including sharp impulses known as switchbacks, can be more stable than traditional theory suggests depending on wind conditions.

Atrial fibrillation substrate and impaired left atrial function: a cardiac MRI study.

Structural and fibrotic remodelling is a well-known contributor to the atrial fibrillation (AF) substrate. Epicardial adipose tissue (EAT) is increasingly recognized as a contributor through electrical remodelling in the atria. We aimed to assess the association of LA fibrosis and EAT with LA strain and function using cardiac magnetic resonance (CMR) imaging in patients with AF. LA fibrosis was assessed using late gadolinium enhancement CMR, LA EAT was assessed using the fat-water separation Dixon sequence, and feature tracking was applied to assess global longitudinal strain in its three components [reservoir (GLRS), conduit (GLCdS), and contractile (GLCtS)]. LA emptying fraction and LA volume were measured using the cine sequences. All CMR images were acquired in sinus rhythm. One hundred one AF patients underwent pre-ablation CMR (39% female, average age 62 years). LA fibrosis was negatively associated with the three components of global longitudinal strain (GLRS: R = -0.35, P < 0.001; GLCdS: R = -0.24, P = 0.015; GLCtS: R = -0.2, P = 0.046). Out of the different sections of the LA, fibrosis in the posterior and lateral walls was most negatively correlated with GLRS (R = -0.32, P = 0.001, and R = -0.33, P = 0.001, respectively). LA EAT was negatively correlated with GLCdS (R = -0.453, P < 0.001). LA fibrosis was negatively correlated with LA emptying fraction but LA EAT was not (R = -0.27, P = 0.007, and R = -0.22, P = 0.1, respectively). LA EAT and fibrosis were both positively correlated with LA volume (R = 0.38, P = 0.003, and R = 0.24, P = 0.016, respectively). LA fibrosis, a major component of the AF substrate, and EAT, an important contributor, are associated with a worsening LA function through strain analysis by CMR.

Quaternized poly(aryl imidazolium) containing bulky binaphthyl group as proton exchange membrane for high-temperature fuel cells

The low power output and high phosphoric acid (PA) leakage are the main constraints restricting the commercialization of PA-doped high-temperature proton exchange membranes (HT-PEMs). Ionized imidazoles have been shown to be an effective strategy to improve PA retention, however, less research has been conducted on the fractional free volume (FFV) of the backbone of the main chain on PA loss. Herein, novel imidazolium ions polymer (PQBN-4-IM) material with bulky binaphthyl (BN) group was prepared as PA-doped HT-PEM using a one-step superoxid acid catalyzed polycondensation and subsequent methylation process. The rigidity and hydrophobicity of the BN group promote PQBN-4-IM PEM to produce more obvious microphase separation morphology and large FFV, which is beneficial for forming better ion transport channels and excellent PA interaction. Notably, the PA-doped PQBN-4-IM (PQBN-4-IM/PA) membrane has the highest proton conductivity (90.26 mS cm−1, 180 ℃) and peak power density (PPD) (802.5 mW cm−2, 180 ℃) than PQTP-4-IM/PA and m-PBI/PA HT-PEMs. Moreover, the PQBN-4-IM/PA membrane has higher PA retention at 80 ℃/40 % relative humidity (RH), 40 ℃/60 % RH, or immersed in water due to enhancement on ion-pair interactions by microstructure. Under the accelerated stress test (AST) of the fuel cell (FC), the PQBN-4-IM/PA membrane loses only 12.22 % of PPD after 200 cycles at 80 ℃, which exhibits higher PPD retention than that of the PQBP-4-IM/PA (70.23 %), PQTP-4-IM/PA (74.36 %) and m-PBI/PA (65.25 %) membranes, and shows excellent durability of cell performance for more than 1000 h without significant voltage decay at 160 °C. Thus, the outstanding performance suggests that the microstructure and morphology of imidazolium ions polymer membranes significantly influence proton conductivity, performance, and the durability of a cell.

Clinical Relevance of Different Loads of Perivascular Spaces According to Their Localization in Patients with a Recent Small Subcortical Infarct.

Background and Purpose: Perivascular spaces (PVS) are usually enlarged in small vessel disease (SVD). However, the significance of PVS patterns in different locations is uncertain. Hence, we analyzed the distribution of PVS in patients with a recent small subcortical infarct (RSSI) and their correlation with clinical and imaging factors. Materials and Methods: In a cohort of 71 patients with an RSSI with complete clinical data, including the Pittsburgh Sleep Quality Index (PSQI), we segmented PVS in white matter (WM-PVS), basal ganglia (BG-PVS), and brainstems (BS-PVS) on 3T-MRI T2-weighted sequences, obtaining fractional volumes (%), and calculated the WM/BG-PVS ratio. We analyzed the Pearson's correlation coefficients between PVS regional loads. We used normalized PVS measures to assess the associations with clinical and MRI-SVD features (white matter hyperintensities (WMHs), number of lacunes, and microbleeds) in univariable and multivariable linear regressions adjusted for age, sex, and hypertension. Results: In our cohort (mean age 70 years; 27% female), the Pearson's correlation coefficients between WM-PVS/BG-PVS, WM-PVS/BS-PVS, and BG-PVS/BS-PVS were 0.67, 0.61, and 0.59 (all p < 0.001). In the adjusted models, BG-PVS were associated with lacunes (p = 0.034), WMHs (p = 0.006), and microbleeds (p = 0.017); WM-PVS with lacunes (p = 0.003); while BS-PVS showed no associations. The WM/BG-PVS ratio was associated with lacunes (p = 0.018) and the PSQI (p = 0.046). Conclusions: PVS burdens in different regions are highly correlated in patients with RSSI but with different SVD patterns. Sleep quality impairment might affect waste removal mechanisms differently in the WM and BG regions.

Sacubitril-Valsartan Lowers Atrial Fibrillation Recurrence and Left Atrial Volume Post-catheter Ablation: Systematic Review and Meta-Analysis.

In patients with atrial fibrillation (AF) who have undergone catheter ablation, the comparative effectiveness of sacubitril-valsartan (SV) versus ACE inhibitors (ACEi) or angiotensin-receptor blockers (ARB) in preventing AF recurrence remains unclear. The purpose of the present systematic review and meta-analysis is to determine whether SV offers superior outcomes in this clinical setting. This study systematically reviewed PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs) and propensity-matched cohorts (PMC), evaluating SV's efficacy in preventing AF recurrence after catheter ablation. Outcomes included AF recurrence and structural remodeling assessed via left ventricular ejection fraction (LVEF) and left atrial volume index (LAVi), with statistical analyses performed using Review Manager 5.1.7 and heterogeneity assessed via I2 statistics. The analysis comprised 642 patients from three RCTs and one PMC (319 SV-treated). SV significantly reduced AF recurrence [risk ratios (RR) 0.54; 95% confidence intervals (CI) 0.41-0.70; p < 0.00001; I2 = 0%), a trend also observed when considering RCTs exclusively (RR 0.58; 95% CI 0.41-0.84; p = 0.004; I2 = 0%). Moreover, SV demonstrated a notable reduction in LAVi [mean deviation (MD) -5.34 mL/m2; 95% CI -8.77 to -1.91; p = 0.002; I2 = 57%] compared with ARB, alongside a significant improvement in LVEF (MD 1.83%; 95% CI 1.35-2.32; p < 0.00001; I2 = 0%). Subgroup analyses among patients with hypertension and LVEF < 50% also indicated lower AF recurrence with SV. SV therapy exhibited superior efficacy in reducing AF recurrence compared with ACEi or ARB and demonstrated superior outcomes in attenuating atrial structural remodeling after catheter ablation. These findings underscore the potential of SV as a therapeutic option for patients with AF undergoing catheter ablation, highlighting its efficacy in mitigating AF recurrence and structural remodeling. PROSPERO identifier number CRD42024497958.

Label-Free Optical Biopsy Reveals Biomolecular and Morphological Features of Diabetic Kidney Tissue in 2D and 3D.

Kidney disease, the ninth leading cause of death in the United States, has one of the poorest diagnostic efficiencies of only 10%1. Conventional diagnostic methods often rely on light microscopy analysis of 2D fixed tissue sections with limited molecular insight compared to omics studies. Targeting multiple features in a biopsy using molecular or chemical reagents can enhance molecular phenotyping but are limited by overlap of their spatial and chromatic properties, variations in quality of the products, limited multimodal nature and need additional tissue processing. To overcome these limitations and increase the breadth of molecular information available from tissue without an impact on routine diagnostic workup, we implemented label-free imaging modalities including stimulated Raman scattering (SRS) microscopy, second harmonic generation (SHG), and two photon fluorescence (TPF) into a single microscopy setup. We visualized and identified morphological, structural, lipidomic, and metabolic biomarkers of control and diabetic human kidney biopsy samples in 2D and 3D at a subcellular resolution. The label-free biomarkers, including collagen fiber morphology, mesangial-glomerular fractional volume, lipid saturation, redox status, and relative lipid and protein concentrations in the form of Stimulated Raman Histology (SRH), illustrate distinct features in kidney disease tissues not previously appreciated. The same tissue section can be used for routine diagnostic work up thus enhancing the power of cliniopathological insights obtainable without compromising already limited tissue. The additional multimodal biomarkers and metrics are broadly applicable and deepen our understanding of the progression of kidney diseases by integrating lipidomic, fibrotic, and metabolic data.

Mainchain and sidechain-involving H-bonded asymmetric polyimides containing rigid amide and flexible ether linkages

Hydrogen bonds (H-bonds), usually mainchain amide H-bonds, have been well recognized to play important roles in modulating the properties of polyimides (PIs) by strengthening macromolecular interaction. While the structure-properties relationships of symmetric mainchain amide H-bonded PIs have been extensively researched, the asymmetric H-bonded PIs, particularly those containing rigid-flexible backbone structure, and sidechain-involving H-bonds, have been rarely explored. Herein, starting from designed synthesis of diamine monomers, we present two series of asymmetric PIs containing rigid amide and flexible ether linkages that form mainchain amide-amide and amide-imide H-bonds, lacking or bearing pendent trifluoromethyls (-CF3) that form sidechain-involving amide-CF3 H-bonds. The presence of these three types of H-bonds were revealed by RDF simulation and confirmed by FTIR. Mainchain H-bonded PIs (PI-Ax) show higher Tg than sidechain-involving H-bonded PIs (PI-Tx), while PI-Tx series exhibit higher optical transparency and hydrophobicity, lower dielectric constant (ε′) and better mechanical properties than PI-Ax. The general researches on the PIs’ solubility, WAXD spectra, thermal properties, fluorescence emission and optical transparency, the dihedral angles (φ), fractional free volume (FFV), theoretical gas transport properties, chain geometry optimization and HOMO-LUMO energy gap (ΔE) values have been comprehensively carried out from the aspects of both experiments and theoretical calculation.