The predictive value of lesion-specific pericoronary fat attenuation index for major adverse cardiovascular events in patients with type 2 diabetes.

BACKGROUND: The purpose of this study was to explore the prognostic significance of the lesion-specific pericoronary fat attenuation index (FAI) in forecasting major adverse cardiovascular events (MACE) among patients with type 2 diabetes mellitus (T2DM). METHODS: This study conducted a retrospective analysis of 304 patients diagnosed with T2DM who underwent coronary computed tomography angiography (CCTA) in our hospital from December 2011 to October 2021. All participants were followed for a period exceeding three years. Detailed clinical data and CCTA imaging features were carefully recorded, encompassing lesion-specific pericoronary FAI, FAI of the three prime coronary arteries, features of high-risk plaques, and the coronary artery calcium score (CACS). The MACE included in the study comprised cardiac death, acute coronary syndrome (which encompasses unstable angina pectoris and myocardial infarction), late-phase coronary revascularization procedures, and hospital admissions prompted by heart failure. RESULTS: Within the three-year follow-up, 76 patients with T2DM suffered from MACE. The lesion-specific pericoronary FAI in patients who experienced MACE was notably higher compared to those without MACE (-84.87 ± 11.36 Hounsfield Units (HU) vs. -88.65 ± 11.89 HU, p = 0.016). Multivariate Cox regression analysis revealed that CACS ≥ 100 (hazard ratio [HR] = 4.071, 95% confidence interval [CI] 2.157-7.683, p < 0.001) and lesion-specific pericoronary FAI higher than - 83.5 HU (HR = 2.400, 95% CI 1.399-4.120, p = 0.001) were independently associated with heightened risk of MACE in patients with T2DM over a three-year period. Kaplan-Meier analysis showed that patients with higher lesion-specific pericoronary FAI were more likely to develop MACE (p = 0.0023). Additionally, lesions characterized by higher lesion-specific pericoronary FAI values were found to have a greater proportion of high-risk plaques (p = 0.015). Subgroup analysis indicated that lesion-specific pericoronary FAI higher than - 83.5 HU (HR = 2.017, 95% CI 1.143-3.559, p = 0.015) was independently correlated with MACE in patients with T2DM who have moderate to severe coronary calcification. Moreover, the combination of CACS ≥ 100 and lesion-specific pericoronary FAI>-83.5 HU significantly enhanced the predictive value of MACE in patients with T2DM within 3 years. CONCLUSIONS: The elevated lesion-specific pericoronary FAI emerged as an independent prognostic factor for MACE in patients with T2DM, inclusive of those with moderate to severe coronary artery calcification. Incorporating lesion-specific pericoronary FAI with the CACS provided incremental predictive power for MACE in patients with T2DM.

A PEDOT: PSS/GO fiber microelectrode fabricated by microfluidic spinning for dopamine detection in human serum and PC12 cells.

Rapid and accurate in situ determination of dopamine is of great significance in the study of neurological diseases. In this work, poly (3,4-ethylenedioxythiophene): poly (styrenesulfonic acid) (PEDOT: PSS)/graphene oxide (GO) fibers were fabricated by an effective method based on microfluidic wet spinning technology. The composite microfibers with stratified and dense arrangement were continuously prepared by injecting PEDOT: PSS and GO dispersion solutions into a microfluidic chip. PEDOT: PSS/GO fiber microelectrodes with high electrochemical activity and enhanced electrochemical oxidation activity of dopamine were constructed by controlling the structure composition of the microfibers with varying flow rate. The fabricated fiber microelectrode had a low detection limit (4.56 nM) and wide detection range (0.01-8.0 µM) for dopamine detection with excellent stability, repeatability, and reproducibility. In addition, the PEDOT: PSS/GO fiber microelectrode prepared was successfully used for the detection of dopamine in human serum and PC12 cells. The strategy for the fabrication of multi-component fiber microelectrodes is a new and effective approach for monitoring the intercellular neurotransmitter dopamine and has high potential as an implantable neural microelectrode.

Sociocultural Antecedents and Mechanisms of COVID-19 Vaccine Uptake among Mexican-Origin Youth.

Mexican-origin youth, as a large and growing population among U.S. youth, have been disproportionately affected by COVID-19. Understanding what, when, and how sociocultural factors may influence their COVID-19 vaccine uptake could inform current and future pandemic-response interventions promoting vaccination behaviors among Mexican-origin youth. The current study takes a developmental approach to reveal the long-term and short-term sociocultural antecedents of 198 Mexican-origin adolescents' COVID-19 vaccination uptake behaviors and explores the underlying mechanism of these associations based on the Knowledge-Attitude-Behavior model. The current study adopted Wave 1 (2012-2015) and Wave 4 (2021-2022) self-reported data from a larger study. Analyses were conducted to examine four mediation models for four sociocultural antecedents-daily discrimination, ethnic discrimination, foreigner stress, and family economic stress-separately. Consistent indirect effects of higher levels of concurrent sociocultural risk factors on a lower probability of COVID-19 vaccine uptake were observed to occur through less knowledge about the COVID-19 vaccines and less positive attitudes toward the COVID-19 vaccines at Wave 4. Significant direct effects, but in opposite directions, were found for the associations between Wave 1 ethnic discrimination/Wave 4 daily discrimination and the probability of COVID-19 vaccine uptake. The findings highlight the importance of considering prior and concurrent sociocultural antecedents and the Knowledge-Attitude-Behavior pathway leading to COVID-19 vaccination uptake among Mexican-origin youth and suggest that the impact of discrimination on COVID-19 vaccination uptake may depend on the type (e.g., daily or ethnic) and the context (e.g., during the COVID-19 pandemic or not) of discrimination experienced.

Intercalation-Induced Localized Conversion Reaction in h-CuSe for Ultrafast-Rechargeable and Long-Cycling Sodium Metal Battery.

Cathode materials of sodium-based batteries with high specific capacity and fast charge-discharge mode, as well as ultralong reversible cycles at wide applied temperatures, are essential for future development of advanced energy storage system. Developing transition metal selenides with intercalation features provides a new strategy for realizing the above cathode materials. Herein, this work reports a storage mechanism of sodium ion in hexagonal CuSe (h-CuSe) based on the density functional theory (DFT) guidance. This work reveals that the two-dimensional ion intercalation triggers localized redox reaction in the h-CuSe bulk phase, termed intercalation-induced localized conversion (ILC) mechanism, to stabilize the sodium storage structure by forming localized Cu7Se4 transition phase and adjusting the near-edge coordination state of the Cu sites to achieve high reversible capacity and ultra-long cycling life, while allowing rapid charge-discharge cycling over a wide temperature range.

Sea Anemone-Inspired Slippery Liquid-Infused Porous Surface (SLIPS) with Bionic Cilia for Responsive 4D Antifouling.

The formation process of biofouling is actually a 4D process with both spatial and temporal dimensions. However, most traditional antifouling coatings, including slippery liquid-infused porous surface (SLIPS), are limited to performing antifouling process in the 2D coating plane. Herein, inspired by the defensive behavior of sea anemones' wielding toxic tentacles, a "4D SLIPS" (FSLIPS) is constructed with biomimetic cilia via a magnetic field self-assembly method for antifouling. The bionic cilia move in 3D space driven by an external magnetic field, thereby preventing the attachment of microorganisms. The FSLIPS releases the gaseous antifoulant (nitric oxide) at 1D time in response to light, thereby achieving a controllable biocide effect on microorganisms. The FSLIPS regulates the movement of cilia via the external magnetic field, and controls the release of NO overtime via the light response, so as to adjust the antifouling modes on demand during the day or night. The light/magnetic response mechanism endow the FSLIPS with the ability to adjust the antifouling effect in the 4D dimension of 1D time and 3D space, effectively realizing the intelligence, multi-dimensionality and precision of the antifouling process.

Teaching diagnostic radiology to radiology majors: Implementation and evaluation of a flipped classroom model.

PURPOSE: Radiology instruction focuses on cultivating medical students' diagnostic thinking skills and practical competence, and lecture-based learning (LBL) is the most commonly used teaching approach. While fact-based, this type of traditional instruction is often non-engaging, leading to a shift toward student-centered models, one of which is the flipped classroom (FC). However, studies involving a comprehensive evaluation of students' experiences using the FC approach and its effects on their learning are lacking. Therefore, this study analyzed the teaching efficacy of the FC approach based on data of large groups of radiology students, accumulated over time. METHODS: Data from 636 medical radiology students taught using the FC and LBL models from 2012 to 2021 were retrospectively collected and analyzed. RESULTS: The test scores of the FC group were significantly higher than those of the LBL group, and improvements in learning initiative and learning ability were notably higher in the FC than in the LBL group. The two groups showed no significant difference in the critical thinking disposition indicator, and the proportion of students with positive critical thinking tendencies was higher in the FC than in the LBL group. The academic and social self-perception scores of the FC group were significantly higher than those of the LBL group, and there was a significant difference in Kolb's learning style. CONCLUSIONS: Based on evidence of completing pre-, in-, and after-class work, the FC approach improved students' academic performance, learning initiative, diagnostic ability, and satisfaction with learning and the teaching institution. Our findings suggest that FC instruction promotes students' assimilation and convergence of learning styles, and cultivates positive critical thinking.

Survival Analysis and Socio-Cognitive Factors in the Timing of COVID-19 Vaccination Among Mexican-Origin Youth.

OBJECTIVE: The COVID-19 pandemic disproportionately affected ethnic minority populations and exacerbated preexisting health disparities. The current study aims to promote vaccine uptake among Mexican-origin youth from immigrant families by examining their time to COVID-19 vaccine uptake and assessing the influence of demographic, cognitive, and social factors on the incidence of COVID-19 vaccination. METHODS: The study conducted Survival Analysis using a Cox proportional hazards model based on a sample of 202 Mexican-origin youth (61.39% female; Mage = 20.41) with data collected from August 2021 to January 2023 in central Texas. RESULTS: The results show a critical time period for vaccine uptake (i.e., in the first six months after the vaccines were publicly available), evidenced by a surge decrease in COVID-19 unvaccination probability. In addition, more positive attitudes toward the COVID-19 vaccine (Hazard ratio/HR = 1.89, 95% Confidence Interval/CI = [1.64, 2.18]), greater motivation (HR = 2.29, 95% CI = [1.85, 2.85]), higher education levels (HR = 1.52, 95% CI = [1.24, 1.86]), and fewer general barriers to COVID-19 vaccine knowledge (HR = 0.75, 95% CI = [0.60, 0.94]) were associated with greater incidences of receiving COVID-19 vaccines at any given time point during the pandemic. CONCLUSION: The findings suggest that COVID-19 vaccine uptake among Mexican-origin youth occurred primarily within the initial months of vaccines being publicly distributed. To encourage vaccination among Mexican-origin youth, sustained COVID-19 vaccine promotion efforts are needed by targeting their motivation and positive attitudes and reducing barriers to vaccine information, particularly for youth with lower education levels.

Comparing the double-echo steady-state with water excitation and constructive interference in steady state sequence techniques for identifying extracranial facial nerve and tumor positions in patients with parotid tumors.

BACKGROUND AND PURPOSE: Reliable preoperative visualization of facial nerve morphology and understanding the spatial relationship between the facial nerve and tumor in the parotid gland can help clinicians perform safe and effective surgeries. Hence, this study aimed to compare the image quality of extracranial facial nerves obtained using double-echo steady-state with water excitation (DESS-WE) and constructive interference in steady state (CISS) sequences and evaluate their diagnostic efficacy in the localization of parotid tumors. MATERIALS AND METHODS: In total, 32 facial nerves of 16 healthy volunteers and 25 facial nerves of 25 patients with parotid tumors were included in this retrospective study. All participants underwent noncontrast-enhanced extracranial facial nerve magnetic resonance imaging with DESS-WE and CISS with a 3T MR scanner equipped with a 64-channel head and neck coil. Image quality was subjectively evaluated using a 5-point Likert scale by two radiologists. Inter- and intra-rater agreements were assessed using the Cohen kappa coefficient (κ). Receiver operating characteristic analysis was performed, and the diagnostic efficacies of DESS-WE and CISS images in localizing parotid tumors were calculated. RESULTS: For healthy volunteers (11 men and 5 women; median age, 26 years), image quality scores for CISS were significantly higher than those for DESS-WE for the discrimination of the temporofacial and cervicofacial trunks (both, p <0.001). In patients with parotid tumors (12 men and 13 women; median age, 58 years), CISS performed better than DESS-WE in terms of visualizing the spatial relationship of the facial nerve to the tumor and diagnostic confidence (both, p<0.001). Regarding the localization of parotid tumors, CISS showed excellent performance, comparable to that of DESS-WE (area under the curve, 0.981 versus 0.942, p = 0.1489). CONCLUSIONS: CISS achieved diagnostic performance comparable to DESS-WE in parotid tumor localization, with favorable image quality and more reliable morphological visualization of the facial nerve. ABBREVIATIONS: 3D = three-dimensional; CISS = constructive interference in steady state; DESS-WE = double-echo steady-state with water excitation; IQS = image quality score; AUC = area under the curve.

Pearl-Inspired Intelligent Marine Hetero Nanocomposite Coating Based on "Brick&Mortar" Strategy: Anticorrosion Durability and Switchable Antifouling.

Corrosion activities and biofouling pose significant challenges for marine facilities, resulting in substantial economic losses. Inspired by the "brick&mortar" structure of pearls, a novel nanocomposite coating (Pun-HJTx) with long-lasting anticorrosion and intelligent antifouling modes is fabricated by integrating a compatible MoS2/MXene heterostructure as the "brick" into a polyurea-modified PDMS (Pun) acting as "mortar." Notably, the presence of multiple hydrogen bonds within the coating effectively reduces the pinholes resulted from solution volatilizing. In the dark, where fouling adhesion and microbial corrosion activities are weakened, the MoS2/MXene plays a role in contact bactericidal action. Conversely, during daylight when fouling adhesion and microbial corrosion activities intensify, the coating releases reactive oxygen species (such as hydroxyl radicals and superoxide ions) to counteract fouling adhesion. Additionally, the coating exhibits multisource self-healing performance under heated or exposed to light (maximum self-healing rate can reach 99.46%) and proves efficient self-cleaning performance and adhesion strength (>2.0 Mpa), making it highly suitable for various practical marine applications. Furthermore, the outstanding performance of the Pun-HJT1 is maintained for ≈180 days in real-world marine conditions, which proving its practicality and feasibility in real shallow sea environments.

Accelerating Oxygen Electrocatalysis Kinetics on Metal-Organic Frameworks via Bond Length Optimization.

Metal-organic frameworks (MOFs) have been developed as an ideal platform for exploration of the relationship between intrinsic structure and catalytic activity, but the limited catalytic activity and stability has hampered their practical use in water splitting. Herein, we develop a bond length adjustment strategy for optimizing naphthalene-based MOFs that synthesized by acid etching Co-naphthalenedicarboxylic acid-based MOFs (donated as AE-CoNDA) to serve as efficient catalyst for water splitting. AE-CoNDA exhibits a low overpotential of 260 mV to reach 10 mA cm-2 and a small Tafel slope of 62 mV dec-1 with excellent stability over 100 h. After integrated AE-CoNDA onto BiVO4, photocurrent density of 4.3 mA cm-2 is achieved at 1.23 V. Experimental investigations demonstrate that the stretched Co-O bond length was found to optimize the orbitals hybridization of Co 3d and O 2p, which accounts for the fast kinetics and high activity. Theoretical calculations reveal that the stretched Co-O bond length strengthens the adsorption of oxygen-contained intermediates at the Co active sites for highly efficient water splitting.

Diagnostic and prognostic performance of artificial intelligence-based fully-automated on-site CT-FFR in patients with CAD.

Currently, clinically available coronary CT angiography (CCTA) derived fractional flow reserve (CT-FFR) is time-consuming and complex. We propose a novel artificial intelligence-based fully-automated, on-site CT-FFR technology, which combines the automated coronary plaque segmentation and luminal extraction model with reduced order 3 dimentional (3D) computational fluid dynamics. A total of 463 consecutive patients with 600 vessels from the updated China CT-FFR study in Cohort 1 undergoing both CCTA and invasive fractional flow reserve (FFR) within 90 d were collected for diagnostic performance evaluation. For Cohort 2, a total of 901 chronic coronary syndromes patients with index CT-FFR and clinical outcomes at 3-year follow-up were retrospectively analyzed. In Cohort 3, the association between index CT-FFR from triple-rule-out CTA and major adverse cardiac events in patients with acute chest pain from the emergency department was further evaluated. The diagnostic accuracy of this CT-FFR in Cohort 1 was 0.82 with an area under the curve of 0.82 on a per-patient level. Compared with the manually dependent CT-FFR techniques, the operation time of this technique was substantially shortened by 3 times and the number of clicks from about 60 to 1. This CT-FFR technique has a highly successful (> 99%) calculation rate and also provides superior prediction value for major adverse cardiac events than CCTA alone both in patients with chronic coronary syndromes and acute chest pain. Thus, the novel artificial intelligence-based fully automated, on-site CT-FFR technique can function as an objective and convenient tool for coronary stenosis functional evaluation in the real-world clinical setting.

Integrating artificial intelligence into the modernization of traditional Chinese medicine industry: a review.

Traditional Chinese medicine (TCM) is the practical experience and summary of the Chinese nation for thousands of years. It shows great potential in treating various chronic diseases, complex diseases and major infectious diseases, and has gradually attracted the attention of people all over the world. However, due to the complexity of prescription and action mechanism of TCM, the development of TCM industry is still in a relatively conservative stage. With the rise of artificial intelligence technology in various fields, many scholars began to apply artificial intelligence technology to traditional Chinese medicine industry and made remarkable progress. This paper comprehensively summarizes the important role of artificial intelligence in the development of traditional Chinese medicine industry from various aspects, including new drug discovery, data mining, quality standardization and industry technology of traditional Chinese medicine. The limitations of artificial intelligence in these applications are also emphasized, including the lack of pharmacological research, database quality problems and the challenges brought by human-computer interaction. Nevertheless, the development of artificial intelligence has brought new opportunities and innovations to the modernization of traditional Chinese medicine. Integrating artificial intelligence technology into the comprehensive application of Chinese medicine industry is expected to overcome the major problems faced by traditional Chinese medicine industry and further promote the modernization of the whole traditional Chinese medicine industry.

Electron Redistribution of Ru Site on MoO2@NiMoO4 Support for Efficient Ampere-Level Current Density Electrolysis of Alkaline Seawater.

Seawater electrolysis is a promising but challenging strategy to generate carbon-neutral hydrogen. A grand challenge for hydrogen evolution reaction (HER) from alkaline seawater electrolysis is the development of efficient and stable electrocatalysts to overcome the limitation of sluggish kinetics. Here, a 3D nanorod hybrid catalyst is reported, which comprises heterostructure MoO2@NiMoO4 supported Ru nanoparticles (Ru/ MoO2@NiMoO4) with a size of ≈5 nm. Benefitting from the effect of strongly coupled interaction, Ru/MoO2@NiMoO4 catalyst exhibits a remarkable alkaline seawater hydrogen evolution performance, featured by a low overpotential of 184 mV at a current density of 1.0 A cm-2, superior to commercial Pt/C (338 mV). Experimental observations demonstrate that the heterostructure MoO2@NiMoO4 as an electron-accepting support makes the electron transfer from the Ru nanoparticles to MoO2, and thereby implements the electron redistribution of Ru site. Mechanistic analysis elucidates that the electron redistribution of active Ru site enhances the ability of hydrogen desorption, thereby promoting alkaline seawater HER kinetics and finally leading to a satisfactory catalysis performance at ampere-level current density of alkaline seawater electrolysis.

Multi-residual 2D network integrating spatial correlation for whole heart segmentation.

Whole heart segmentation (WHS) has significant clinical value for cardiac anatomy, modeling, and analysis of cardiac function. This study aims to address the WHS accuracy on cardiac CT images, as well as the fast inference speed and low graphics processing unit (GPU) memory consumption required by practical clinical applications. Thus, we propose a multi-residual two-dimensional (2D) network integrating spatial correlation for WHS. The network performs slice-by-slice segmentation on three-dimensional cardiac CT images in a 2D encoder-decoder manner. In the network, a convolutional long short-term memory skip connection module is designed to perform spatial correlation feature extraction on the feature maps at different resolutions extracted by the sub-modules of the pre-trained ResNet-based encoder. Moreover, a decoder based on the multi-residual module is designed to analyze the extracted features from the perspectives of multi-scale and channel attention, thereby accurately delineating the various substructures of the heart. The proposed method is verified on a dataset of the multi-modality WHS challenge, an in-house WHS dataset, and a dataset of the abdominal organ segmentation challenge. The dice, Jaccard, average symmetric surface distance, Hausdorff distance, inference time, and maximum GPU memory of the WHS are 0.914, 0.843, 1.066 mm, 15.778 mm, 9.535 s, and 1905 MB, respectively. The proposed network has high accuracy, fast inference speed, minimal GPU memory consumption, strong robustness, and good generalization. It can be deployed to clinical practical applications for WHS and can be effectively extended and applied to other multi-organ segmentation fields. The source code is publicly available at https://github.com/nancy1984yan/MultiResNet-SC.

Genome constitution and evolution of Elymus atratus (Poaceae: Triticeae) inferred from cytogenetic and phylogenetic analysis.

BACKGROUND: Elymus atratus (Nevski) Hand.-Mazz. is perennial hexaploid wheatgrass. It was assigned to the genus Elymus L. sensu stricto based on morphological characters. Its genome constitution has not been disentangled yet. OBJECTIVE: To identify the genome constitution and origin of E. atratus. METHODS: In this study, genomic in situ hybridization and fluorescence in situ hybridization, and phylogenetic analysis based on the Acc1, DMC1 and matK sequences were performed. RESULTS: Genomic in situ hybridization and fluorescence in situ hybridization results reveal that E. atratus 2n = 6x = 42 is composed of 14 St genome chromosomes, 14 H genome chromosomes, and 14 Y genome chromosomes including two H-Y type translocation chromosomes, suggesting that the genome formula of E. atratus is StStYYHH. The phylogenetic analysis based on Acc1 and DMC1 sequences not only shows that the Y genome originated in a separate diploid, but also suggests that Pseudoroegneria (St), Hordeum (H), and a diploid species with Y genome were the potential donors of E. atratus. Data from chloroplast DNA showed that the maternal donor of E. atratus contains the St genome. CONCLUSION: Elymus atratus is an allohexaploid species with StYH genome, which may have originated through the hybridization between an allotetraploid Roegneria (StY) species as the maternal donor and a diploid Hordeum (H) species as the paternal donor.

Language brokering profiles of Mexican-origin adolescents in immigrant communities: Social-cultural contributors and developmental outcomes.

This study examines social-cultural contributors and developmental outcomes of language brokers. From 2012 to 2020, three waves of data were collected from 604 Mexican-origin adolescent language brokers (Mage = 12.92, SD = 0.92, 54% girls). The study (1) identified four distinct subgroups of language brokers (efficacious, conservative, nonchalant, and burdened) who translated for mothers and fathers, after incorporating objective bilingual proficiency along with multiple dimensions of language brokering; (2) showed that early adolescents' Mexican, rather than U.S., cultural values and orientation were related to later language brokering profiles; and (3) showed that the efficacious group was the most resilient while burdened was the most vulnerable to developmental problems. Preservation of Mexican culture may facilitate language brokering experiences related to more positive developmental outcomes.

Evaluation and analysis of surgical treatment for single-level or multi-level lumbar degenerative disease based on radiography.

Background: Radiography has a low level of radiation exposure while providing valuable information. Due to its cost effectiveness and widespread availability, the preoperative radiographic imaging examination is a valuable approach for assessing patients with spinal disease. This study aimed to examine the influence of preoperative X-ray evaluation on the surgical treatment of patients with single- or multi-level lumbar degenerative disease (LDD). Methods: A retrospective cohort analysis was conducted of 172 patients diagnosed with LDD who underwent transforaminal lumbar interbody fusion (TLIF) or posterior lumbar interbody fusion (PLIF) surgery between December 2021 and February 2023 at the Shanghai Changzheng Hospital. Various parameters were measured on preoperative radiographs, including the iliac crest height, median iliac angle (MIA), lumbar lordosis (LL), intervertebral facet joint degeneration, lumbosacral angle (LSA), intervertebral foramen height (IFH), and surgical segment. The surgical treatment was evaluated based on the operative time, intraoperative blood loss, and postoperative complications. A correlation analysis and independent sample t-tests were used to assess the relationship between preoperative radiographic variables and surgical treatments. Further, a multivariate linear regression analysis was employed to identify the risk factors affecting the clinical outcomes. Results: The correlation analysis and t-test results showed that the MIA, height of the iliac crest, intervertebral facet joint degeneration, and surgical segment were significantly correlated with the surgical treatments (P<0.05). Specifically, the height of the iliac crest, intervertebral facet joint degeneration, and surgical segment were positively correlated with the surgical treatments. Conversely, the MIA was negatively correlated with the surgical treatments. However, no significant differences were observed between the IFH, LSA, and LL in relation to posterior lumbar surgery (P>0.05). The multiple linear regression analysis showed that the height of the iliac crest, MIA, intervertebral facet joint degeneration, and surgical segment were independent factors affecting the surgical treatments of patients with single- or multi-level LDD. These findings highlight the importance of considering these factors when planning and performing lumbar surgery. Conclusions: The measurements taken from radiographs, including the height of the iliac crest, MIA, intervertebral facet joint degeneration, and surgical segment, demonstrate potential influences on the treatment of single- and multi-level lumbar spine surgery. These variables can be captured in plain film imaging and can provide valuable insights into the surgical procedure and offer guidance for the operation. By analyzing these radiographic measurements, surgeons can gain a better understanding of a patient's condition and tailor the surgical approach accordingly, thus optimizing the outcomes of the surgery.

Site-selective protonation enables efficient carbon monoxide electroreduction to acetate.

Electrosynthesis of acetate from CO offers the prospect of a low-carbon-intensity route to this valuable chemical--but only once sufficient selectivity, reaction rate and stability are realized. It is a high priority to achieve the protonation of the relevant intermediates in a controlled fashion, and to achieve this while suppressing the competing hydrogen evolution reaction (HER) and while steering multicarbon (C2+) products to a single valuable product--an example of which is acetate. Here we report interface engineering to achieve solid/liquid/gas triple-phase interface regulation, and we find that it leads to site-selective protonation of intermediates and the preferential stabilization of the ketene intermediates: this, we find, leads to improved selectivity and energy efficiency toward acetate. Once we further tune the catalyst composition and also optimize for interfacial water management, we achieve a cadmium-copper catalyst that shows an acetate Faradaic efficiency (FE) of 75% with ultralow HER (<0.2% H2 FE) at 150 mA cm-2. We develop a high-pressure membrane electrode assembly system to increase CO coverage by controlling gas reactant distribution and achieve 86% acetate FE simultaneous with an acetate full-cell energy efficiency (EE) of 32%, the highest energy efficiency reported in direct acetate electrosynthesis.

Precise coordination of high-loading Fe single atoms with sulfur boosts selective generation of nonradicals.

Nonradicals are effective in selectively degrading electron-rich organic contaminants, which unfortunately suffer from unsatisfactory yield and uncontrollable composition due to the competitive generation of radicals. Herein, we precisely construct a local microenvironment of the carbon nitride-supported high-loading (~9 wt.%) Fe single-atom catalyst (Fe SAC) with sulfur via a facile supermolecular self-assembly strategy. Short-distance S coordination boosts the peroxymonosulfate (PMS) activation and selectively generates high-valent iron-oxo species (FeIV=O) along with singlet oxygen (1O2), significantly increasing the 1O2 yield, PMS utilization, and p-chlorophenol reactivity by 6.0, 3.0, and 8.4 times, respectively. The composition of nonradicals is controllable by simply changing the S content. In contrast, long-distance S coordination generates both radicals and nonradicals, and could not promote reactivity. Experimental and theoretical analyses suggest that the short-distance S upshifts the d-band center of the Fe atom, i.e., being close to the Fermi level, which changes the binding mode between the Fe atom and O site of PMS to selectively generate 1O2 and FeIV=O with a high yield. The short-distance S-coordinated Fe SAC exhibits excellent application potential in various water matrices. These findings can guide the rational design of robust SACs toward a selective and controllable generation of nonradicals with high yield and PMS utilization.

A new predictor of coronary artery disease in acute ischemic stroke or transient ischemic attack patients: pericarotid fat density.

OBJECTIVES: The study aims to evaluate the incremental predictive value of pericarotid fat density (PFD) on head and neck computed tomography angiography (CTA) for the obstructive coronary artery disease (CAD) (≥ 50% stenosis) relative to a clinical risk model (Framingham risk score (FRS)) and the degree of carotid artery stenosis and plaque type in acute ischemic stroke (AIS) or transient ischemic attack (TIA) patients without a known history of CAD. METHODS: In a cohort of 134 consecutive stable patients diagnosed with AIS or TIA undergoing head and neck CTA between January 2010 and December 2021, pericarotid adipose tissue density (PFD) was quantified using a dedicated software. We collected demographic and clinical data, assessed the risk of CAD using the FRS, and analyzed coronary and carotid artery CTA images. Univariate and multivariate logistic regression analyses were performed to assess associations between FRS, PFD, CTA variables, and obstructive CAD risk. Four prediction models were established to evaluate the incremental predictive value of PFD relative to FRS, stenosis degree, and plaque types. Receiver operating characteristic (ROC) curves were generated, and the areas under the curves (AUC) were compared. RESULTS: Increasing FRS, stenosis degree, and PFD values were positively correlated with obstructive CAD (all p < 0.05). In the predictive models for obstructive CAD, the model incorporating carotid stenosis exhibited superior predictive performance compared to FRS alone (p < 0.05). Moreover, the predictive model integrating PFD demonstrated enhanced performance and yielded the highest AUC of the receiver operator characteristic curve (AUC = 0.783), with sensitivity and specificity values of 86.89% and 65.75%, respectively. CONCLUSION: CTA-derived PFD measurements offer supplementary predictive value for obstructive CAD beyond FRS and stenosis, thereby facilitating improved risk stratification of TIA or stroke patients without a history of CAD history. CLINICAL RELEVANCE STATEMENT: CTA-derived PFD provides incremental predictive value for obstructive coronary artery disease in acute ischemic stroke or transient ischemic attack patients without CAD history, beyond Framingham risk score and carotid artery stenosis degree, improving risk stratification. KEY POINTS: • Pericarotid fat density is associated with obstructive coronary artery disease in acute ischemic stroke or transient ischemic attack patients. • Higher pericarotid fat density corresponds to an increased risk of obstructive coronary artery disease. • Estimation of pericarotid fat density using computed tomography angiography imparts additional predictive value for obstructive CAD in risk stratification of acute ischemic stroke or transient ischemic attack patients.