Prognostic impact and predictors of persistent renal dysfunction in acute kidney injury after percutaneous coronary intervention for acute myocardial infarction.

This study aimed to evaluate the prognostic impact and predictors of persistent renal dysfunction in acute kidney injury (AKI) after an emergency percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). A total of 877 patients who underwent emergency PCI for AMI were examined. AKI was defined as serum creatinine (SCr) ≥ 0.3 mg/dL or ≥ 50% from baseline within 48 h after PCI. Persistent AKI was defined as residual impairment of SCr ≥ 0.3 mg/dL or ≥ 50% from baseline 1 month after the procedure. The primary outcome was the composite endpoints of death, myocardial infarction, hospitalization for heart failure, stroke, and dialysis. AKI and persistent AKI were observed in 82 (9.4%) and 25 (2.9%) patients, respectively. Multivariate Cox proportional hazards analysis demonstrated that persistent AKI, but not transient AKI, was an independent predictor of primary outcome (hazard ratio, 4.99; 95% confidence interval, 2.30-10.8; P < 0.001). Age > 75 years, left ventricular ejection fraction < 40%, a high maximum creatinine phosphokinase MB level, and bleeding after PCI were independently associated with persistent AKI. Persistent AKI was independently associated with worse clinical outcomes in patients who underwent emergency PCI for AMI. Advanced age, poor cardiac function, large myocardial necrosis, and bleeding were predictors of persistent AKI.

Oxidative phosphorylation is a pivotal therapeutic target of fibrodysplasia ossificans progressiva.

Heterotopic ossification (HO) is a non-physiological bone formation where soft tissue progenitor cells differentiate into chondrogenic cells. In fibrodysplasia ossificans progressiva (FOP), a rare genetic disease characterized by progressive and systemic HO, the Activin A/mutated ACVR1/mTORC1 cascade induces HO in progenitors in muscle tissues. The relevant biological processes aberrantly regulated by activated mTORC1 remain unclear, however. RNA-sequencing analyses revealed the enrichment of genes involved in oxidative phosphorylation (OXPHOS) during Activin A-induced chondrogenesis of mesenchymal stem cells derived from FOP patient-specific induced pluripotent stem cells. Functional analyses showed a metabolic transition from glycolysis to OXPHOS during chondrogenesis, along with increased mitochondrial biogenesis. mTORC1 inhibition by rapamycin suppressed OXPHOS, whereas OXPHOS inhibitor IACS-010759 inhibited cartilage matrix formation in vitro, indicating that OXPHOS is principally involved in mTORC1-induced chondrogenesis. Furthermore, IACS-010759 inhibited the muscle injury-induced enrichment of fibro/adipogenic progenitor genes and HO in transgenic mice carrying the mutated human ACVR1. These data indicated that OXPHOS is a critical downstream mediator of mTORC1 signaling in chondrogenesis and therefore is a potential FOP therapeutic target.

Non-classical Monocytes Enhance the Efficacy of Immune Checkpoint Inhibitors on Colon Cancer in a Syngeneic Mouse Model.

BACKGROUND/AIM: The response rate to immune checkpoint inhibitors (ICIs) is approximately 10%-30% and only in a few cancer types. In the present study, we determined whether non-classical monocytes (NCMs) could enhance ICI efficacy in colon cancer using a syngeneic mouse model. MATERIALS AND METHODS: The MC38 C57BL/6 mouse colon cancer model was used. Cells collected from the bone marrow of C57BL/6 mice were cultured, and NCMs were fractionated by cell sorting and administered via the tail veins to the mice implanted with MC38 cells. The anti-mouse PD-L1 antibody was administered three times, and tumor volume and overall survival were observed. RESULTS: More tumors were eradicated and more complete response occurred, after cotreatment with ICIs and NCMs than after treatment with ICIs alone. Moreover, no efficacy was observed when NCMs were administered alone. CONCLUSION: NCMs enhance ICI efficacy. The underlying mechanisms and clinical applications will be studied in the future.

Development of a Novel Artificial Intelligence System for Laparoscopic Hepatectomy.

BACKGROUND/AIM: Laparoscopic hepatectomy (LH) requires accurate visualization and appropriate handling of hepatic veins and the Glissonean pedicle that suddenly appear during liver dissection. Failure to recognize these structures can cause injury, resulting in severe bleeding and bile leakage. This study aimed to develop a novel artificial intelligence (AI) system that assists in the visual recognition and color presentation of tubular structures to correct the recognition gap among surgeons. PATIENTS AND METHODS: Annotations were performed on over 350 video frames capturing LH, after which a deep learning model was developed. The performance of the AI was evaluated quantitatively using intersection over union (IoU) and Dice coefficients, as well as qualitatively using a two-item questionnaire on sensitivity and misrecognition completed by 10 hepatobiliary surgeons. The usefulness of AI in medical education was qualitatively evaluated by 10 medical students and residents. RESULTS: The AI model was able to individually recognize and colorize hepatic veins and the Glissonean pedicle in real time. The IoU and Dice coefficients were 0.42 and 0.53, respectively. Surgeons provided a mean sensitivity score of 4.24±0.89 (from 1 to 5; Excellent) and a mean misrecognition score of 0.12±0.33 (from 0 to 4; Fail). Medical students and residents assessed the AI to be very useful (mean usefulness score, 1.86±0.35; from 0 to 2; Excellent). CONCLUSION: The novel AI presented was able to assist surgeons in the intraoperative recognition of microstructures and address the recognition gap among surgeons to ensure a safer and more accurate LH.

Crystal plasticity simulations with representative volume element of as-build laser powder bed fusion materials.

Additive manufacturing of as-build metal materials with laser powder bed fusion typically leads to the formations of various chemical phases and their corresponding microstructure types. Such microstructures have very complex shape and size anisotropic distributions due to the history of the laser heat gradients and scanning patterns. With higher complexity compared to the post-heat-treated materials, the synthetic volume reconstruction of as-build materials for accurate modelling of their mechanical properties is a serious challenge. Here, we present an example of complete workflow pipeline for such nontrivial task. It takes into account the statistical distributions of microstructures: object sizes for each phase, several shape parameters for each microstructure type, and their morphological and crystallographic orientations. In principle, each step in the pipeline, including the parameters in the crystal plasticity model, can be fine-tuned to achieve suitable correspondence between experimental and synthetic microstructures as well as between experimental stress-strain curves and simulated results. To our best knowledge, this work represents an example of the most challenging synthetic volume reconstruction for as-build additive manufacturing materials to date.

Novel quantitative immunohistochemical analysis for evaluating PD-L1 expression with phosphor-integrated dots for predicting the efficacy of patients with cancer treated with immune checkpoint inhibitors.

Introduction: Programmed cell death ligand 1 (PD-L1) expression in tumor tissues is measured as a predictor of the therapeutic efficacy of immune checkpoint inhibitors (ICIs) in many cancer types. PD-L1 expression is evaluated by immunohistochemical staining using 3,3´-diaminobenzidine (DAB) chronogenesis (IHC-DAB); however, quantitative and reproducibility issues remain. We focused on a highly sensitive quantitative immunohistochemical method using phosphor-integrated dots (PIDs), which are fluorescent nanoparticles, and evaluated PD-L1 expression between the PID method and conventional DAB method. Methods: In total, 155 patients with metastatic or recurrent cancer treated with ICIs were enrolled from four university hospitals. Tumor tissue specimens collected before treatment were subjected to immunohistochemical staining with both the PID and conventional DAB methods to evaluate PD-L1 protein expression. Results: PD-L1 expression assessed using the PID and DAB methods was positively correlated. We quantified PD-L1 expression using the PID method and calculated PD-L1 PID scores. The PID score was significantly higher in the responder group than in the non-responder group. Survival analysis demonstrated that PD-L1 expression evaluated using the IHC-DAB method was not associated with progression-free survival (PFS) or overall survival (OS). Yet, PFS and OS were strikingly prolonged in the high PD-L1 PID score group. Conclusion: Quantification of PD-L1 expression as a PID score was more effective in predicting the treatment efficacy and prognosis of patients with cancer treated with ICIs. The quantitative evaluation of PD-L1 expression using the PID method is a novel strategy for protein detection. It is highly significant that the PID method was able to identify a group of patients with a favorable prognosis who could not be identified by the conventional DAB method.

Differences in the feasibility, anatomical parameters predicting procedural difficulty, and isolation area of a left atrial posterior wall isolation using radiofrequency versus cryoballoon catheters.

BACKGROUNDS: The difficulty and outcome of the adjunctive left atrial posterior wall isolation (LAPWI) in patients with persistent atrial fibrillation (PersAF) may be affected by the ablation energy used. This study aimed to compare the completion rate, anatomical parameters predicting procedural difficulty, and the isolation area of a LAPWI between the use of radiofrequency (RFA) and cryoballoon ablation (CBA). METHODS: We enrolled 95 and 93 patients with PersAF who underwent pulmonary vein isolation (PVI)+LAPWI using RFA (RF group) and CBA (CB group), respectively. Preoperative computed tomography was used to evaluate the anatomical features associated with an incomplete LAPWI. Post-ablation 3-dimensional maps were analyzed to quantify the isolation area. RESULTS: The completion rate of the LAPWI was significantly higher in the RF group than the CB group without touch-up RFA (88.4% vs. 72.0%; p = .005). Predictors of incomplete LAPWI were a longer left inferior pulmonary vein (LIPV)-esophageal distance (p < .001) for RFA and a steeper angle of the LAPW (p < .001) and longer transverse LAPW diameter (p = .016) for CBA. The isolated non-PV area with RFA or CBA alone was significantly greater in the CB group than the RF group (27.5 ± 9.5 cm2 vs. 22.9 ± 6.9 cm2 ; p < .001). CONCLUSION: The position of the esophagus at a distance from the LIPV was associated with an incomplete LAPWI using RFA, while a steeper angle of the LAPW and transverse enlargement of the LAPW were associated with that using CBA. The completion rate of the LAPWI was higher with RFA, but the isolation area outside of the PVs was greater with CBA.

Effect of ozone stress on crop productivity: A threat to food security.

Tropospheric ozone (O3), the most important phytotoxic air pollutant, can deteriorate crop quality and productivity. Notably, satellite and ground-level observations-based multimodel simulations demonstrate that the present and future predicted O3 exposures could threaten food security. Hence, the present study aims at reviewing the phytotoxicity caused by O3 pollution, which threatens the food security. The present review encompasses three major aspects; wherein the past and prevailing O3 concentrations in various regions were compiled at first, followed by discussing the physiological, biochemical and yield responses of economically important crop species, and considering the potential of O3 protectants to alleviate O3-induced phytotoxicity. Finally, the empirical data reported in the literature were quantitatively analysed to show that O3 causes detrimental effect on physiological traits, photosynthetic pigments, growth and yield attributes. The review on prevailing O3 concentrations over various regions, where economically important crop are grown, and their negative impact would support policy makers to implement air pollution regulations and the scientific community to develop countermeasures against O3 phytotoxicity for maintaining food security.

Monocyte subsets associated with the efficacy of anti­PD­1 antibody monotherapy.

Immune checkpoint inhibitors (ICIs) are among the most notable advances in cancer immunotherapy; however, reliable biomarkers for the efficacy of ICIs are yet to be reported. Programmed death (PD)-ligand 1 (L1)-expressing CD14+ monocytes are associated with shorter overall survival (OS) time in patients with cancer treated with anti-PD-1 antibodies. The present study focused on the classification of monocytes into three subsets: Classical, intermediate and non-classical. A total of 44 patients with different types of cancer treated with anti-PD-1 monotherapy (pembrolizumab or nivolumab) were enrolled in the present study. The percentage of each monocyte subset was investigated, and the percentage of cells expressing PD-L1 or PD-1 within each of the three subsets was further analyzed. Higher pretreatment classical monocyte percentages were correlated with shorter OS (r=-0.32; P=0.032), whereas higher non-classical monocyte percentages were correlated with a favorable OS (r=0.39; P=0.0083). PD-L1-expressing classical monocytes accounted for a higher percentage of the total monocytes than non-classical monocytes with PD-L1 expression. In patients with non-small cell lung cancer (NSCLC), a higher percentage of PD-L1-expressing classical monocytes was correlated with shorter OS (r=-0.60; P=0.012), which is similar to the observation for the whole patient cohort. Comparatively, higher percentages of non-classical monocytes expressing PD-L1 were significantly associated with better OS, especially in patients with NSCLC (r=0.60; P=0.010). Moreover, a higher percentage of non-classical monocytes contributed to prolonged progression-free survival in patients with NSCLC (r=0.50; P=0.042), with similar results for PD-L1-expressing non-classical monocytes. The results suggested that the percentage of monocyte subsets in patients with cancer before anti-PD-1 monotherapy may predict the treatment efficacy and prognosis. Furthermore, more classical monocytes and fewer non-classical monocytes, especially those expressing PD-L1, are involved in shortening OS time, which may indicate the poor efficiency of anti-PD-1 treatment approaches.

The First Case in Japan of Fulminant Myocarditis Due to Multisystem Inflammatory Syndrome in Children (MIS-C) That Required Mechanical Circulatory Support.

Multisystem inflammatory syndrome in children (MIS-C) is a novel hyperinflammatory syndrome that is associated with severe acute respiratory syndrome coronavirus 2 infections. Reports describing the mechanical circulatory support (MCS) and myocardial biopsy for fulminant myocarditis due to MIS-C are limited.A 13-year-old male patient with MIS-C underwent treatment, including immunosuppressive therapy and MCS devices, and managed to recover from pulseless electrical activity cardiac arrest.This is the first patient in Japan with MIS-C who required MCS devices in Japan. Appropriate and immediate treatment with immunosuppressive therapy and MCS devices is important.

Therapeutic Potential of Seaweed-Derived Laminaran: Attenuation of Clinical Drug Cytotoxicity and Reactive Oxygen Species Scavenging.

ß-glucan has been shown to be effective for several diseases such as immune regulation and blood pressure suppression. Seaweed contains a ß-1,3/1,6-glucan called laminaran. The present commercial source of ß-glucan is black yeast; however, a fermentation process using organic carbon substrates makes production unsustainable, whereas macroalgae provide a sustainable alternative with the use of CO2 and seawater as growth substrates. However, bioactivity studies on laminaran are limited. We aimed to evaluate whether laminaran can scavenge reactive oxygen species (ROS) and attenuate cytotoxicity caused by clinical drugs such as indomethacin (Ind) and dabigatran (Dab). Electron spin resonance assay revealed that laminaran scavenged singlet oxygen (1O2) and superoxide anions (O2•-) directly but did not scavenge hydroxyl radicals (•OH). Mitochondrial ROS detection dye showed that laminaran scavenged mitochondrial O2•- produced upon administration of Ind or Dab. Moreover, significant reductions in •OH and peroxynitrate (ONOO-) levels were observed. Since •OH and ONOO- are generated from O2•- in the cells, laminaran could indirectly suppress the generation of •OH and ONOO- via the removal of O2•-. Both Ind and Dab induce cell injury via ROS production. Laminaran attenuated the cytotoxicity derived from these drugs and may represent a functional food with anti-aging and disease prevention properties.

Associations of Dental Health With the Progression of Hippocampal Atrophy in Community-Dwelling Individuals: The Ohasama Study.

BACKGROUND AND OBJECTIVES: Although tooth loss and periodontitis have been considered risk factors of Alzheimer disease, recent longitudinal researches have not found a significant association with hippocampal atrophy. Therefore, this study aimed to clarify a longitudinal association between the number of teeth present (NTP) and hippocampal atrophy dependent on the severity of periodontitis in a late middle-aged and older adult population. METHODS: This study included community-dwelling individuals aged 55 years or older who had no cognitive decline and had undergone brain MRI and oral and systemic data collection twice at 4-year intervals. Hippocampal volumes were obtained from MRIs by automated region-of-interest analysis. The mean periodontal probing depth (PD) was used as a measure of periodontitis. Multiple regression analysis was performed with the annual symmetric percentage change (SPC) of the hippocampal volume as the dependent variable and including an interaction term between NTP and mean PD as the independent variable. The interaction details were examined using the Johnson-Neyman technique and simple slope analysis. The 3-way interaction of NTP, mean PD, and time on hippocampal volume was analyzed using a linear mixed-effects model, and the interaction of NTP and time was examined in subgroups divided by the median mean PD. In all models, dropout bias was adjusted by inverse probability weighting. RESULTS: Data of 172 participants were analyzed. The qualitative interaction between NTP and the mean PD was significant for the annual SPC in the left hippocampus. The regression coefficient of the NTP on the annual SPC in the left hippocampus was positive (B = 0.038, p = 0.026) at the low-level mean PD (mean -1 SD) and negative (B = -0.054, p = 0.001) at the high-level mean PD (mean +1 SD). Similar results were obtained in the linear mixed-effects model; the interaction of NTP and time was significant in the higher mean PD group. DISCUSSION: In a late middle-aged and older cohort, fewer teeth were associated with a faster rate of left hippocampal atrophy in patients with mild periodontitis, whereas having more teeth was associated with a faster rate of atrophy in those with severe periodontitis. The importance of keeping teeth healthy is suggested.

Relationship between the amount of black carbon particles deposited on the leaf surface and leaf surface traits in nine urban greening tree species.

To select urban greening tree species suitable for the purification of the atmosphere polluted by black carbon (BC) particles, it is necessary to clarify the determinants of the amount of BC particles deposited on the tree leaves. In the present study, we investigated the relationship between the amount of BC particles that were deposited from the atmosphere and firmly adhered to the leaf epicuticular wax, and leaf surface traits in seedlings of nine tree species grown for two years under natural conditions (Fuchu, Tokyo, Japan). There was a significant interspecific difference in the maximum amount of BC particles deposited on the leaf surface, and the order was as follows: Ilex rotunda > Cornus florida > Osmanthus fragrans > Cornus kousa > Quercus glauca ≒ Quercus myrsinifolia > Magnolia kobus ≒ Zelkova serrata ≒ Styrax japonicus. In the nine tree species, significant highly positive correlations were observed between the amount of BC particles deposited on the leaf surface, and the hydrophobicity of leaf epicuticular wax determined by its chemical composition. Therefore, we concluded that the hydrophobicity of leaf epicuticular wax is an important determinant of the amount of BC particles deposited on the leaf surface of urban greening tree species.

This is the first paper that shows that the hydrophobicity of leaf epicuticular wax is an important determinant of the amount of BC particles deposited on the leaf surface of urban greening tree species. This study will provide the basic and novel information for the selection of urban greening tree species suitable for the purification of the air polluted by BC particles.

Overexpression of GRK2 in vascular smooth muscle leads to inappropriate hypertension and acute heart failure as in clinical scenario 1.

Clinical scenario 1 (CS1) is acute heart failure (HF) characterized by transient systolic blood pressure (SBP) elevation and pulmonary congestion. Although it is managed by vasodilators, the molecular mechanism remains unclear. The sympathetic nervous system plays a key role in HF, and desensitization of cardiac ß-adrenergic receptor (AR) signaling due to G protein-coupled receptor kinase 2 (GRK2) upregulation is known. However, vascular ß-AR signaling that regulates cardiac afterload remains unelucidated in HF. We hypothesized that upregulation of vascular GRK2 leads to pathological conditions similar to CS1. GRK2 was overexpressed in vascular smooth muscle (VSM) of normal adult male mice by peritoneally injected adeno-associated viral vectors driven by the myosin heavy chain 11 promoter. Upregulation of GRK2 in VSM of GRK2 overexpressing mice augmented the absolute increase in SBP (+ 22.5 ± 4.3 mmHg vs. + 36.0 ± 4.0 mmHg, P < 0.01) and lung wet weight (4.28 ± 0.05 mg/g vs. 4.76 ± 0.15 mg/g, P < 0.01) by epinephrine as compared to those in control mice. Additionally, the expression of brain natriuretic peptide mRNA was doubled in GRK2 overexpressing mice as compared to that in control mice (P < 0.05). These findings were similar to CS1. GRK2 overexpression in VSM may cause inappropriate hypertension and HF, as in CS1.

Effect of scan strategy on the formation of a pure nickel single-crystal structure using a flat-top laser beam via laser powder bed fusion.

In this study, the role of a scan strategy in the fabrication of a single crystal (SX) structure of face-centered cubic (fcc) pure Ni using a flat-top laser profile by a laser powder bed fusion (LPBF) process was investigated. A flat-top laser with a uniform heat intensity across the beam profile was employed to fabricate the SX structure with a <001> texture parallel to the build direction (║BD). A meander scan strategy with an XY-90° scan rotation was required to achieve the flat-top-derived SX structure. The meander scanning strategy promoted the epitaxial <001> fcc growth along the direction ║BD, leading to the <001>║BD texture formation. Meanwhile, the XY-90° scan rotation induced the epitaxial growth of <001> fcc phase on the hatch direction (HD)-scan direction (SD) plane in the direction deviated by approximately 45° relative to the SD. This 45° deviation relative to the SD occurred to accommodate the beam movement and the circular beam geometry on the HD - SD plane, resulting in the preferred configurations of <011>║SD and HD. Thus, this paper reports the importance of meander scanning with a 90° scan-rotation strategy to yield a flat-top-LPBF-derived SX structure with <001>║BD and <011>║SD and HD textures.

Effects of elevated ozone and carbon dioxide on the dynamic photosynthesis of Fagus crenata seedlings under variable light conditions.

Ozone (O3) is an air pollutant that is toxic to trees. O3 reduces steady-state net photosynthetic rate (A), and the adverse effects of O3 are mitigated under elevated CO2 condition. However, the combined effects of O3 and elevated CO2 on dynamic photosynthesis under variable light conditions have not yet been clarified. In this study, we investigated the effects of O3 and elevated CO2 on dynamic photosynthesis in the leaves of Fagus crenata seedlings under variable light conditions. The seedlings were grown under four gas treatments comprising two levels of O3 concentration (lower and two times higher than the ambient O3 concentration) and two levels of CO2 concentration (ambient and 700 ppm). Although O3 significantly decreased steady-state A under ambient CO2 concentrations, no significant decrease was observed under elevated CO2 concentrations, indicating the mitigating effect of elevated CO2 on O3-induced adverse effects on steady-state A. During photosynthetic induction, the response of A to the change in photosynthetic photon flux density (PPFD) from 50 (low light) to 1000 µmol m-2 s-1 (high light) showed that the increase in A was slowed by O3 and accelerated by elevated CO2. Under fluctuating light condition of repeating low light for 4 min and high light for 1 min, A at end of each high light period gradually decreased in all treatments, and O3 and elevated CO2 accelerated the reduction of A. In contrast to steady-state A, no mitigating effect of elevated CO2 was observed for any parameters related to dynamic photosynthesis. We conclude that the combined effects of O3 and elevated CO2 on A of F. crenata are different under steady-state and variable light conditions, and the O3-induced decrease in leaf A may not be mitigated by elevated CO2 in the field under variable light conditions.

Derivation and validation of a clinical predictive model of NT-proBNP ≥125 pg/mL to detect pre-heart failure.

BACKGROUND: Several guidelines recommend the measurement of N-terminal pro-B-type natriuretic peptide (NT-proBNP) to diagnose heart failure (HF); however, no screening criteria for measuring NT-proBNP in asymptomatic patients exist. We develop/validate a clinical prediction model for elevated NT-proBNP to support clinical outpatient decision-making. METHODS: In this multicenter cohort study, we used a derivation cohort (24 facilities) from 2017 to 2021 and a validation cohort at one facility from 2020 to 2021. Patients were aged ≥65 years with at least one risk factor of HF. The primary endpoint was NT-proBNP ≥125 pg/mL. The final model was selected using backward stepwise logistic regression analysis. Diagnostic performance was evaluated for sensitivity and specificity, the area under the curve (AUC), and calibration. In total, 1645 patients (derivation cohort, n = 837; validation cohort, n = 808) were included, of whom 378 (23.0 %) had NT-proBNP ≥125 pg/mL. Body mass index, age, systolic blood pressure, estimated glomerular filtration rate, cardiothoracic ratio, and heart disease were used as predictors and aggregated into a BASE-CH score of 0-11 points. RESULTS: Internal validation resulted in an AUC of 0.74 and an external validation AUC of 0.70. CONCLUSIONS: Based on available clinical and laboratory variables, we developed and validated a new risk score to predict NT-proBNP ≥125 pg/mL in patients at risk for HF or with pre-HF.

Stomatal ozone uptake of a Quercus serrata stand based on sap flow measurements with calibrated thermal dissipation sensors.

The amount of ozone absorbed by the tree leaves is a critical factor determining the ozone effects on forest trees. Stomatal ozone uptake of a forest canopy can be estimated from the ozone concentration and canopy conductance (gc) determined by the sap-flow-based method. This method measures sap flow as a metric of crown transpiration and then derives gc. The thermal dissipation method (TDM) has been used to measure sap flow in most studies adopting this approach. However, recent studies have indicated that TDM may underestimate sap flow, especially in ring-porous tree species. In the present study, the accumulated stomatal ozone uptake (AFST) of a stand of Quercus serrata, a typical ring-porous tree species in Japan, was estimated by measuring sap flow using species-specific calibrated TDM sensors. Laboratory calibration of the TDM sensors revealed that the parameters (α and ß) in an equation converting outputs from the sensors (K) to sap flux density (Fd) were substantially larger for Q. serrata than those originally proposed by Granier (1987). The Fd measured in the Q. serrata stand using calibrated TDM sensors were significantly larger than those obtained using non-calibrated sensors. The diurnal average of gc and daytime AFST (10.4 mm s-1 and 10.96 mmol O3 m-2 month-1) of the Q. serrata stand estimated by using calibrated TDM sensors in August 2020 were similar to those of forests dominated by Quercus species estimated by micrometeorological measurements in previous studies. In contrast, the gc and daytime AFST of the Q. serrata stand estimated by non-calibrated TDM sensors were remarkably lower than those estimated by micrometeorological measurements in previous studies, indicating severe underestimation. Therefore, it is strongly recommended that sap flow sensors are species-specifically calibrated when estimating the canopy conductance and ozone uptake of forests dominated by ring-porous trees based on sap flow measurements using TDM.

Prevention of Contrast-Induced Nephropathy After Emergency Percutaneous Coronary Intervention With a Single Bolus Administration of High-Concentrate Sodium Bicarbonate　- Rationale and Design of a Single-Arm Study Compared With Historical Controls.

Background: Contrast-induced nephropathy (CIN) is clinically important because of its poor prognosis. The incidence of CIN is higher in emergency than elective percutaneous coronary intervention (PCI) because there is no established method to prevent CIN. The aim of this study is to evaluate whether bolus administration of a concentrated solution of sodium bicarbonate can prevent CIN in patients undergoing emergency PCI. Methods and Results: This multicenter prospective single-arm trial with historical controls will include patients who are aged ≥20 years and will undergo cardiac catheterization for suspected acute myocardial infarction (AMI). Patients will receive an intravenous bolus administration of concentrated sodium bicarbonate solution (7% or 8.4%, 20 mEq) and will be observed for 72±12 h. Data for the control group, comprising all patients who underwent PCI for AMI between January 1, 2020 and December 31, 2020 across participating hospitals, will be extracted. The primary endpoint is the incidence of CIN, defined as an increase in serum creatinine of >0.5 mg/dL or >25% from baseline within 48±12 h. We will evaluate the endpoints in the prospective group and compare them with those in the historical control group. Conclusions: This study will evaluate whether a single bolus administration of concentrated sodium bicarbonate can prevent CIN after emergency PCI.