Contrast material–enhanced MRA overestimates severity of carotid stenosis, compared with 3D time-of-flight MRA

AbstractObjectiveNon–contrast-enhanced magnetic resonance angiography (MRA) carotid imaging with the time-of-flight (TOF) technique compares favorably with angiography, ultrasound, and excised plaques. However, gadolinium contrast-enhanced MRA (CE-MRA) has almost universally replaced TOF-MRA, because it reduces imaging time (25 seconds vs 10 minutes) and improves signal-to-noise ratio. In our practice we found alarming discrepancies between CE-MRA and TOF-MRA, which was the impetus for this study.Study designTo compare the two techniques, we measured stenosis, demonstrated on three-dimensional images obtained at TOF and CE-MRA, in 107 carotid arteries in 58 male patients. The measurements were made on a Cemax workstation equipped with enlargement and measurement tools. Measurements to 0.1 mm were made at 90 degrees to the flow channel at the area of maximal stenosis and distal to the bulb where the borders of the internal carotid artery lumen were judged to be parallel (North American Symptomatic Carotid Endarterectomy Trial criteria). Experiments with carotid phantoms were done to test the comtribution of imaging software to image quality.ResultsTwelve arteries were occluded. In the remaining 95 arteries, compared with TOF-MRA, CE-MRA demonstrated a greater degree of stenosis in 42 arteries, a lesser degree of stenosis in 14 arteries, and similar (±5%) stenosis in 39 arteries (P = .02, χ2 analysis). The largest discrepancies were arteries with 0% to 70% stenosis. In those arteries in which CE-MRA identified a greater degree of stenosis than shown with TOF-MRA, mean increase was 21% for 0% to 29% stenosis, 36% for 30% to 49% stenosis, and 38% for of 50% to 69% stenosis. The carotid phantom experiments showed that the imaging parameters of CE-MRA, particularly the plane on which frequency encoding gradients were applied, reduced signal acquisition at the area of stenosis.ConclusionsCollectively these data demonstrate that CE-MRA parameters must be retooled if the method is to be considered reliable for determination of severity of carotid artery stenosis. CE-MRA is an excellent screening technique, but only TOF-MRA should be used to determine degree of carotid artery stenosis

Double-lumen carotid plaque: A morbid configuration

AbstractDuring analysis of carotid plaque anatomy for a multicenter carotid imaging trial, we examined plaque specimens from 5 patients with double internal carotid artery lumina. Four of the 5 patients had symptoms referable to the lesion. The second lumen was noted when the plaque specimens were examined ex vivo with high-resolution (200 μm3) magnetic resonance imaging. Plaque structure was correctly identified in only 1 patient preoperatively. However, during retrospective review of the preoperative imaging studies, the second internal carotid artery lumen was identified in 3 patients

Photodegradation of secondary organic aerosol generated from limonene oxidation by ozone studied with chemical ionization mass spectrometry

Photodegradation of secondary organic aerosol (SOA) prepared by ozone-initiated oxidation of D-limonene is studied with an action spectroscopy approach, which relies on detection of volatile photoproducts with chemical ionization mass-spectrometry as a function of the UV irradiation wavelength. Efficient photodegradation is observed for a broad range of ozone (0.1–300 ppm) and D-limonene (0.02–3 ppm) concentrations used in the preparation of SOA. The observed photoproducts are dominated by oxygenated C1-C3 compounds such as methanol, formic acid, acetaldehyde, acetic acid, and acetone. The irradiation wavelength dependence of the combined yield of the photoproducts closely tracks the absorption spectrum of the SOA material suggesting that photodegradation is not limited to the UV wavelengths. Kinetic simulations suggest that RO<sub>2</sub>+HO<sub>2</sub>/RO<sub>2</sub> reactions represent the dominant route to photochemically active carbonyl and peroxide species in the limonene SOA prepared in these experiments. Similar photodegradation processes are likely to occur in realistic SOA produced by OH- or O<sub>3</sub>-initiated oxidation of biogenic volatile organic compounds in clean air

Non-vitamin K Antagonist Oral Anticoagulants and Cognitive Impairment in Atrial Fibrillation: Insights From the Meta-Analysis of Over 90,000 Patients of Randomized Controlled Trials and Real-World Studies

Background: The relationship between the use of non-vitamin K antagonist oral anticoagulants (NOACs) and the impairment of cognition in atrial fibrillation (AF) remains unknown.Methods: A comprehensive database search of Medline, Embase, Cochrane Library databases, and ClinicalTrials.gov Website was performed for randomized controlled trials (RCTs) reporting cognitive impairment events and observational nationwide database studies reporting adjusted hazard ratio (HR) in AF patients with NOACs. The primacy outcome was a composite of any cognitive impairment. Summary of HRs and 95% confidence intervals (95%CI) were calculated using the fixed- and random-effects models. Subgroup analyses were undertaken according to the individual NOACs, study types, and duration of follow-up.Results: Finally, eight studies including 97,595 patients (77,643 patients in 6 RCTs and 19,952 patients in 2 observational database studies) met the inclusion criteria, among which 55,337 (56.7%) patients were receiving NOACs and 42,258 (43.3%) patients were receiving vitamin K Antagonists (VKAs) or acetylsalicylic acid. The results showed a borderline significant association between the use of NOACs and the lower risk of cognitive impairment when compared with VKAs/ acetylsalicylic acid (HR: 0.80, 95%CI: 0.63–0.98 for fixed-effects model; HR: 0.77; 95%CI: 0.53–1.01 for random-effects model), with no significant heterogeneity between the studies (I2 = 39.4%, P = 0.12). The results were consistent across the key subgroups (Pinteraction > 0.05 for each).Conclusions: The results indicated that the use of NOACs might lower the tendency on the risk of cognitive impairment in comparison to VKAs/acetylsalicylic acid, and further RCTs and real-world studies are required on an urgent basis to obtain a robust result

Nocturnal surface ozone enhancement over Portugal during winter: Influence of different atmospheric conditions

our distinct nocturnal surface ozone (NSO) enhancement events were observed, with NSO concentration exceeding 80μg/m3, at multiple ozone (O3) monitoring stations (32 sites) in January, November and December between year 2000–2010, in Portugal. The reasonable explanation for the observed bimodal pattern of surface ozone with enhanced NSO concentration during nighttime has to be transport processes, as the surface ozone production ceases at nighttime. Simultaneous measurements of O3 at multiple stations during the study period in Portugal suggest that horizontal advection alone cannot explain the observed NSO enhancement. Thus, detailed analysis of the atmospheric conditions, simulated with the Weather Research and Forecasting (WRF) model, were performed to evaluate the atmospheric mechanisms responsible for NSO enhancement in the region. Simulations revealed that each event occurred as a result of one or the combination of different atmospheric processes such as, passage of a cold front followed by a subsidence zone; passage of a moving surface trough, with associated strong horizontal wind speed and vertical shear; combination of vertical and horizontal transport at the synoptic scale; formation of a low level jet with associated vertical mixing below the jet stream. The study confirmed that large-scale flow pattern resulting in enhanced vertical mixing in the nocturnal boundary layer, plays a key role in the NSO enhancement events, which frequently occur over Portugal during winter months

Identification and characterization by LC-UV-MS/MS of melanotan II skin-tanning products sold illegally on the Internet

New methods were developed and validated to determine the identity, contents, and purity of samples of melanotan II, asynthetic melanocortin receptor agonist, sold in vials as injectable skin-tanning products that were purchased from three online shops. Methods were based on liquid chromatography with ultra-violet detection (LC-UV) at wavelength 218 nm, and tandem mass spectrometric detection (MS/MS) after collision-induced fragmentation of the double charged [M+2H]²⁺precursor ion (m/z ²⁺513). Identification of melanotan II was verified by correct chromatographic retention time, and relative abundance ratios of five qualifying fragment ions. LC-UV was used to quantify melanotan II as well as impurities. Method validation was performed with reference to guidelines for assessing active substances in authorized medicinal products to reach acceptable accuracy and precision. Vials from two shops contained unknown impurities ranging from 4.1 to 5.9%; impurities from one shop were below the quantification limit. The total amount of melanotan II in vials ranged between 4.32 and 8.84 mg, although each shop claimed that vials contained 10 mg melanotan II. A broad range of drugs used for enhancement purposes can be obtained from the illicit market. However, users of these drugs may be exposed to a range of potential harms, as shown in this study, given that these products are manufactured, distributed and supplied from an illicit market

Fully Gapped Single-Particle Excitations in the Lightly Doped Cuprates

The low-energy excitations of the lightly doped cuprates were studied by angle-resolved photoemission spectroscopy. A finite gap was measured over the entire Brillouin zone, including along the d_{x^2 - y^2} nodal line. This effect was observed to be generic to the normal states of numerous cuprates, including hole-doped La_{2-x}Sr_{x}CuO_{4} and Ca_{2-x}Na_{x}CuO_{2}Cl_{2} and electron-doped Nd_{2-x}Ce_{x}CuO_{4}. In all compounds, the gap appears to close with increasing carrier doping. We consider various scenarios to explain our results, including the possible effects of chemical disorder, electronic inhomogeneity, and a competing phase.Comment: To appear in Phys. Rev.

Baichuan 2: Open Large-scale Language Models

Large language models (LLMs) have demonstrated remarkable performance on a variety of natural language tasks based on just a few examples of natural language instructions, reducing the need for extensive feature engineering. However, most powerful LLMs are closed-source or limited in their capability for languages other than English. In this technical report, we present Baichuan 2, a series of large-scale multilingual language models containing 7 billion and 13 billion parameters, trained from scratch, on 2.6 trillion tokens. Baichuan 2 matches or outperforms other open-source models of similar size on public benchmarks like MMLU, CMMLU, GSM8K, and HumanEval. Furthermore, Baichuan 2 excels in vertical domains such as medicine and law. We will release all pre-training model checkpoints to benefit the research community in better understanding the training dynamics of Baichuan 2.Comment: Baichuan 2 technical report. Github: https://github.com/baichuan-inc/Baichuan

Nuclear Clusters as a Probe for Expansion Flow in Heavy Ion Reactions at 10-15AGeV

A phase space coalescence description based on the Wigner-function method for cluster formation in relativistic nucleus-nucleus collisions is presented. The momentum distributions of nuclear clusters d,t and He are predicted for central Au(11.6AGeV)Au and Si(14.6AGeV)Si reactions in the framework of the RQMD transport approach. Transverse expansion leads to a strong shoulder-arm shape and different inverse slope parameters in the transverse spectra of nuclear clusters deviating markedly from thermal distributions. A clear ``bounce-off'' event shape is seen: the averaged transverse flow velocities in the reaction plane are for clusters larger than for protons. The cluster yields --particularly at low $p_t$ at midrapidities-- and the in-plane (anti)flow of clusters and pions change if suitably strong baryon potential interactions are included. This allows to study the transient pressure at high density via the event shape analysis of nucleons, nucleon clusters and other hadrons.Comment: 38 pages, 9 figures, LaTeX type, eps used, subm. to Phys. Rev.

Progress in Neutron Scattering Studies of Spin Excitations in High-Tc Cuprates

Neutron scattering experiments continue to improve our knowledge of spin fluctuations in layered cuprates, excitations that are symptomatic of the electronic correlations underlying high-temperature superconductivity. Time-of-flight spectrometers, together with new and varied single crystal samples, have provided a more complete characterization of the magnetic energy spectrum and its variation with carrier concentration. While the spin excitations appear anomalous in comparison with simple model systems, there is clear consistency among a variety of cuprate families. Focusing initially on hole-doped systems, we review the nature of the magnetic spectrum, and variations in magnetic spectral weight with doping. We consider connections with the phenomena of charge and spin stripe order, and the potential generality of such correlations as suggested by studies of magnetic-field and impurity induced order. We contrast the behavior of the hole-doped systems with the trends found in the electron-doped superconductors. Returning to hole-doped cuprates, studies of translation-symmetry-preserving magnetic order are discussed, along with efforts to explore new systems. We conclude with a discussion of future challenges.Comment: revised version, to be published in JPSJ, 20 pages, 21 figure