A Case of Combining Coronary Angiography and CT Angiography to Diagnose an Acute ST Segment Elevation Myocardial Infarction and a Single Coronary Artery

Coronary artery anomalies encompass a wide spectrum of clinical presentations and pathophysiological mechanisms, exhibiting signifcant heterogeneity. The majority of coronary artery anomalies exhibit negligible clinical manifestations.. Among these anomalies, the occurrence of a single left coronary artery with congenital right coronary artery agenesis represents an exceedingly rare manifestation. This case report presents the clinical profle of a 37-year-old male patient who underwent intervention and coronary CT to confrm his acute myocardial infarction and a solitary left coronary artery. Athorough understanding of coronary variations and the identifcation of coronary lesions can enable cardiovascular physicians to adopt more personalized treatment strategies for their patients

Cascade degradation and upcycling of polystyrene waste to high-value chemicals

Plastic waste represents one of the most urgent environmental challenges facing humankind. Upcycling has been proposed to solve the low profitability and high market sensitivity of known recycling methods. Existing upcycling methods operate under energy-intense conditions and use precious-metal catalysts, but produce low-value oligomers, monomers, and common aromatics. Herein, we report a tandem degradation-upcycling strategy to exploit high-value chemicals from polystyrene (PS) waste with high selectivity. We first degrade PS waste to aromatics using ultraviolet (UV) light and then valorize the intermediate to diphenylmethane. Low-cost AlCl3 catalyzes both the reactions of degradation and upcycling at ambient temperatures under atmospheric pressure. The degraded intermediates can advantageously serve as solvents for processing the solid plastic wastes, forming a self-sustainable circuitry. The low-value-input and high-value-output approach is thus substantially more sustainable and economically viable than conventional thermal processes, which operate at high-temperature, high-pressure conditions and use precious-metal catalysts, but produce low-value oligomers, monomers, and common aromatics. The cascade strategy is resilient to impurities from plastic waste streams and is generalizable to other high-value chemicals (e.g., benzophenone, 1,2-diphenylethane, and 4-phenyl-4-oxo butyric acid). The upcycling to diphenylmethane was tested at 1-kg laboratory scale and attested by industrial-scale techno-economic analysis, demonstrating sustainability and economic viability without government subsidies or tax credits

Summer extreme consecutive dry days over Northeast China in the changing climate: Observed features and projected future changes based on CESM-LE

Northeast China (NEC) is a major crop base in East Asia, and summer drought is one of the climate extremes that significantly influences NEC agricultural production. Therefore, understanding the response of NEC summer drought to global warming is of significance. In this study, based on observation and large-ensemble simulations of the Community Earth System Model (CESM-LE), the variabilities in summer extreme consecutive dry days (CDDs) over NEC are investigated in the present and future climate. In the observation, the NEC summer extreme CDDs showed an increasing trend during the past half century and experienced a significant interdecadal change around the middle 1990s, which is mainly due to the change in the anticyclone over Lake Baikal-Northeast Asia. The anticyclone-related anomalous downward motion and moisture divergence provided favorable conditions for increased summer CDDs over NEC. The CESM-LE multimember ensemble (MME) simulation could reproduce the change in NEC summer extreme CDDs and its related atmospheric circulations, indicating that the observed change in NEC summer extreme CDDs could be largely contributed by anthropogenic forcing. In the future warmer climate, the NEC summer extreme CDDs are projected to show interdecadal variability, which increase by approximately 6.7% in the early 21st century (2020–2030), then decrease by approximately 0.3% in the middle to late 21st century (2040–2080), and further increase by approximately 2.1% in the late 21st century (2085–2100). In addition, the projected changes in the anticyclone over Lake Baikal-Northeast Asia show a similar feature to that of the NEC summer extreme CDDs, which might further provide some confidence in the projection of the NEC summer extreme CDDs due to the physical connection between CDDs and anticyclone in the future

Excited-state spectroscopy of spin defects in hexagonal boron nitride

We used optically detected magnetic resonance (ODMR) technique to directly probe electron-spin resonance transitions in the excited state of negatively-charged boron vacancy (VB-) defects in hexagonal boron nitride (hBN) at room temperature. The data showed that the excited state has a zero-field splitting of ~ 2.1 GHz, a g factor similar to the ground state and two types of hyperfine splitting ~ 90 MHz and ~ 18.8 MHz respectively. Pulsed ODMR experiments were conducted to further verify observed resonant peaks corresponding to spin transitions in the excited state. In addition, negative peaks in photoluminescence and ODMR contrast as a function of magnetic field magnitude and angle at level anti-crossing were observed and explained by coherent spin precession and anisotropic relaxation. This work provided significant insights for studying the structure of VB- excited states, which might be used for quantum information processing and nanoscale quantum sensing

Revealing intrinsic domains and fluctuations of moir\'e magnetism by a wide-field quantum microscope

Moir\'e magnetism featured by stacking engineered atomic registry and lattice interactions has recently emerged as an appealing quantum state of matter at the forefront condensed matter physics research. Nanoscale imaging of moir\'e magnets is highly desirable and serves as a prerequisite to investigate a broad range of intriguing physics underlying the interplay between topology, electronic correlations, and unconventional nanomagnetism. Here we report spin defect-based wide-field imaging of magnetic domains and spin fluctuations in twisted double trilayer (tDT) chromium triiodide CrI3. We explicitly show that intrinsic moir\'e domains of opposite magnetizations appear over arrays of moir\'e supercells in low-twist-angle tDT CrI3. In contrast, spin fluctuations measured in tDT CrI3 manifest little spatial variations on the same mesoscopic length scale due to the dominant driving force of intralayer exchange interaction. Our results enrich the current understanding of exotic magnetic phases sustained by moir\'e magnetism and highlight the opportunities provided by quantum spin sensors in probing microscopic spin related phenomena on two-dimensional flatland

Experience of management of pediatric upper gastrointestinal perforations: a series of 30 cases

BackgroundThis study aimed to explore the characteristics of pediatric upper gastrointestinal (UGI) perforations, focusing on their diagnosis and management.MethodsBetween January 2013 and December 2021, 30 children with confirmed UGI perforations were enrolled, and their clinical data were analyzed. Two groups were compared according to management options, including open surgical repair (OSR) and laparoscopic/gastroscopic repair (LR).ResultsA total of 30 patients with a median age of 36.0 months (1 day–17 years) were included in the study. There were 19 and 11 patients in the LR and OSR groups, respectively. In the LR group, two patients were treated via exploratory laparoscopy and OSR, and the other patients were managed via gastroscopic repair. Ten and three patients presented the duration from symptom onset to diagnosis within 24 h (p = 0.177) and the number of patients with hemodynamically unstable perforations was 4 and 3 in the LR and OSR groups, respectively. Simple suture or clip closure was performed in 27 patients, and laparoscopically pedicled omental patch repair was performed in two patients. There was no significant difference in operative time and length of hospital stay between the LR and OSR groups. Treatment failed in two patients because of severe sepsis and multiple organ dysfunction syndrome, including one with fungal peritonitis.ConclusionSurgery for pediatric UGI perforations should be selected according to the general status of the patient, age of the patient, duration from symptom onset, inflammation, and perforation site and size. Antibiotic administration and surgical closure remain the main strategies for pediatric UGI perforations