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Antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are commonly prescribed for depression treatment. Animal studies have shown that antidepressants can influence gut microbiota composition and specific bacterial taxa. We aimed to investigate the association between antidepressant use and human gut microbiota composition and functional pathway. We collected information on antidepressant use, demographic, food patterns, and clinical characteristics through questionnaires and medical records. The gut microbiota profiles of 271 depressive patients were carried out through 16S rRNA gene sequencing. Patients were categorized based on different types of antidepressant use groups for gut microbiota comparisons. MaAsLin2 was performed to evaluate microbiota composition across groups. PICRUSt2 was used to predict microbiota functional pathways. Patients taking SSRIs or SNRIs had a lower microbiota diversity. We found seven taxa abundances (Turicibacte r, Barnesiella , Lachnospiraceae_ND3007_group , Romboutia , Akkermansia , Dialister , Romboutia and Fusicatenibacter) differed in patients with various types of antidepressants compared with those without antidepressant treatments (p < 0.05). Turicibacte r inversely correlated with depression severity in SSRIs or SNRI users (r = −0.43, p < 0.05). Top identified pathways were related to compound fermentation and biosynthesis in microbiota function. Antidepressant usage, especially SSRIs and SNRIs, associates with changes in gut microbiota composition and specific taxa. Given our study's preliminary cross-sectional nature, further research is warranted to comprehend the relationship between antidepressant use, treatment response, and gut microbiota, aiming to enhance therapeutic interventions in the future. • Patients with antidepressant medications exhibited reduced microbial diversity. • The utilization of antidepressants and the duration of their use were found to be associated with specific taxa abundance. • Distinct patterns of bacterial correlation were observed among different groups of antidepressant use. • Antidepressant use was associated with specific biosynthetic functional pathways. [ABSTRACT FROM AUTHOR]

This research introduces Meta-Analysis Structural Equation Modeling (MASEM), a novel method that integrates meta-analysis (MA) and structural equation modeling (SEM). The method helps researchers to comprehensively understand issues in the strategic management field. Applying MASEM to analyze data from 112 papers, covering 101,981 observations, the results can be summarized as follows. (1) Entrepreneurial orientation (EO) is significantly positively correlated with firm performance (FP), which addresses the issue of inconsistency among prior studies' findings. (2) There is a significantly positive correlation between EO and market orientation (MO) and a significantly positive relationship between MO and FP, indicating that MO is a mediator variable to the EO-FP. (3) Environmental dynamism (ED) increases a positive link exists between MO and FP; in other words, compared to low ED, the presence of high ED enhances the correlation between MO and FP significantly. (4) ED influences the slope of MO's function as a mediator between EO and FP - that is, high ED increases the slope of the intermediary effect of MO on the MO-FP nexus, and low ED reduces the slope of the mediation effect of MO on the MO-FP nexus. These findings provide new thoughts and insights for studies on the correlation between EO and FP and offer substantial suggestions for enterprises. The aforementioned results indicate that besides providing deeper insights and a more comprehensive understanding, MASEM presents deeper insights for researchers and is more efficient than the traditional meta-analysis method. Moreover, MASEM can be applied to in other fields and used with other methods for greater in-depth analyses. Overall, the MASEM technique herein has high reliability and validity when utilized for discussing relationships among variables and gives more comprehensive and accurate conclusions in theoretical and practical aspects. Plain Language Summary: The Relationship Between Entrepreneurial Orientation and Firm Performance From the perspective of MASEM This research proposes meta-analysis structural equation modeling (MASEM), which combines meta-analysis and structural equation modeling. The method helps researchers to comprehensively understand issues in the strategic management field. Applying MASEM to analyze data from 112 papers, covering 101,981 observations. (1) There is a significantly positive relationship between entrepreneurial orientation (EO) and firm performance (FP), which addresses the issue of inconsistency among prior studies' findings. (2) There is a significantly positive relationship between EO and market orientation (MO) and a significantly positive relationship between MO and FP, indicating that MO is a mediator variable to the EO-FP. (3) Environmental dynamism (ED) increases the positive relationship between MO and FP; compared to low ED, high ED has a greater impact on the relationship between MO and FP. (4) ED influences the slope of the mediation effect of MO on the relationship between EO and FP—that is, high ED increases the slope of the mediation effect of MO on the MO-FP nexus, and low ED reduces the slope of the mediation effect of MO on the MO-FP nexus. These findings provide new thoughts and insights for studies on the correlation between EO and FP and offer substantial suggestions for enterprises. [ABSTRACT FROM AUTHOR]

Periodontitis is a common oral disease mainly caused by bacterial infection and inflammation of the gingiva. In the prevention or treatment of periodontitis, anti-bacterial agents are used to inhibit pathogen growth, despite increasing levels of bacterial resistance. Sapindus mukorossi Gaertn (SM) seed oil has proven anti-bacterial and anti-inflammation properties. However, the possibility of using this plant to prevent or treat periodontitis has not been reported previously. The aim of this study was to evaluate the effects of SM oil on experimental periodontitis in rats by using micro-CT and microbiota analysis. The distance between cementoenamel junction (CEJ) and alveolar bone crest (ABC) on the sagittal micro-CT slide showed that total bone loss (TBL) was significantly lower in CEJ-ABC distances between SM oil and SM oil-free groups on Day 14. Histology data also showed less alveolar bone resorption, a result consistent result with micro-CT imaging. The microbiota analyzed at phylum and class levels were compared between the SM oil and SM oil-free groups on Day 7 and Day 14. At the phylum level, Proteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria were the dominant bacterium. Firmicutes in box plot analysis was significantly less in the SM oil group than in the SM oil-free group on Day 7. At the class level, Bacteroidia, Gammaproteobacteria, Bacilli, Clostridia, and Erysipelotrichia were the dominant bacteria. The bacteria composition proportion of Bacilli, Clostridiay, and Erysipelotrichia could be seen in the SM oil group significantly less than in t SM oil-free group on Day 7. Overall, the present results show that topical application of SM oil can reduce bone resorption and change bacteria composition in the ligature-induced periodontitis model. According to these results, it is reasonable to suggest SM oil as a potential material for preventing oral disease. [ABSTRACT FROM AUTHOR]

This study investigates an improvement in memory characteristics through depositing an In2O3 layer as an oxygen ion reservoir in the switching layer (SL) of resistive random access memory (RRAM). The deposition of In2O3, denoted as Pt/HfO2/In2O3/TiN device, provides better memory characteristics including lower forming voltage (VF), set/reset voltage (VSET/VRESET), larger memory window, and higher resistances with higher uniformity at low resistance state (LRS) and high resistance state (HRS), compared to the devices without the In2O3 deposition, denoted as Pt/HfO2/TiN device. The conduction mechanisms, verified through fitting current–voltage (I - V) curves, are consistent with the results of a varied temperature I - V experiment. Finally, a physical model is proposed to explain our observations. [ABSTRACT FROM AUTHOR]

This study examines the influence of different electrode thermal conductivity on switching behavior during the reset process. Electrical analysis methods and an analysis of current conduction mechanism indicate that better thermal conductivity in the electrode will require larger input power in order to induce more active oxygen ions to take part in the reset process. More active oxygen ions result in a more oxidized switching layer, and cause the effective switching gap (dsw) to become larger in the reset process. The effect of the electrode thermal conductivity and input power are explained by our model and clarified by electrical analysis methods. [ABSTRACT FROM AUTHOR]

• Reuse of harbor sediment and BOF slag as lightweight aggregates is feasible. • Sintering at 1175 °C for 15 min after preheating at 500 °C for 10 min is optimal. • BOF slag addition is recommended not exceeding 30% in weight. • The LWA product shows low water-soluble chloride and heavy metals leachability. The purpose of this study was to evaluate the feasibility of lightweight aggregate (LWA) made from dredged harbor sediment and basic oxygen furnace (BOF) slag to increase their reutilization. The effects of preheating, sintering and raw materials proportion on the properties of LWA were discussed in term of particle density, water absorption, and compressive strength. Microscopic structure, water-soluble chloride and heavy metals leachability of the LWA were also examined. Results showed that the mixture of the dredged harbor sediment and BOF slag under the manufacturing process with preheating temperature at 500 °C for 10 min and sintering temperature at 1175 °C for 15 min was conducive to be a low water absorption and high strength LWA, which had as low as 1.73 g cm−3 and 3.45% for dry particle density and water absorption respectively. Its compressive strength reached 23.2 MPa when the addition of BOF slag was up to 27%. The LWA prepared in this study also have very low water-soluble chloride and heavy metals leachability, all compliant with Taiwan regulatory standards, thus would be suitable for further civil engineering application. The results of this study provide useful information on co-treating of wastes and recycled resources as LWA. [ABSTRACT FROM AUTHOR]

The research nature of this study is to examine the priority of English as a foreign language in many non-English speaking countries in the context of globalization with a focus on the importance of English for cross-linguistic communication and interpersonal communication. The research purpose is to understand the effects of language picture books applied to interactive teaching methods on English language learning motivation, learning performance, and language and reading ability of elementary school students in southern Taiwan. The research method used herein is an experimental design model. In total, 192 students in eight classes in Grade Six of two elementary schools in southern Taiwan, each with four classes of 24 students, who used the same picture book materials are taken as the research subjects for an experimental study. The research method includes the application of language picture books to interactive teaching methods, combined with a variety of teaching activities, to create a fun and enjoyable learning atmosphere. The study observes students' active participation and learning performance in the classroom and evaluates the impacts of these activities on their learning motivation, language ability, and reading ability were evaluated. The findings of this study are as follows. 1) The use of the interactive teaching method with language picture books has a significant effect on students' motivation to learn English, by observing students' active participation in the classroom. 2) The English picture books inspire children's curiosity and interest in reading, increase their motivation for English learning, and make them quite interested in reading. 3) The course incorporated a variety of teaching activities to create a happy learning atmosphere, so that students can continue to work toward their English learning goals after the course is over. We also present the conclusions and discussions based on the results in the hope that language picture books can develop students' capacity for listening and concentration and contribute to the development and improvement of their language ability and reading ability. Plain Language Summary: The Impact of Interactive Picture Book Teaching Methods This study aims to understand the effects of applying language picture books to interactive teaching methods on the English learning motivation, performance, and language and reading abilities of elementary school students in southern Taiwan. The research method employed is an experimental design model. In total, 192 students from eight Grade Six classes across two elementary schools in southern Taiwan, each class consisting of 24 students, utilized the same picture book materials for this experimental study. The methodology integrates language picture books with interactive teaching methods, combined with various teaching activities, to create a fun and enjoyable learning environment. This study observes students' active participation and performance in the classroom and evaluates the impact of these activities on their learning motivation, language proficiency, and reading skills. The findings of this study are as follows: 1) The use of interactive teaching methods with language picture books significantly enhances students' motivation to learn English, as evidenced by their active participation in class. 2) English picture books ignite children's curiosity and interest in reading, boosting their motivation to learn English and fostering a profound interest in reading. 3) The curriculum, enriched with diverse teaching activities, establishes a joyful learning atmosphere, motivating students to continue their English learning journey even after the course concludes. Based on the results, we also present conclusions and discussions, hoping that language picture books can cultivate students' listening and concentration abilities and contribute to the growth and enhancement of their language and reading skills. [ABSTRACT FROM AUTHOR]

A novel leaky-wave slot antenna for broadside circularly polarized (CP) radiation is presented. The antenna simply consists of a slotline for the feed, an exponentially tapered slot for the radiator, and a shaped end for the terminator. Separating the feed from the curved radiating slot makes the presented antenna unique in design and compact in size. The resulting antenna yields inherent broadband characteristics of leaky-wave antennas on the input impedance, axial ratio (AR), and radiation gain. Particularly, to solve the tilt-beam problem commonly seen in leak-wave antennas, we proposed an extended dual-slot design that successfully achieved the pattern stability over a wide bandwidth. An antenna module with a reflector for unidirectional pattern applications was also developed. The measured performances of the final prototype were found to exhibit 10-dB return loss bandwidth of 40%, 3-dB AR bandwidth of 53%, and half-power gain bandwidth of 59% with CP gain level about 8 dBic. The measured and simulated results were well consistent with each other. [ABSTRACT FROM PUBLISHER]

A compact sequential-phase (SP) feed for circularly polarized sequential-rotation (SR) arrays is presented. Unlike traditional SP feed using multiple segments for impedance transformations, the presented SP feed employs only a single-stage transition where the transmission line width is uniform, making the whole SP feed very compact and neat in layout. The radial design of SP-feed lines to antenna elements may further facilitate the optimization work in adjusting the element spacing. Two miniature square SP feeds of the sizes \lambdag/4 and 3 \lambdag/8 are given and compared. Experimental prototypes were built and verified with measured results. The proposed compact SP feed can be extended to 2^N\times 2^N feeding networks, and is very suitable for large-scale printed CP arrays. [ABSTRACT FROM PUBLISHER]

Abstract: We have performed electrical transport measurements on InN films. Our results show that the electron transport in our InN films is metallic-like, that is, within the experimental error the carrier density is temperature-independent over a wide temperature range (4K≤T≤290K). At low temperatures, the resistivities of our InN devices appear to saturate and show gradual increase with increasing temperatures. We suggest that residue impurity scattering limits the electron mobility in InN films. We compare our results with existing theoretical models. [Copyright &y& Elsevier]

The HfZrOx (HZO) ferroelectric material is a promising material for ferroelectric memory and is compatible with the semiconductor process for ferroelectric random access memory (FeRAM) and negative capacitance field effect transistor. However, defects often exist in the grain boundary to influence the performance or reliability of devices. In addition, uniformity between devices must be considered when they are mass-produced. Therefore, the grain size will become important in determining the performance and reliability. In this study, we use electrical measurements of current–voltage, capacitance–voltage, and polarization–voltage measurements to test high- and low-temperature deposition devices, with a transmission electron microscope (TEM) image to confirm the grain size. Finally, we propose a model to explain the phenomenon and provide a method to obtain better ferroelectric memory. [ABSTRACT FROM AUTHOR]

In this study, electrical measurements on ferroelectric random-access memory by prior x-ray irradiation are conducted. Compared with an unirradiated device, parameters such as current leakage and remnant polarization of the irradiated device were unexpectedly improved. Besides, better reliabilities including the number of endurance times and retention time have also been demonstrated. To clarify the underlying physical mechanism, the electrical properties are analyzed. The current–voltage curve (I–V) implies a change in the grain size in the ferroelectric layer (FL), and the capacitance–voltage curve (C – V) profile indicates that the FL undergoes a phase change during irradiation. Finally, according to the electrical results, a physical model is proposed as an explanation. [ABSTRACT FROM AUTHOR]

A solid-state semiconductor battery with the n-type WO3/silica-coated TiO2 core–shell nanoparticles/p-type NiO laminated structure for the rechargeable device has been developed. The electricity storage layer comprises poly-acrylonitrile mixed with core–shell nanoparticles containing n-type TiO2 particles coated with an insulating SiO2 shell. The average diameter size of nanoparticles was determined from 20 to 50 nm by a high-resolution transmission electron microscope and the relative atomic weight percentage of the Si on the coated TiO2 nanoparticles had been qualitatively determined by the energy dispersive spectrometer. The silica-coated TiO2 nanoparticles in the composite were assigned to the mixed phases of Anatase and Rutile by XRD analysis. Furthermore, photoluminescence analysis has verified the energy levels present in the bandgap of the silica-coated TiO2 core–shell nanoparticles. The device exhibits a constant-current discharge capacity of 0.16 mA h at a discharge voltage of 2.46 V. The energy density of the charging layer has been estimated to 12.3 Wh/kg. Finally, a mechanism of the solid-state semiconductor battery has also been proposed. [ABSTRACT FROM AUTHOR]

In this study, an advanced supercritical fluid (SCF) technique that is suitable for materials and electronic devices with low temperature (80 °C) and high pressure (4000 psi) is proposed for a ZnO-based resistive random access memory (RRAM). After an SCF treatment, X-ray photoelectron spectroscopy (XPS) analysis confirms that the concentration of oxygen ions increases in the zinc oxide thin film. Moreover, electrical measurements confirm that the treated ZnO-based random access memory exhibits a lower forming voltage, lower set voltage, and higher ratio of high and low resistance states compared with a device without treatment. Next, the carrier transport mechanism is investigated by fitting the current–voltage curves. Finally, physical models are introduced to illustrate the extra oxygen ions that create better memory characteristics in the random access memory device after the SCF treatment. This significant SCF technique increases the content of oxygen ions without altering the original element ratio and maintains a simple device structure. Thus, the technique shows potential for feasible material improvement capable of effective real applications in the near future. [ABSTRACT FROM AUTHOR]

This study compares the capacitance–voltage (C–V) characteristics in silicon–germanium (SiGe) metal-oxide-semiconductor capacitances with and without a silicon oxide capping layer. The SiGe channel with the silicon oxide capping layer exhibits an improved C–V property at room temperature but has an abnormal shift and depression at low temperature (77 K). We determined that the threshold voltage shift was induced by the Fermi-level when ambient temperature was changed. The additional silicon capping layer was responsible for introducing defects resulting in depression and hump in the C–V measurements. Such a phenomenon is mainly caused by the different distribution of defects, which was established by modifying the alternating current pulse amplitude during the C–V measurement. [ABSTRACT FROM AUTHOR]

This research investigates one of the process or element doping methods used to enhance the reliability of resistive random access memory (RRAM). A supercritical fluid process combines the advantages of the high permeability of gas with the solubility of liquids, and this novel process introduces water molecules into the supercritical fluid for oxidation in order to improve the resistance of random storage. In terms of reliability of the memory, while previous research has used an oxygen plasma treatment to improve RRAM device performance, this work performed a comparison of the two methods and found that the supercritical oxidation treatment can reduce the forming voltage by 25% and produce superior electrical operation, with an endurance test exhibiting an increase to 108 cycles and an improvement of 102. The material analysis confirmed that, during the resistance switching process, the switching layer was more oxidized after this novel supercritical oxidation, resulting in the reduction of operating current and improved reliability compared with the plasma oxidation device. [ABSTRACT FROM AUTHOR]

HfZrOx (HZO)-based materials have received much attention due to their special film characteristics in recent years. Ferroelectric random access memory (FeRAM) based on this HZO material also has promising potential as a next generation memory due to its non-volatile characteristics, excellent endurance, and low power consumption. Previous research has mainly focused on the material properties of HZO-based FeRAM. However, an in-depth investigation of the electrical properties of HZO-based FeRAM is necessary to better understand its transporting mechanism. In this contribution, this study aims to investigate the mechanism of an HZO-based metal–ferroelectric-metal capacitor using comprehensive experimental results, including current–voltage, capacitance–voltage, and polarization–voltage measurements. Experiments at various temperatures are also conducted to help verify the transport mechanism. The low current transport by the Fowler–Nordheim tunneling mechanism does not change with temperature, whereas the high current transport via the Schottky mechanism increases with increasing temperature. We found that the orientation of the dipole plays an important role. Finally, we also propose a band model to explain the electron transport in this HZO-based FeRAM. [ABSTRACT FROM AUTHOR]

In the Daya Bay Reactor Neutrino Experiment 960 20-cm-diameter waterproof photomultiplier tubes are used to instrument three water pools as Cherenkov detectors for detecting cosmic-ray muons. Of these 960 photomultiplier tubes, 341 are recycled from the MACRO experiment. A systematic program was undertaken to refurbish them as waterproof assemblies. In the context of passing the water leakage check, a success rate better than 97% was achieved. Details of the design, fabrication, testing, operation, and performance of these waterproofed photomultiplier-tube assemblies are presented. [ABSTRACT FROM AUTHOR]

Nanostructured cobalt selenide (CoSe2) thin films were deposited on a glass substrate using the selenization of Co films at different selenization temperatures (300 °C, 400 °C, and 500 °C) in a pure Se vapor for two hours. The morphology and structure of the as-deposited films shows that the film morphology and crystallinity are affected by the selenization temperature. Increasing the selenization temperature from 300 °C to 400 °C and 500 °C results in a change in the surface and cross sectional morphology. At 300 °C, the Co films have an almost amorphous structure, while at temperatures of 400 and 500 °C, the Co films have a crystalline nanostructure with bilayered morphology. Optical analyses of the CoSe2 films at 500 °C show a large absorption (α > 1.0 × 105 cm−1) and a direct band gap (∼1.0 eV). [ABSTRACT FROM AUTHOR]

Improving material and interface defects are an important issue in reducing solar cell leakage current and enhancing their efficiency. From back surface field (BSF)-based solar cell to passivated emitter and rear cell (PERC), solar cell structures have been designed to reduce defects. In this study, a supercritical fluid (SCF) technique is applied as a low temperature defect passivation technology to passivate defects in a PERC solar cell, enhancing device performance. Owing to the high penetration and high solubility of the supercritical fluid, hydrogen is the passivation source carried into the device to passivate Al 2 O 3 /Si interface defects. Furthermore, electronic analysis is used to confirm the benefits of the SCF treatment on the solar cell properties of open-circuit voltage (Voc), short-circuit current (Jsc), fill factor (FF), efficiency, power (Pmax) and series resistance (Rs), all measured under a standard light source. Finally, a model is proposed to explain how the SCF treatment passivates interface defects and enhances device performance. [Display omitted] [ABSTRACT FROM AUTHOR]

Abstract: Resistive plate chambers will be used in the Daya Bay reactor neutrino experiment to help veto backgrounds created by cosmic-ray muons. The mass production of RPCs began in 2008 and by the end of 2009, 1600 RPCs (3500m2) had been produced and tested. This paper describes the production and quality control procedures, and quality assurance using cosmic-ray testing. [Copyright &y& Elsevier]

Because left atrial (LA) volume plays a critical role in determining cardiovascular outcomes, it was hypothesized that this might be related to the distensibility of the left atrium and how this relates to left ventricular filling pressure (LVFP). Echocardiographic estimates of LVFP were compared to cardiac catheterization measurements in 521 consecutive patients with acute myocardial infarction and correlated with short- and long-term outcomes. Receiver-operating characteristic curve analysis was performed to investigate the sensitivity and specificity of echocardiographic parameters for predicting elevated LVFP (>15 mm Hg). LA distensibility was calculated as (maximal volume − minimal volume) × 100%/minimal volume. and was found to be logarithmically associated with LVFP (p <0.0001). LA distensibility was superior to mitral E/annular Em for identifying increased LVFP (area under the receiver-operating characteristic curve 0.92 vs 0.78). A total of 44 patients died during hospitalization, and 89 patients had died or experienced heart failure requiring rehospitalization at 12-month follow-up. In a multivariate Cox regression model, LA distensibility was an independent predictor of in-hospital mortality (hazard ratio 2.373 for LA distensibility ≤60%, p = 0.026), while LA volume was an independent prognostic factor of 1-year death or heart failure (hazard ratio 2.266 for LA volume ≥34 ml/m2, p = 0.007). In conclusion, LA distensibility accurately identifies patients with increased LVFP after acute myocardial infarction and is an independent predictor of in-hospital mortality. [ABSTRACT FROM AUTHOR]

Echocardiograms and left ventricular (LV) filling pressure were obtained from 95 patients with chronic severe mitral regurgitation (MR) and 16 patients with acute severe MR. All patients underwent catheterization for preoperative examinations and LV filling pressure measurements. A total of 52 age-, gender- and co-morbidity–matched patients with negative coronary angiographic results served as the controls. Echocardiography, including assessment of left atrial (LA) distensibility, was performed simultaneously. LA distensibility correlated logarithmically with the LV filling pressure. However, the early-diastolic mitral inflow velocity divided by the early-diastolic mitral annular velocity (mitral E/E′) correlated linearly with the LV filling pressure. Bivariate correlation analysis revealed that LV filling pressure correlated positively with the maximum and minimum indexed LA volume, as well as the E/E′, but the LV filling pressure correlated negatively with LA distensibility, LA ejection fraction, and LV ejection fraction. However, the MR regurgitation volume was associated only with the maximum and minimum indexed LA volume. Receiver operating characteristic curve analysis indicated that LA distensibility was not inferior to E/E′ for identifying a LV filling pressure >15 mm Hg. However, to identify acute severe MR, LA distensibility was superior to E/E′. In conclusion, LA distensibility, as is E/E′, is a valuable diastolic parameter. In patients with severe MR, it offers adequate power to assess the LV filling pressure and to identify acute severe MR. [Copyright &y& Elsevier]

Abstract: Background: Classifying acute coronary syndrome (ACS) as ST elevation ACS (STE-ACS) or non-ST elevation ACS (NSTE-ACS) is critical for clinical prognosis and therapeutic decision-making. Assessing the differences in composition and configuration of culprit lesions between STE-ACS and NSTE-ACS can clarify their pathophysiologic differences. Objective: This study focused on evaluating the ability of 64-slice multidetector computed tomography (MDCT) to investigate these differences in culprit lesions in patients with STE-ACS and NSTE-ACS. Methods: Of 161 ACS cases admitted, 120 who fit study criteria underwent MDCT and conventional coronary angiography. The following MDCT data were analyzed: calcium volume, Agatston calcium scores, plaque area, plaque burden, remodeling index, and plaque density. Results: The MDCT angiography had a good correlation with conventional coronary angiography regarding the stenotic severity of culprit lesions (r = 0.86, p <0.001). The STE-ACS culprit lesions (n =54) had significantly higher luminal area stenosis (78.6±21.2% vs. 66.7±23.9%, p =0.006), larger plaque burden (0.91±0.10 vs. 0.84±0.12, p =0.007) and remodeling index (1.28±0.34 vs. 1.16±0.22, p =0.021) than those with NSTE-ACS (n =66). The percentage of expanding remodeling index (remodeling index >1.05) was significantly higher in the STE-ACS group (81.5% vs. 63.6%, p =0.031). The patients with STE-ACS had significantly lower MDCT density of culprit lesions than patients with NSTE-ACS (25.8±13.9HU vs. 43.5±19.1HU, p <0.001). Conclusions: Sixty-four-slice MDCT can accurately evaluate the stenotic severity and composition of culprit lesions in selected patients with either STE-ACS or NSTE-ACS. Culprit lesions in NSTE-ACS patients had significantly lower luminal area stenosis, plaque burden, remodeling index and higher MDCT density, which possibly reflect differences in the composition of vulnerable culprit plaques and thrombi. [Copyright &y& Elsevier]

The objective of this study was to develop tissue Doppler parameters that could be used to differentiate right ventricular (RV) volume overload from RV pressure overload. The RV-pressure-overload group consisted of 40 patients with severe pulmonary hypertension, and the RV-volume-overload group consisted of 40 patients who had an atrial septal defect without evidence of right-to-left shunt, significant pulmonary hypertension, or Eisenmenger’s complex. Another 40 healthy subjects were enrolled and served as a control group. Routine echocardiography and tissue Doppler imaging were performed. RV myocardial performance index was determined based on data collected during tissue Doppler imaging over the lateral tricuspid annulus. In patients with RV pressure overload, tissue Doppler parameters showed characteristically lower systolic velocity over the tricuspid annulus (RV myocardial systolic wave [Sm]) and longer isovolumic relaxation time (RV-IVRT). Nevertheless, in patients with RV volume overload, RV-Sm increased significantly, but early-diastolic velocity over tricuspid annulus was relatively low. In conclusion, RV-MPI, RV-Sm/early-diastolic velocity over tricuspid annulus, and RV-IVRT/RV-Sm were all useful to differentiate RV pressure overload from volume overload, although RV-IVRT/RV-Sm was the best parameter, with excellent sensitivity and specificity. [Copyright &y& Elsevier]

The present study was undertaken to determine the sensitivity and specificity of echocardiography in the diagnosis of pulmonary embolism (PE). The study consisted of 2 stages. First, 600 patients were enrolled to measure bilateral pulmonary blood flow by echocardiography. Using multidetector row computed tomography, 200 subjects were diagnosed with pulmonary hypertension and 100 with defined PE. Another 300 subjects without cardiopulmonary distress served as controls. The time-velocity integral (TVI) and flow volume of both pulmonary arteries were obtained. The percentage differences in bilateral pulmonary arterial TVI (ΔTVI/mean) were 12.0 ± 9.3%, 13.8 ± 12.1%, and 38.6 ± 14.9% for controls, subjects with pulmonary hypertension, and subjects with PE, respectively. The percentage differences in bilateral pulmonary flow (Δflow/mean) were 15.1 ± 11.7%, 17.6 ± 14.9%, and 36.8 ± 17.5% for controls, subjects with pulmonary hypertension, and subjects with PE, respectively. By receiver-operating characteristic curve analysis, the cut-off points for ΔTVI/mean and Δflow/mean to identify PE were 25% and 26.5%, respectively. In the second part of study, the accuracy of ΔTVI/mean and Δflow/mean to screen 300 patients with suspected PE was tested. Echocardiography provided high degrees of sensitivity and specificity for the diagnosis of PE. In conclusion, bilateral pulmonary arterial flow measurement is a simple and useful test to assess the possibility of PE. [Copyright &y& Elsevier]

In this study, myocardial performance index (MPI) was used to identify pulmonary embolism (PE) in patients with echocardiographic signs of pulmonary hypertension. One hundred patients with echocardiographic signs of pulmonary hypertension were enrolled in this study after informed consent was obtained. All patients underwent multidetector-row computed tomography of the chest, and PE was found in 50 patients. Another 100 patients without any cardiopulmonary distress or echocardiographic signs of pulmonary hypertension served as the control group. All cohorts were enrolled after the exclusion of (1) any rhythm other than sinus rhythm; (2) complete bundle branch block; (3) ischemic heart disease proved by stress test, perfusion scan, or coronary angiography; (4) a left ventricular (LV) ejection fraction <50%; and (5) inadequate echocardiograms. Routine echocardiography and tissue Doppler imaging were performed, including the MPIs of the right and left ventricles. The right ventricular (RV) MPI was significantly higher in patients with PE than in others (p <0.0001). Patients without PE had concordant changes in the RV and LV MPIs. In patients with acute PE, the RV MPI became higher, but the LV MPI was relatively constant. Using the RV MPI divided by the LV MPI (the V index), PE could be distinguished in patients with echocardiographic signs of pulmonary hypertension. By receiver-operating characteristic curve analysis, the V index >1.2 identified PE with sensitivity of 82% and specificity of 83%. In conclusion, the V index is a useful parameter to assess the possibility of PE in patients with echocardiographic signs of pulmonary hypertension. [Copyright &y& Elsevier]

The objective of this study was to use tissue Doppler parameters to identify pulmonary embolism (PE) in patients with echocardiographic signs of pulmonary hypertension. One hundred fifty patients with echocardiographic signs of pulmonary hypertension were enrolled, 50 of whom had PE on multidetector row computed tomography of the chest. Another 150 patients without cardiopulmonary distress or echocardiographic signs of pulmonary hypertension served as a control group. All patients were in sinus rhythm. Routine echocardiography and tissue Doppler imaging were performed. The right ventricular (RV) myocardial performance index (MPI) was obtained during tissue Doppler imaging over the lateral tricuspid annulus. The M index was measured and defined as the peak early diastolic mitral inflow velocity divided by the RV MPI. Statistical analysis was preformed using receiver-operating characteristic curves. Peak early diastolic mitral inflow velocity was significantly less and the RV MPI was significantly greater in patients with PE than in patients without PE (both p values <0.0001). The RV MPI and the M index were useful in identifying PE in patients with echocardiographic signs of pulmonary hypertension. On statistical analysis, a RV MPI >0.55 identified PE with a sensitivity of 85% and a specificity of 78%. A M index <112 had a sensitivity of 92% and a specificity of 92%. In conclusion, the sensitivity and specificity of the RV MPI and the M index to identify PE were excellent. Echocardiography is a useful method to screen for PE. [Copyright &y& Elsevier]

Abstract: A complication following placement of the pulmonary artery catheter (PAC) is presented. Resistance was experienced during insertion of the introducer sheath, and the PAC could not be advanced into the right heart. Finally, the PAC was successfully placed through the left internal jugular vein. Perforation of the right innominate vein was identified following emergent exploratory surgery for cardiovascular collapse. [Copyright &y& Elsevier]