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Background Cardiopulmonary arrest (CPA) is the most serious presentation of acute myocardial infarction (AMI). However, the frequency and prognostic impact of CPA in young patients with AMI have been still unclear. Objectives This study aimed to characterize AMI in young patients who underwent primary percutaneous coronary intervention using large-scale nationwide all-comer registry data in Japan (J-PCI registry). Methods Data on risk factor profiles, clinical features, post-procedural complications, and in-hospital outcomes were reviewed within the J-PCI registry between 2014 and 2018. Results Among 213,297 patients with AMI, 23,985 (11.2%) were young (age, 20–49 years). Compared with the older group (age, 50–79 years; n=189,312), the young group included a higher number of men, smokers, patients with dyslipidemia, and patients with single-vessel disease, and a lower number of patients with hypertension and diabetes. Despite favorable clinical profiles, younger age was associated with a higher rate of presentation with CPA (Figure 1). Further, concomitant CPA was strongly associated with in-hospital mortality in the young group (Table 1). Conclusions Young patients with AMI presented a higher risk of CPA than older patients, which was strongly associated with in-hospital mortality. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): JSPS KAKENHI

Asia has attracted research attention because it has the highest anthropogenic emissions in the world, and the Model Inter-Comparison Study for Asia (MICS-Asia) phase III was carried out to foster our understanding of the status of air quality over Asia. This study analyzed wet deposition in southeast Asian countries (Myanmar, Thailand, Lao People's Democratic Republic (PDR), Cambodia, Vietnam, the Philippines, Malaysia, and Indonesia) with the aim of providing insights into the seasonal variation of wet deposition. Southeast Asia was not fully considered in MICS-Asia phase II due to a lack of observational data; however, the analysis period of MICS-Asia III, namely the year 2010, is covered by ground observations of the Acid Deposition Monitoring Network in East Asia (EANET), and the coordinated simulation domain was extended to cover these observation sites. The analyzed species are wet depositions of S (sulfate aerosol, sulfur dioxide (SO2), and sulfuric acid (H2SO4)), N (nitrate aerosol, nitrogen monoxide (NO), nitrogen dioxide (NO2), and nitric acid (HNO3)), and A (ammonium aerosol and ammonia (NH3)). The wet deposition simulated with seven models driven by a unified meteorological model in MICS-Asia III was used with the ensemble approach, which effectively modulates the differences in performance among models. By comparison with EANET observations, although the seven models generally captured the wet depositions of S, N, and A, there were difficulties capturing these in some cases. Considering the model performance for ambient aerosol concentrations over southeast Asia, this failure of models is considered to be related to the difficulty in capturing the precipitation in southeast Asia, especially during the dry and wet seasons. Generally, meteorological fields overestimate the precipitation during the dry season, which leads to the overestimation of wet deposition during this season. To overcome this, a precipitation-adjusted approach that scaled the modeled precipitation to the observed value was applied, and it was demonstrated that the model performance was improved. Satellite measurements were also used to adjust for precipitation data, which adequately accounted for the spatiotemporal precipitation patterns, especially in the dry season. As the statistical scores were mostly improved by this adjustment, the estimation of wet deposition with precipitation adjustment was considered to be superior. To utilize satellite measurements, the spatial distribution of wet deposition was revised. Based on this revision, it was found that Vietnam, Malaysia, and Indonesia were upward corrected, and Myanmar, Thailand, Lao PDR, Cambodia, and the Philippines were downward-corrected; these corrections were up to ±40 %. The improved accuracy of precipitation amount was key to estimating wet deposition in this study. These results suggest that the precipitation-adjusted approach has the potential to obtain accurate estimates of wet deposition through the fusion of models and observations.

Background Large-scale registries have demonstrated that in-hospital mortality after percutaneous coronary intervention (PCI) varies widely across institutions; however, the underlying reasons are not fully understood. Bleeding has been regarded as one of the most serious PCI-related complications associated with increase in mortality. To date, reducing bleeding complications have tended to be addressed, though appropriate care for patients who developed bleeding complications may be also important. Therefore, we sought to investigate which was more involved in the inter-institutional variations in in-hospital mortality. Methods We analyzed 388,866 procedures at 718 hospitals performed from 2017 to 2018, using data from a representative nationwide PCI registry in Japan. A bleeding complication was defined as post-procedural bleeding that required a blood transfusion. We first divided the hospitals into quintiles according to their risk-adjusted in-hospital mortality (very low, low, medium, high, and very high). Then, the bleeding complication rate and in-hospital mortality rate among patients who developed bleeding complications were calculated for each quintile. Results In total, 4,048 (1.04%) in-hospital deaths and 1,535 (0.39%) bleeding complications occurred. In-hospital mortality varied widely from 0.22% to 2.46% in very-low- to very-high-mortality hospitals. The bleeding complication rate also increased modestly from 0.27% to 0.57% (odds ratio, 1.95; 95% confidence interval, 1.58–2.39). However, the mortality rate among patients who developed bleeding complications markedly increased by quintile; the mortality rate of very-high-morality hospitals was 6-fold higher than that of very-low-mortality hospitals (29.0% vs. 4.8%, respectively; odds ratio, 12.2; 95% confidence interval, 6.9–21.7). Conclusions Wide variation in in-hospital mortality was observed within the Japanese nationwide PCI registry, and this variation was largely driven by differences in mortality among patients with bleeding complications, rather than crude incidence of bleeding complications. These results underscore the importance of efforts toward reducing not only bleeding complications but also, even more importantly, mortality once bleeding has occurred. Funding Acknowledgement Type of funding sources: None.

Cathode materials with highly reactive surfaces and long-term stability are required to achieve high-performance solid oxide fuel cells (SOFCs). In this study, a promising cathode material, La0.6Sr0.4Co0.2Fe0.8O3−δ (LSCF), was prepared as a nanostructured thin film using pulsed laser deposition (PLD) on gadolinia-doped ceria (GDC)-buffered YSZ single crystal substrates having (100) and (111) orientations. Characterization revealed intrinsic differences among the as-grown LSCF thin films in terms of dominant crystalline orientation and nanostructure depending on GDC preparation as well as the YSZ substrate orientation. Evaluation of the oxygen exchange properties using the isotope exchange depth profile method revealed that LSCF thin films grown on (111) GDC/YSZ exhibited higher values of the apparent surface exchange coefficient compared to LSCF thin films grown on (100) GDC/YSZ. However, when subjected to long-term annealing at high temperatures, the former exhibited a stronger tendency to surface segregation as compared to the latter. These behaviors are correlated with the intrinsic properties of LSCF thin films, including the nanostructure, the possible effects attributed to SrO activity, and the stability of perovskite surfaces which would drive surface segregation. These results have implications for tailoring the performance of cathode thin films by understanding the dependence of oxygen exchange properties and surface segregation on driving forces such as surface chemistry and nanostructure.

BackgroundIn cases of systematic lupus erythematosus (SLE) that lead to surgery due to the development of heart diseases such as valvular disease, ischemic heart disease and aortic aneurysm, early detection and careful monitoring are important. An absence of background diseases or immunopathological examination of the myocardial tissue in SLE cases with cardiovascular lesions demonstrates the lack of knowledge in this area. In recent years, however, there have been reports of neutrophil extracellular traps being involved in the fulminant onset of SLE.ObjectivesThis study aimed to analyze clinically and immunohistopathologically the pathophysiology of heart diseases associated with SLE.MethodsWe performed left atrial appendage resection in 34 patients, including patients with cardiovascular lesions, who underwent heart surgery for SLE complications from 2012 to 2021. Tissue analysis was conducted in 9 cases. The left atrial appendage, in cases of non-collagen valvular disease, was used as the control. Tissue staining of cardiomyocytes was carried out by adding anti-neutrophil extracellular(NE) antibodies(Abs) to anti-human IgG antibody (Ab), anti-IgM Ab and anti-C3 Ab.ResultsOf the 34 SLE patients 14 had valvular disease, 8 had ischemic heart disease and 12 had aneurysms. Preoperative SLE activity was relatively stable with only 1 patient below the CH50 standard and 6 patients above the anti-DNA Ab standard. The Ab positivity rate for the patients in this study was higher than that of the 687 SLE patients who were previously tested in 2019. The presence of anti-CL Abs was 55.6%, which was higher than the 25.5% observed in previous SLE patients. In this study, anti-SS-A and anti-RNP Abs tended to be relatively numerous. An example of immunohistochemical staining of IgG in the left atrial appendage is presented (Figure 1a). IgG deposits were not observed on the left side of the myocardial fibers in the control group, whereas IgG deposits were observed on the right side in the SLE group. Deposits were also observed in tissues that were not located in the affected areas. The presence or absence of tissue deposition in the myocardial fibers and clinical findings in 2 cases of the control group and 9 cases of the SLE complication group are reported in Table 1. IgG deposits were found in the myocardial fibers of 6 of the 9 patients in the SLE complication group, and deposits were found in the left atrial appendage tissue regardless of the type of heart disease, suggesting a potential change in the heart tissue. In the SLE group, 5 cases were positive for antiphospholipid (APS) Abs, while 7 cases were positive for either anti-SS-A or anti-RNP Abs. Only 2 cases had elevated preoperative anti-DNA Ab and complement reduction. Of the SLE complication group, 2 of the 9 cases were negative for all Abs but IgG deposits were observed in a case. Of these 4 cases were selected and stained with anti-IgM, anti-C3 and anti-NE Abs. However IgM and C3 deposits were only observed in one patient who developed myocardial infarction at the age of 39 and was triple positive for APS, anti-SS-A and anti-RNP Abs (Figure 1b). There were also no NE deposits in any of the cases. Even if complement and anti-DNA Ab levels in the serum are normal, attention should be paid to heart disease complications during the long-term observation of SLE patients. In particular, attention should be paid to various autoantibody-positive cases such as APS, anti-SS-A Ab and anti-RNP Ab. The anti-NE Ab was not stained in this study because the tissue was different from the lesion site and because it occurred during the chronic course.ConclusionIn SLE patients who developed cardiovascular lesions and required surgery, immunological abnormalities may occur in the myocardial tissue even if serum complement and anti-DNA Ab levels are stable.References[1]Stephane Zuily et al. Valvular Curr Rheumatol Rep (2013) 15:320.[2]Zawadowski GM et al. Lupus. 2012;21(13):1378-84.[3]Daniel Appelgren et al. Autoimmunity 2018,vol51,No.6,310-318.Disclosure of InterestsNone declared

Background Impact of SYNTAX score II (SSII) on long-term clinical outcomes after cobalt-chromium everolimus-eluting stent (CoCr-EES) implantation remains unclear. Methods Between February 2010 and May 2011, 1064 consecutive patients with 1440 lesions were treated only with CoCr-EES implantation. Of these, the SSII was calculated in 1013 patients with 1345 lesions. Patients were divided into the tertile group: Tertiles for SSII (low SSII [12–28.9], n=334; intermediate SSII [29–39.1], n=339; and high SSII [39.2–80.8], n=340). We assessed the cumulative 7-year incidences of major adverse cardiac events (MACE), defined as a composite of cardiac death, myocardial infarction, definite stent thrombosis, and clinically driven target lesion revascularization (CDTLR) based on SSII groupings. Results Cumulative 7-year incidence of MACE was significantly higher in the high SSII group than in the other groups (34.1% vs. 18.6% vs. 17.2%, p Conclusions SSII has significantly impact on 7 years clinical outcomes after CoCr-EES implantation. Cumulative incidence of MACE Funding Acknowledgement Type of funding source: None

The rate-determining step (RDS) in the oxygen reduction process on a LaNi0.6Co0.4O3-δ film electrode was analyzed using electrochemical impedance spectroscopy in varied temperatures (873–1073 K), oxygen partial pressures (1–10−3 bar), and DC bias. From the evaluation of the area-specific interfacial conductivity, σE, and chemical capacitance, CE, it is suggested that the RDS is surface reaction under low p(O2) (10−2–10−3 bar) but there appears a contribution of bulk diffusion under high p(O2) in the film electrode at any given temperature. The change of the RDS was also confirmed using isotope exchange depth profile method where a significant change in the oxygen profile in the film electrode was observed. This is attributed to the rate of the bulk diffusion of O2− which is almost constant when the oxygen nonstoichiometry of LaNi0.6Co0.4O3-δ is small, whereas the surface reaction rate strongly depends on p(O2). At low p(O2), the surface reaction is slower than the bulk diffusion, so that the potential drop on the surface of the electrode film is large. In contrast, at high p(O2), the surface reaction is faster than the bulk diffusion where the potential decay is sluggish inside the film electrode.

Relevant factors affecting an oxygen reduction reaction (ORR) in a heterostructure electrode comprising a Ce0.9Gd0.1O1.95 porous layer on LaNi0.6Fe0.4O3 − δ film electrode were evaluated using electrochemical impedance spectroscopy and isotope depth profile analyses. Despite the LaNi0.6Fe0.4O3 − δ film – porous Ce0.9Gd0.1O1.95 electrode having higher interfacial conductivity, σE, compared to a bare LaNi0.6Fe0.4O3 − δ film electrode, σE behavior as a function of p(O2) was similar to each measured temperature. This exhibits a good correlation with the isotopic oxygen depth profile analysis where the evaluated surface oxygen exchange coefficient, k*, showed enhancement compared to bare LaNi0.6Fe0.4O3 − δ film and exhibited the same behavior on p(O2). Based on the analyses, there are two plausible reasons for this enhancement: (a) the formation of triple phase boundaries at the junction of LaNi0.6Fe0.4O3 − δ film, porous Ce0.9Gd0.1O1.95, and gas phase, where the incorporation process during an ORR process takes place via the porous Ce0.9Gd0.1O1.95; and (b) a modification of the subsurface layer just below the film surface where the presence of diffused Ce and Gd appears to accelerate the ORR process.

In order to elucidate the electronic conduction mechanism and defect chemical model of LaNi 0.4 Fe 0.6 O 3 − δ at high temperatures, electrical conductivity ( σ ), Seebeck coefficient ( S ), and oxygen vacancy concentration ( δ ) of LaNi 0.4 Fe 0.6 O 3 − δ were measured as a function of oxygen partial pressure ( p (O 2 )) and temperature. Relatively large σ and small positive S values are observed, which indicates the contribution of ionic conduction is negligibly small to thermoelectric power and the major electronic carrier is a hole. From the analysis of σ and S , it is expected that the LaNi 0.4 Fe 0.6 O 3 − δ has small polaron hopping conduction mechanism where an electron is localized on the Fe. The slope of δ vs p (O 2 ) shows a minimum value near the stoichiometric composition and the δ increases as p (O 2 ) reduces and temperature increases. The relationship between δ vs. log p (O 2 ) is analyzed by a localized electron model and the behavior of the oxygen nonstoichiometry of LaNi 0.4 Fe 0.6 O 3 − δ can be explained.

High durability against carbon deposition on Ni anodes of internal-reforming solid oxide fuel cells (SOFCs) is one of the most significant challenges in the utilization of SOFCs. Carbon deposition is strongly affected by the type of solid oxide electrolyte, although it occurs on Ni surfaces which are a few hundred nanometers away from the solid oxide electrolyte. Carbon deposition under CH4 flow at 1,073 K on Ni particles on yttria-stabilized ZrO2 was determined to occur more readily than on Ni particles on Gd-doped CeO2. We have examined how the solid oxides interact with the Ni surfaces in anodes using Auger electron microanalysis and infrared spectroscopy with adsorbed molecules. The results suggest that the CeO2 species migrate on the Ni surfaces under reducing conditions. The chemical influence of CeO2 migration on the Ni surface was confirmed by infrared spectra of adsorbed CO on Ni sites.

Cathode materials with highly reactive surfaces and long-term stability are required to achieve high-performance solid oxide fuel cells (SOFCs). In this study, a promising cathode material, La0.6Sr0.4Co0.2Fe0.8O3-δ (LSCF), was prepared as a nanostructured thin film using pulsed laser deposition (PLD) on gadolinia-doped ceria (GDC)-buffered YSZ single crystal substrates having (100) and (111) orientations. Characterization revealed intrinsic differences among the as-grown LSCF thin films in terms of dominant crystalline orientation and nanostructure depending on GDC preparation as well as the YSZ substrate orientation. Evaluation of the oxygen exchange properties using the isotope exchange depth profile method revealed that LSCF thin films grown on (111) GDC/YSZ exhibited higher values of the apparent surface exchange coefficient compared to LSCF thin films grown on (100) GDC/YSZ. However, when subjected to long-term annealing at high temperatures, the former exhibited a stronger tendency to surface segregation as compared to the latter. These behaviors are correlated with the intrinsic properties of LSCF thin films, including the nanostructure, the possible effects attributed to SrO activity, and the stability of perovskite surfaces which would drive surface segregation. These results have implications for tailoring the performance of cathode thin films by understanding the dependence of oxygen exchange properties and surface segregation on driving forces such as surface chemistry and nanostructure.

In order to understand the hydrogen oxidation reaction (HOR) mechanism in real Ni/YSZ porous anodes, the electrochemical properties as a function of hydrogen partial pressure p(H2) and water vapor pressure p(H2O) (dry, 1% - 60% humidity) at 973 K of a commercial anode-supported solid oxide fuel cell (SOFC) were measured. The impedance spectra from electrochemical impedance spectroscopy (EIS) measurement were analyzed by 1-D approximation transmission line model (TLM) to observe changes in the reaction resistance (rP) between the Ni/YSZ and reaction capacitance (Cp) from the anode. From the analysis, rp is essentially independent over p(H2) in dry atmosphere but decreased with increasing p(H2O) at the anode side. In contrast, the rp shows a large dependency on p(H2) in wet atmosphere indicating that the rate-limiting step of HOR is probably different between dry and wet atmospheres. On the other hand, the Cp is independent of p(H2) in dry and wet condition. However, similar to rp, it has strong dependency on p(H2O). From these results, the difference in HOR between dry and wet atmospheres is assumed to be an additional reaction pathway formed in the latter where the formation of OH−ad on the Ni metal surface possibly enhanced the HOR rate.

In order to investigate the relevant factors affecting the transport properties of solid oxide fuel cell cathodes upon coating with Ce0.9Gd0.1O1.95 (GDC), the surface oxygen exchange coefficient, k*, and oxide ion diffusivity, D*, of La0.6Sr0.4CoO3-δ (LSC) and La0.6Sr0.4Co0.2Fe0.8O3-δ (LSCF) were measured by a combination of isotope exchange technique and secondary ion mass spectrometry (SIMS). The k* of LSCF/GDC enhanced compared to a bare LSCF for all measured temperatures. In contrast, the k* of LSC/GDC only showed an enhancement compared to the bare LSC at relatively low temperatures (below 873 K) but not at higher temperatures. From these results, GDC has a less significant effect on the k* of LSC compared to LSCF. This suggests that the enhancement of k* is possibly induced only when the oxygen vacancy concentration, δ, of the cathode is lower than that of GDC, although another factor may affect the enhancement. The enhancement of k* is attributed to the formation of triple-phase boundary where a spill-over mechanism controlled the oxygen reduction reaction. The change of rate-determining step of LSCF due to the GDC coating suggests that the enhancement of the k* is not only with respect to the incorporation process, but it is possibly enhancing the reaction steps that involve δ as well.

The surface oxygen exchange coefficient (k*) and the oxide ion diffusivity (D*) in the La0.6Sr0.4Co0.2Fe0.8O3-δ (LSCF) related perovskite materials with various strontium (Sr) and cobalt (Co) compositions were determined by a combination of isotope exchange (IE) technique and secondary ion mass spectrometry (SIMS). Results show that the derived values of k* and D* decrease with decreasing Sr and Co content in those LSCF samples. To corroborate the results, electrochemical impedance spectroscopy (EIS) was performed on porous LSCF samples with the same Sr and Co deficiency; obtained impedance spectra were analyzed by the transmission line model (TLM) to derive k* and D*. It showed that those k* and D* values obtained from the isotope exchange experiments are in good agreement with the electrochemically determined values. For further analysis, thermogravimetry was performed to evaluate the oxygen vacancy concentration (δ) for respective samples. It has been found that changes in log D* can be well correlated with the log (δ/(3-δ)) as expected from the vacancy mechanism for the oxide ion diffusion. On the other hand, changes in log k* are not correlated only with the ionic properties like log (δ/(3-δ)) but also with the electron properties; this can be seen in the h plane coordinated with log D* and log k*.

The hyperinsulinemic-euglycemic clamp (EGC) technique was used to investigate the effects of calcium salts of long-chain fatty acids (LCFA-Ca) and rumen-protected Met (RPM) on insulin sensitivity in the peripheral tissues of lactating cows. Six multiparous Holstein cows were used in a 3 × 3 Latin square experiment in each 14-d period. Dietary treatments were 0 (RPM0), 20 (RPM20), and 60 (RPM60) g/d of RPM, supplemented with a diet containing 1.5% of LCFA-Ca equal to 110% of the cows' ME requirement. And as a control for the 3 LCFA-Ca-containing diets, a dietary treatment without LCFA-Ca (Con) was also included. After a 10-d adaptation period, milk samples were collected for 4 d, and EGC experiments were performed on d 14 of each treatment period. Insulin solution was infused through a jugular vein catheter at a rate of 0.1, 0.2, 0.3, and 0.4 milliunits·kg BW-1·min-1 for 30 min and then at a rate of 0.5 milliunits·kg BW-1·min-1 for 60 min. Glucose solution was variably infused to maintain plasma glucose at steady state through the same catheter. Blood samples for measurements were taken using the contralateral catheter. Plasma total cholesterol, cholesterol ester, free cholesterol, and phospholipid concentrations in RPM0 and RPM20 were higher than those in Con, whereas the concentrations in RPM60 were low at the same degree of those in RPM0 (P < 0.05). Plasma Met concentration was greatest in RPM60 (P < 0.05). In the EGC experiment, the glucose infusion rate was greater in RPM60 than in RPM0 and RPM20 and an effective concentration of insulin resulting in 50% maximal glucose infusion rate was lower in RPM60 compared with RPM0 (P < 0.05), indicating that insulin sensitivity was intensified in RPM60. Although the insulin sensitivity evaluated from the EGC data in RPM0, RPM20, and RPM60 was not different from Con, a slight decline was observed in RPM0 and insulin sensitivity in RPM60 was higher than Con. Our results from the EGC experiment demonstrated that the feeding RPM lead to increased insulin sensitivity, which suggests that dietary Met affects lipid metabolism via insulin action in lactating dairy cows fed a LCFA-Ca-containing diet.

In a preliminary open-label trial by our group, Bifidobacterium bifidum YIT 10347 (YIT10347) relieved gastric symptoms in patients with functional gastrointestinal disorders. Hence, in this study, we investigated the effects of YIT10347 on gastrointestinal symptoms in healthy adults. In this prospective double-blind, randomized, placebo-controlled trial (UMIN000024654), 100 healthy Japanese adults were randomly assigned to a YIT10347 group or placebo group and consumed 100 mL of YIT10347-fermented milk or placebo fermented milk, respectively, every day for 4 wk. Gastrointestinal symptoms were evaluated by using the modified Frequency Scale for Symptoms of Gastroesophageal Reflux Disease (m-FSSG) and Gastrointestinal Symptom Rating Scale (GSRS) as primary endpoints. Mental symptoms, quality of life, salivary stress markers, and gastric emptying were evaluated as secondary endpoints. Effectiveness and safety were analyzed in a per-protocol set (YIT10347 group, n=39; placebo group, n=40) and full analysis set (YIT10347 group, n=50; placebo group, n=50), respectively. In the m-FSSG evaluation, the YIT10347 group had a significantly higher relief rate of postprandial discomfort and greater changes in postprandial epigastric pain score from baseline than the placebo group. In the GSRS evaluation, the YIT10347 group had significantly higher relief rates of overall gastrointestinal symptoms, upper gastrointestinal symptoms, flatus, and diarrhea than the placebo group. We detected no significant differences in scores or relief rates of mental symptoms and quality of life, a salivary stress marker, or gastric emptying between the 2 groups. No severe adverse events associated with test beverage consumption were observed in either group. These findings suggest that daily consumption of YIT10347-fermented milk exerts beneficial effects on gastrointestinal discomfort and symptoms such as postprandial discomfort and epigastric pain in healthy adults.

The integration of gasification and solid oxide fuel cells is promising direction to meet the demand of clean and efficient utilization of coal for power generation. This study focused on the impact on performance of Ni-YSZ SOFC anode of ppm-level H2S contamination in wet hydrogen or simulated coal syngas (mixtures of H2 and CO). We observed that the trace level contamination of fuel with H2S ranged from 0.02 to 2ppm resulted in the irrecoverable performance loss and slight acceleration of chemical degradation of anode which depended on the concentration of H2S. We also found that the injection of contaminated simulated coal syngas led to the faster degradation compared to the case with hydrogen injection.

The presence of asymptomatic third molars can represent a potential problem in the mandible when these teeth are retained and the patient has lost all normally erupted teeth. Once the mandibular first and second molars are removed, the mandibular body becomes weaker with time, increasing the complexity, morbidity and incidence of complication in the surgical procedure to remove the retained third molar. This paper reports a case where the mandibular third molars retained in a severely resorbed mandible were removed in a 54-year-old female patient. The treatment plan was based on the safe surgical removal of the teeth and prosthetic rehabilitation with an implant-supported milled bar overdenture and a bone-mucous-supported complete denture in the mandibular and maxillary arch, respectively. If the removal of a retained third molar is indicated in a severely resorbed edentulous mandible, the treatment plan must involve not only preventive measures in order to avoid mandible fracture during or after tooth removal, but also alternatives that allow an adequate mandibular rehabilitation. A presença de terceiros molares inclusos assintomáticos pode representar um grande problema quando estes dentes encontram-se inclusos em um paciente desdentado total. Uma vez que os primeiros e segundos molares foram extraídos, o corpo mandibular torna-se mais frágil com o passar do tempo, o que aumenta a complexidade, a morbidade e a incidência de complicações nas cirurgias de remoção de terceiros molares inclusos. Neste artigo é apresentado um caso de uma paciente de 54 anos de idade com severa reabsorção do osso mandibular onde os terceiros molares mandibulares encontravam-se inclusos e com necessidade de extração. O plano de tratamento objetivou a extração segura dos dentes e a reabilitação mandibular com o uso de uma prótese implanto-suportada. Se a extração dos terceiros molares inclusos é indicada em pacientes que apresentam mandíbula atrófica, o plano de tratamento deve incluir não apenas as medidas preventivas com o intuito de prevenir a fratura da mandíbula durante ou após a remoção dos dentes, mas também alternativas de tratamento que possibilitem uma adequada reabilitação.

This paper presents a new technology for constructing cool roofs composed of fractal shapes. The roofs consist of many Sierpinski tetrahedron units and block 100% sunlight from a particular direction. The sunlight from other directions partly penetrates the roof, creating a leafy shaded area under the roof. Compared with ordinary flat roofs, these roofs greatly reduce surface temperature and consequently provide a cool environment without strong heat radiation. The fractal structure of the tetrahedron units is similar to that of natural trees. Three-dimensional measurements revealed that natural trees have a fractal dimension of approximately 2, which is similar to that of the Sierpinski tetrahedrons. In this study, fractal roofs made from different materials were tested at two sites. The results showed that they were very effective in reducing surface temperatures in sunlight.

Subcutaneous emphysema in the cervical region is a well-documented event that may occur secondary to tonsillectomy, dental treatment, oropharyngeal barotraumas, scaling and root planning therapy, punch biopsy, endotracheal intubation, orthognathic surgery, extraction of impacted teeth, or after maxillofacial trauma. After trauma episodes, subcutaneous emphysema may be caused by a maxillary antral wall fracture that occurs when air pressure is introduced into the fascial planes of the connective tissue. Retropharyngeal emphysema is a severe condition associated with traumatic aerodigestive tract injury and may be associated with life-threatening situations requiring prompt attention and diagnosis in order to prevent serious consequences. We reported a case of cervicofacial and retropharyngeal emphysema in a 54-year-old patient who stated concerns after blowing his nose several times after a traumatic episode involving orbitozygomatic region. During the patient’s hospital course, his airway remained stable, and he was discharged from the hospital 7 days later with a prognosis of full recovery, excellent occlusion and facial appearance, and complete resolution of subcutaneous emphysema.

The effective rural electrification method varies with economic status and geographical location, and the benefits of decentralized generation differ for each energy system depending on its characteristics. This paper evaluates the most effective generation strategies with rural electrification in an optimized power system of Papua New Guinea (PNG) using a linear programming model. The energy system model developed for the study includes decentralized generation, centralized generation, and grid systems of electricity and gas with consideration for the current energy system and infrastructure. Two methods of rural electrification, decentralized generation and grid extension, are compared with and without the Clean Development Mechanism (CDM). The results of simulations show that extending the power grid that allows economical generation such as coal-fired power and hydropower to supply rural electricity is a more cost effective way for rural electrification. Although grid extension is more capital intensive than decentralized generation, the former reduces the total system cost through reduction of the fossil fuel use. Extending the power grid is also effective at attracting CDM investments, since it makes the power system flexible and provides opportunities to advance low emitting energy such as hydropower.

We have investigated the structures, magnetic properties and spin polarization of bulk Fe2CrSi and Fe2Cr1-xVxSi Heusler alloys. Single-phase structures were obtained for all samples by setting the composition 22% forY-atom of X2YZ Heusler alloy. The saturation magnetization of Fe2Cr1-xVxSi for x 0.5 decreased monotonically with increasing V content, while their Curie temperatures Tc and spin polarization P remained constant. For alloys with x > 0.5, saturation magnetization decreased rapidly with increasing V content. Experimental results of spin polarization P were discussed from the viewpoint of the Fe, Cr and V partial density of states determined by the band calculation.

We have investigated the preparation, structures, and magnetic properties of bulk Fe2CrSi and Fe2Cr1-xTixSi Heusler alloys. Although a Cr-rich secondary phase coexists with the Heusler mother phase in stoichiometric Fe2CrSi samples, high temperature annealing (1200°C) effectively reduces the extent of the Cr-rich secondary phase. We found that pure single-phase samples can be prepared in a narrow composition range of 22% Cr. For a Fe2Cr1-xTixSi system with Ti content x of up to 1/8, virtually single-phase Heusler alloys have been obtained. The saturation magnetization of Fe2Cr1-xTixSi decreased with increasing Ti content, while their Curie temperatures Tc remained constant.

Recent studies revealed that Amblyomma or Ixodes tick bites may cause red meat allergy, in which galactose-α-1,3-galactose (α-Gal) is a major IgE-binding epitope. The incidence of red meat allergy is high in Shimane Prefecture, as is tick-transmitted Japanese spotted fever. Therefore, we speculated that tick bites may cause these meat allergies. The carbohydrate α-Gal was detected in the salivary gland protein of Haemaphysalis longicornis (H. longicornis), the vector for Japanese spotted fever, by immunoblotting using anti-α-Gal antibody. H. longicornis salivary gland protein-specific IgE was detected in the sera of 24 of 30 patients with red meat allergies. Sensitization to tick salivary gland protein containing α-Gal is possibly a major etiology of red meat allergy; the carbohydrate plays a crucial role in its allergenicity. These results further indicate that the α-Gal epitope is present not only in Amblyomma or Ixodes, but also in Haemaphysalis.

The hyperinsulinemic-euglycemic clamp (EGC) technique was used to investigate the effects of calcium salts of long-chain fatty acids (LCFA-Ca) and rumen-protected Met (RPM) on insulin sensitivity in the peripheral tissues of lactating cows. Six multiparous Holstein cows were used in a 3 × 3 Latin square experiment in each 14-d period. Dietary treatments were 0 (RPM0), 20 (RPM20), and 60 (RPM60) g/d of RPM, supplemented with a diet containing 1.5% of LCFA-Ca equal to 110% of the cows' ME requirement. And as a control for the 3 LCFA-Ca-containing diets, a dietary treatment without LCFA-Ca (Con) was also included. After a 10-d adaptation period, milk samples were collected for 4 d, and EGC experiments were performed on d 14 of each treatment period. Insulin solution was infused through a jugular vein catheter at a rate of 0.1, 0.2, 0.3, and 0.4 milliunits·kg BW-1·min-1 for 30 min and then at a rate of 0.5 milliunits·kg BW-1·min-1 for 60 min. Glucose solution was variably infused to maintain plasma glucose at steady state through the same catheter. Blood samples for measurements were taken using the contralateral catheter. Plasma total cholesterol, cholesterol ester, free cholesterol, and phospholipid concentrations in RPM0 and RPM20 were higher than those in Con, whereas the concentrations in RPM60 were low at the same degree of those in RPM0 (P0.05). Plasma Met concentration was greatest in RPM60 (P0.05). In the EGC experiment, the glucose infusion rate was greater in RPM60 than in RPM0 and RPM20 and an effective concentration of insulin resulting in 50% maximal glucose infusion rate was lower in RPM60 compared with RPM0 (P0.05), indicating that insulin sensitivity was intensified in RPM60. Although the insulin sensitivity evaluated from the EGC data in RPM0, RPM20, and RPM60 was not different from Con, a slight decline was observed in RPM0 and insulin sensitivity in RPM60 was higher than Con. Our results from the EGC experiment demonstrated that the feeding RPM lead to increased insulin sensitivity, which suggests that dietary Met affects lipid metabolism via insulin action in lactating dairy cows fed a LCFA-Ca-containing diet.

Dilute trichloroethylene (TCE) and other volatile organic compounds (VOC) in air were decomposed by using the nonthermal plasma process combined with catalysts. To enhance the energy efficiency of the TCE decomposition, some catalysts were tested including their location. It was found that the newly proposed indirect process (VOC cannot be exposed in the plasma region) can also decompose TCE and other VOCs which is due to the ozone dissociation effect. The manganese oxide dissociates ozone to generate oxygen radicals which decompose TCE and other VOCs.

Decomposition performance of dilute (100-1000 ppm) trichloroethylene (TCE) contaminated in air by using nonthermal plasma processing was studied to improve the decomposition efficiency. Three kinds of experiments were performed. One is the observation of the decomposition efficiency related to the processing gas flow rate. There exists an optimal gas flow rate for our reactor. The second experiment is the plasma decomposition performance observation related to the catalysts. Some catalysts, such as vanadium oxide (V/sub 2/O/sub 5/) or tungsten oxide (WO/sub 3/) on/in titanium oxide (TiO/sub 2/) pellets, improve decomposition performance. Indirect plasma processing (plasma processed pure air is mixed with TCE contaminated air) suggests the existence of very active oxidation radicals whose lifetime is more than a few minutes but details of them are not yet clear.

We studied the variation in bark chemistry between and within 19 European white birch (Betula pendula) clones and its implications to resistance to the mountain hare (Lepus timidus). We used one-year-old clonal plantlets originating from randomly selected naturally regenerated parental trees. The same clones were used in both chemical analyses and in feeding experiments. The condensed tannins were analysed by an acid butanol assay, other phenolic components by HPLC-DAD, and triterpenoid components by HPLC-MS. The resistance to hare was tested in open-field feeding experiment. The main phenolic compounds in birch bark were catechin derivatives, rhododendrin, platyphylloside, and condensed tannins, and the main triterpenoids were papyriferic acid and pendulic acid. Most of the variation in the concentrations of the studied compounds was found between clones for the studied phenolics and large variation for triterpenoid components were found both between clones and among plantlets within the same clone. Hares clearly selected among the studied clones. Our results suggest that birch bark chemistry play an important role in resistance to herbivory by hare. The total triterpenoids and total flavonoid-aglycones showed significant negative correlation with hare feeding. It seems that a genetic basis for bark chemistry and birch resistance is strong. Such a high variation in secondary chemistry both between clones and within individual clones indicates that European white birch populations have a good resistance towards variable environmental conditions and varying pressures from herbivory.

Physiological and chemical responses of 17 birch (Betula pendula Roth) clones to 1.5–1.7 × ambient ozone were studied in an open-field experiment over two growing seasons. The saplings were studied for growth, foliar visible injuries, net photosynthesis, stomatal conductance, and chlorophyll, carotenoid, Rubisco, total soluble protein, macronutrient and phenolic concentrations in leaves. Elevated ozone resulted in growth enhancement, changes in shoot-to-root (s/r) ratio, visible foliar injuries, reduced stomatal conductance, lower late-season net photosynthesis, foliar nutrient imbalance, changes in phenolic composition, and reductions in pigment, Rubisco and soluble protein contents indicating accelerated leaf senescence. Majority of clones responded to ozone by changing C allocation towards roots, by stomatal closure (reduced ozone uptake), and by investment in low-cost foliar antioxidants to avoid and tolerate ozone stress. A third of clones, showing increased s/r ratio, relied on inducible efficient high-cost antioxidants, and enhanced leaf production to compensate ozone-caused decline in leaf-level net photosynthesis. However, the best ozone tolerance was found in two s/r ratio-unaffected clones showing a high constitutive amount of total phenolics, investment in low-cost antioxidants and N distribution to leaves, and lower stomatal conductance under ozone stress. The results highlight the importance of phenolic compounds in ozone defence mechanisms in the birch population. Depending on the genotype, ozone detoxification was improved by an increase in either efficient high-cost or less efficient low-cost antioxidative phenolics, with close connections to whole-plant physiology.

The performance of nonthermal plasma processing for dilute (100 or 1000 ppm) trichloroethylene (TCE) decomposition in air was investigated in combination with titania (TiO/sub 2/) catalysts. One type of catalyst consisted of 2-3-mm-diameter spherical titania pellets coated with vanadium oxide, V/sub 2/O/sub 5/. Homemade various-sized titania pellets sintered at 400/spl deg/C and 1000/spl deg/C were also tested. Gas chromatograph mass spectrometer analysis of the plasma-processed gas suggested that the catalyst was effective in enhancing TCE-decomposing energy efficiency, but the catalyst caused the generation of some byproducts. These results indicate that the size and surface state of the catalytic particulates were very important in determining the barrier discharge mode, and the energy efficiency of the plasma process was strongly dependent on the discharge mode.

The purpose of this study was to compare, by mechanical in vitro testing, a regular 5-hole plate and a long 4-hole plate with a regular 4-hole plate, applied to stabilize a simulated mandibular angle fracture.The plates from the 2.0-mm titanium-based system were adapted and stabilized passively in the same site in both groups using four screws, 6 mm long. During the resistance-to-load test, the force was applied perpendicular to the occlusal plane at three different points: first molar at the plated side, first molar at the contralateral side, and between the central incisors.The regular 5-hole plates and longer 4-hole plates were superior to the regular 4-hole plates. Furthermore, no statistically significant difference was found between the regular 5-hole plates and long 4-hole plate.The length and shape of plates did not interfere with the effectiveness to stabilize the fragments.The purpose of this study was to compare, by mechanical in vitro testing, a regular 5-hole plate and a long 4-hole plate with a regular 4-hole plate, applied to stabilize a simulated mandibular angle fracture.Study design The plates from the 2.0-mm titanium-based system were adapted and stabilized passively in the same site in both groups using four screws, 6 mm long. During the resistance-to-load test, the force was applied perpendicular to the occlusal plane at three different points: first molar at the plated side, first molar at the contralateral side, and between the central incisors.The regular 5-hole plates and longer 4-hole plates were superior to the regular 4-hole plates. Furthermore, no statistically significant difference was found between the regular 5-hole plates and long 4-hole plate.Conclusions The length and shape of plates did not interfere with the effectiveness to stabilize the fragments.

The effect of the electrode material on the high voltage stoichiometry-polarization (“electrocoloration”) of Fe-doped SrTiO3 single crystals has been studied. For different electrode materials (150-nm Ag/15-nm Cr and 150-nm Au/15-nm Cr) secondary ion mass spectrometry (SIMS) was used to measure the depth profile of the 18O-isotope after high-field stress. The results were compared with spatially resolved impedance measurements on electrocolored Fe-doped SrTiO3 single crystals. For Au/Cr as well as Ag/Cr electrodes a large dc voltage leads to moving color fronts which are usually correlated with a pronounced stoichiometry polarization of the samples due to electrodes blocking the ionic current. However, the local impedance measurements demonstrate that the conductivity profiles near the cathode depend on the electrode material. This finding is in accordance with the SIMS measurements which indicate that the Ag/Cr-electrodes are, in contrast to Au/Cr-electrodes not completely inactive for the oxygen incorporation into the Fe-doped SrTiO3. The results are discussed in terms of defect chemical models.

A simple model is developed to understand superconductivity in α ′ -TTF[Pd(dmit)2]2. We include electron-intra molecular and intermolecular phonon interactions as the mechanism of superconductivity. Intramolecular vibrations included are the eight symmetric Ag modes of the Pd(dmit)2 molecule. Intermolecular vibrations included are the longitudinal acoustic and transverse acoustic (LA and TA) modes of the Pd(dmit)2 column. All the electron-phonon coupling constants are calculated from first principles. We find that largest el-intramolecular vibration coupling is to the Ag mode with the highest frequency (1449 cm-1). The el-intermolecular coupling to the LA mode is found to be larger than the total el-intramolecular couplings. We also find el-(TA)phonon coupling to be at least an order of magnitude smaller than el-(LA)phonon coupling. Estimate of superconducting transition temperature is comparable to experimental result. We also provide a detailed discussion, employing the results of recent numerical calculations on two-chain Hubbard model and the specific material parameters, on the relative importance of el-ph and Coulomb-origin mechanisms of superconductivity in α ′ -TTF[Pd(dmit)2]2 and TTF[Ni(dmit) 2 ] 2 .

This study was designed to examine the effect of aging on bone formation induced by recombinant human bone morphogenetic protein-2 (rhBMP-2) combined with a fibrous collagen membrane (FCM). Implantation was done subperiosteally in bilateral palatal grooves in 34 male Wistar rats divided into three age groups: a 10-week-old group (10w group), a 30-week-old group (30w group) and a 70-week-old group (70w group). RhBMP-2-combined FCMs were implanted on the left palatal grooves as BMP-implanted sites (BMP site), while rhBMP-2 was not implanted on the right palatal grooves as control sites. The rats were sacrificed 6 weeks after implantation, and histometric evaluations were performed. New bone formation was observed in every site of each age group and the new bone was almost completely continuous with the original bone. The new bone volume (NBV) of the BMP site was significantly higher than that of the control site in each age group. The NBV of both the control and BMP sites were highest in the 10w group and lowest in the 70w group. The disparity of NBV between the control and BMP sites, which indicated the response to implanted BMP excluding the effect of skeletal growth and surgical stimulation, did not significantly differ among the age groups. These results indicate that rhBMP-2-combined FCM has the ability to induce new bone formation continuous with original bone even in senescent rats. Furthermore, it appeared that, in the case of palatal subperiosteal implantation, the responsiveness to implanted BMP was independent of age, although the total volume of newly formed bone declined with aging.

This paper proposes a newly developed cooperative control scheme between an HVDC transmission system and a radially connected thermal power plant. The proposed control scheme aims at stable control of the generator frequency during and after the transition from AC/DC parallel connected operation to radially connected operation of the HVDC system and the thermal power plant due to loss of AC transmission. The advantage of the proposed control scheme is to minimize the loss of generation in the transition state by the high-speed cooperative control where control quantities, calculated based on the necessary data acquired prior to the occurrence of the loss of AC transmission, are applied. A prototype of the control equipment was manufactured and subjected to performance evaluation tests by means of a large-scale analog simulator.

Bicrystals of SrTiO3 with twisted boundaries were prepared by a HIP method and were observed with a transmission electron microscope (TEM). The bicrystals exhibited different nonlinear current-voltage characteristics depending on twist angle. A Molecular dynamics calculation was applied in order to understand the detailed interface structure. The periodicity of the Σ5 twisted boundary was calculated to be 1.58 times longer than the lattice constant of SrTiO3 along the (130) axis, and agreed with the periodicity observed by TEM, i.e., 1.57. Coincidence sites formed between Ti ions of the TiO2 layer and O ions of the SrO layer at the interface and did not shift the positions predicted by a coincidence sites lattice model; such coincidence sites caused the structural periodicity along the interface.

Lupus anticoagulant (LAC) is associated with arterial and venous thrombosis, thrombocytopenia, and recurrent fetal loss. We have reported previously that plasma with LAC activity induces apoptosis in endothelial cells and binds annexin V (Nakamura, N., Y. Shidara, N. Kawaguchi, C. Azuma, N. Mitsuda, S. Onishi, K. Yamaji, and Y. Wada. 1994. Biochem. Biophys. Res. Commun. 205:1488-1493). In this study, we separated two IgG antibody fractions, one with and one without affinity for annexin V, from 10 patients with LAC. LAC and apoptotic activities were localized in the annexin V-binding fraction in all 10 patients. DNA fragmentation was dose-dependent, paralleling the amount of IgG added to the human umbilical vein endothelial cell culture medium, and was inhibited by preincubation with annexin V. Removal of the antiphospholipid antibodies from patient IgG with phospholipid liposomes did not abolish the apoptosis-inducing activities or binding to annexin V. These results imply that patients with LAC often have antibodies that do not bind phospholipids and are responsible for the induction of apoptosis in endothelial cells.

k c2sT d within the Ginzburg-Landau-Abrikosov-Gor'kov theory and the Lawrence-Doniach model to the case of strong magnetic fields. From this equation, it follows that orbital effects of an electron motion along an open Fermi surface in a magnetic field start to restore superconductivity at magnetic fields higher than the quasiclassical upper critical field and result in the appearance of a reentrant phase with TcsH d. T c s 0 d . A stability of the reentrant phase against fluctuations is discussed. (S0031-9007(98)05633-6)

This paper proposes advanced frequency control strategies for the DC radial system with isolated generators. The DC power order in the DC radial operation is set by an automatic frequency regulator (AFR), which is composed of an integral function and a proportional function. The AFR balances DC transmitted power with mechanical output power of generators to maintain frequency deviation as close as the one in an AC radial link. Also, a universal and autonomous HVDC control strategy is proposed for the secure transfer of the generator operation from an AC-DC parallel to a DC radial. This control can suppress transient frequency within permissible limits, and matches with turbine generator speed controls and turbine over speed protection in a stable manner. A prototype controller is implemented to verify the strategies. The validity and effectiveness are confirmed through a factory test using a DC simulator.

This paper proposes unique DC control strategies to prevent dynamic commutation failures during and following faults, and to obtain better recovery from the faults. The strategy is based on an idea of sine-cosine components detector in which AC voltages are detected fast in terms of two components on the rotational reference frame synchronized with an AC system frequency. The controller quickly predicts a necessary control angle according to the magnitude, the phase angle, and involved harmonics that are calculated from these two components. The validity and effectiveness of the controller are confirmed through the EMTP simulations. The DC simulator results using the fabricated controller confirm the EMTP simulations.

The paper describes the development of insulation structure and enhancement of insulation reliability of 500 kV DC GIS (gas insulated switchgear). Considering problems of metallic particles and charge accumulation on spacers, the developed insulation structure of GIS consisted of three regions, i.e. the spacer, particle scavenging and nonlevitating regions. Particles could be efficiently scavenged, and the developed GIS withstood all insulation specifications with sufficient margins under the clean and particle-contaminated condition. Now, a long-term site test for one year of the 500 kV DC GIS has been continued since October in 1995.

Instability of the arc in an HVDC circuit breaker was investigated both analytically and experimentally. The analytical work showed that the amplification coefficient and the frequency of the oscillation that leads to the current zero can be given as functions of parallel impedance and arc characteristics. The process to estimate the arc characteristics from the amplification coefficient and the frequency experimentally observed was proposed and the result was compared with the estimation of the same characteristics by the analysis of the current zero behavior. It was shown that a description of the DC arc by a simple Mayr type model could reproduce the initiation and the growth of the oscillation and the interruption of the current.

Among special insulation tests for DC power converter transformers, polarity reversal tests can be substituted by applied AC voltage tests from a stress similarity in oil ducts. In order to investigate equivalent levels of other insulation tests to polarity reversal tests, the dielectric strength of a transformer at polarity reversals was examined by use of a model of typical oil/paper composite insulation. From the comparison of polarity reversal and other insulation tests, it was found that dielectric strength of transformer insulation at polarity reversals is phenomenally similar to that under switching impulse stresses. Equivalent AC test voltage to polarity reversal test was also estimated from the experimental results. The breakdown characteristics of polarity reversal tests showed that partial discharges at polarity reversals impose less harmful stress on insulation barriers than those at usual AC or impulse tests.