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The aim of this retrospective analysis was to investigate the prevalence and prognostic importance of incidental malignancy detected during pre-TAVI computed tomography. Among 579 patients, CT-work-up for TAVI exposed previously undetected malignancy in 4.5% of patients. TAVI patients with a new malignancy had a 2.9-fold increased risk of death at one year, and a 16 month shorter mean survival time compared to patients with no malignancy.

Objective: to identify the sociodemographic profile and the characteristics of interpersonal violence against older adults during the first year of the COVID-19 pandemic in a capital city from the Brazilian Southeast region. Method: a descriptive and exploratory research study with a cross-sectional design based on the notifications of suspected or confirmed cases of violence against older adults between March 2020 and March 2021. A univariate statistical analysis and Fisher’s exact test (p

Objective: to identify the sociodemographic profile and the characteristics of interpersonal violence against older adults during the first year of the COVID-19 pandemic in a capital city from the Brazilian Southeast region. Method: a descriptive and exploratory research study with a cross-sectional design based on the notifications of suspected or confirmed cases of violence against older adults between March 2020 and March 2021. A univariate statistical analysis and Fisher’s exact test (p

Resumen Objetivo: identificar el perfil sociodemográfico y las características de la violencia interpersonal contra los adultos mayores en el primer año de la pandemia de COVID-19 en una ciudad capital de la región sureste de Brasil. Método: investigación descriptiva, exploratoria con diseño transversal a partir del análisis de las notificaciones de casos sospechosos o confirmados de violencia contra el adulto mayor, ocurridos entre marzo de 2020 y marzo de 2021. Se realizó un análisis estadístico univariado y la prueba exacta de Fisher (p< 0,05). Resultados: hubo 2681 notificaciones en el período. Las principales víctimas fueron personas entre 60 y 64 años, de sexo femenino, blancas y con baja escolaridad. La mayoría de los casos se registró en el hogar. La violencia física y psicológica fueron las más comunes, con uso de fuerza física/golpes y amenaza, respectivamente. El agresor era generalmente del sexo masculino, más joven que la víctima, hijo o pareja. Las agresiones se produjeron más de una vez y fueron motivadas por conflictos generacionales. Hubo baja derivación a organismos de protección de adultos mayores. Conclusión: el perfil sociodemográfico obtenido revela que son víctimas vulnerables, sujetas a múltiples formas de violencia y que la integridad de su salud está en riesgo potencial.

Background/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is essential for the diagnosis of pancreatic cancer. The feasibility of comprehensive genomic profiling (CGP) using samples obtained by EUS-TA has been under recent discussion. This study aimed to evaluate the utility of EUS-TA for CGP in a clinical setting.Methods: CGP was attempted in 178 samples obtained from 151 consecutive patients with pancreatic cancer at the Aichi Cancer Center between October 2019 and September 2021. We evaluated the adequacy of the samples for CGP and determined the factors associated with the adequacy of the samples obtained by EUS-TA retrospectively.Results: The overall adequacy for CGP was 65.2% (116/178), which was significantly different among the four sampling methods (EUS-TA vs. surgical specimen vs. percutaneous biopsy vs. duodenal biopsy, 56.0% [61/109] vs. 80.4% [41/51] vs. 76.5% [13/17] vs. 100.0% [1/1], respectively; p=0.022). In a univariate analysis, needle gauge/type was associated with adequacy (22 G fine-needle aspiration vs. 22 G fine-needle biopsy [FNB] vs. 19 G-FNB, 33.3% (5/15) vs. 53.5% (23/43) vs. 72.5% (29/40); p=0.022). The sample adequacy of 19 G-FNB for CGP was 72.5% (29/40), and there was no significant difference between 19 G-FNB and surgical specimens (p=0.375).Conclusions: To obtain adequate samples for CGP with EUS-TA, 19 G-FNB was shown to be the best in clinical practice. However, 19 G-FNB was not still sufficient, so further efforts are required to improve adequacy for CGP.

Reports of mortality-associated risk factors in patients with coronavirus disease (COVID-19) are limited.We evaluated the clinical features that were associated with mortality among patients who died during hospitalization (N=158) and those who were alive at discharge (N=2,736) from the large-scale, multicenter, retrospective, observational cohort CLOT-COVID study enrolled consecutively hospitalized COVID-19 patients from 16 centers in Japan from April to September 2021. Data from 2,894 hospitalized COVID-19 participants of the CLOT-COVID study were analyzed in this study.Patients who died were older (71.1 years versus 51.6 years, P0.001), had higher median D-dimer values on admission (1.7 μg/mL versus 0.8 μg/mL, P0.001), and had more comorbidities. On admission, the patients who died had more severe COVID-19 than did those who survived (mild: 16% versus 63%, moderate: 47% versus 31%, and severe: 37% versus 6.2%, P0.001). In patients who died, the incidence of thrombosis and major bleeding during hospitalization was significantly higher than that in those who survived (thrombosis: 8.2% vs. 1.5%, P0.001; major bleeding: 12.7% vs. 1.4%, P0.001). Multivariable logistic regression analysis revealed that age70 years, high D-dimer values on admission, heart disease, active cancer, higher COVID-19 severity on admission, and development of major bleeding during hospitalization were independently associated with a higher mortality risk.This large-scale observational study in Japan identified several independent risk factors for mortality in hospitalized patients with COVID-19 that could facilitate appropriate risk stratification of patients with COVID-19.

Background: Ang II (angiotensin II) type 1 (AT 1 ) receptors play a critical role in cardiovascular diseases such as hypertension. Rodents have 2 types of AT 1 receptor (AT 1A and AT 1B ) of which knock-in Tagln -mediated smooth muscle AT 1A silencing attenuated Ang II–induced hypertension. Although vascular remodeling, a significant contributor to organ damage, occurs concurrently with hypertension in Ang II–infused mice, the contribution of smooth muscle AT 1A in this process remains unexplored. Accordingly, it is hypothesized that smooth muscle AT 1A receptors exclusively contribute to both medial thickening and adventitial fibrosis regardless of the presence of hypertension. Methods: About 1 µg/kg per minute Ang II was infused for 2 weeks in 2 distinct AT 1A receptor silenced mice, knock-in Tagln -mediated constitutive smooth muscle AT 1A receptor silenced mice, and Myh11 -mediated inducible smooth muscle AT 1A together with global AT 1B silenced mice for evaluation of hypertensive cardiovascular remodeling. Results: Medial thickness, adventitial collagen deposition, and immune cell infiltration in aorta were increased in control mice but not in both smooth muscle AT 1A receptor silenced mice. Coronary arterial perivascular fibrosis in response to Ang II infusion was also attenuated in both AT 1A receptor silenced mice. Ang II–induced cardiac hypertrophy was attenuated in constitutive smooth muscle AT 1A receptor silenced mice. However, Ang II–induced cardiac hypertrophy and hypertension were not altered in inducible smooth muscle AT 1A receptor silenced mice. Conclusions: Smooth muscle AT 1A receptors mediate Ang II–induced vascular remodeling including medial hypertrophy and inflammatory perivascular fibrosis regardless of the presence of hypertension. Our data suggest an independent etiology of blood pressure elevation and hypertensive vascular remodeling in response to Ang II.

BACKGROUND The Valve-in-Valve International Data (VIVID) registry proposed a simplified classification to assess the risk of coronary obstruction during valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) based on preprocedural multi-detector computed tomography (MDCT). We investigated the validity of the VIVID classification in patients undergoing ViV-TAVI for degenerated bioprostheses. METHODS Patients undergoing ViV-TAVI for degenerated bioprostheses were prospectively included in this study. The risk of coronary obstruction among patients treated with stented valves was retrospectively evaluated based on anatomical assessment on pre-procedural MDCT. RESULTS Among a total of 137 patients that underwent ViV-TAVI between August 2007 and June 2021, 109 patients had stented, sutureless, or transcatheter degenerated bioprosthesis of which 96 (88%) had adequate MDCT data for risk assessment. High-risk anatomy for coronary obstruction (VIVID type IIB, IIIB, or IIIC) in either the left or right coronary artery was observed in 30 patients (31.3%). Of the 30 patients with high-risk anatomy, coronary protection using wire protection or BASILICA (bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction) was performed in 3 patients (10.0%). Three patients treated with stentless valves and one patient treated with a stented valve with externally mounted leaflets had coronary obstruction. None of the patients with high risk anatomy according to MDCT had coronary obstruction even without coronary protection. CONCLUSIONS Coronary obstruction occurred in none of the patients classified as high-risk patients according to the VIVID classification despite the absence of coronary protection. Refined tools are required to assess the risk of coronary obstruction. CLINICAL TRIAL REGISTRATION https://www. CLINICALTRIALS gov. NCT01368250.

BACKGROUND Self-expanding transcatheter heart valves (THVs) are associated with better echocardiographic hemodynamic performance than balloon-expandable THVs and are considered preferable in patients with small annuli. OBJECTIVES This study sought to compare 5-year outcomes between self-expanding vs balloon-expandable THVs in severe aortic stenosis (AS) patients with small annuli. METHODS Consecutive severe AS patients with an aortic valve annulus area

A new Levenberg–Marquardt (LM) method for solving nonlinear least squares problems with convex constraints is described. Various versions of the LM method have been proposed, their main differences being in the choice of a damping parameter. In this paper, we propose a new rule for updating the parameter so as to achieve both global and local convergence even under the presence of a convex constraint set. The key to our results is a new perspective of the LM method from majorization-minimization methods. Specifically, we show that if the damping parameter is set in a specific way, the objective function of the standard subproblem in LM methods becomes an upper bound on the original objective function under certain standard assumptions. Our method solves a sequence of the subproblems approximately using an (accelerated) projected gradient method. It finds an $$\varepsilon$$ ε -stationary point after $$O(\varepsilon ^{-2})$$ O ( ε - 2 ) computation and achieves local quadratic convergence for zero-residual problems under a local error bound condition. Numerical results on compressed sensing and matrix factorization show that our method converges faster in many cases than existing methods.

Objective The effectiveness of everolimus for the management of pancreatic neuroendocrine neoplasms (PNENs), including the G3/NEC types, remains unclear. We therefore investigated the effectiveness of the drug for the management of PNENs. Methods We analyzed the progression-free survival (PFS) and overall survival (OS) associated with everolimus and factors influencing the PFS and OS. Results One hundred patients were evaluated. The PFS associated with the G1/G2 types tended to be significantly longer than that associated with the G3/NEC types (hazard ratio [HR], 0.45; p =0.005). A multivariate analysis showed that the significant factors influencing the PFS were age (65 years old; HR, 0.44; p =0.002), grade (G1/G2; HR, 0.42; p =0.006), everolimus treatment line (≤2nd; HR, 0.55; p =0.031), and presence of treatment with metformin (yes; HR, 0.29; p =0.044). The median OS was 63.8 months. In the multivariate analysis, the significant factors influencing the OS were grade (G1/G2; HR, 0.21; p0.001), volume of liver metastasis (≤25%; HR, 0.27; p0.001), everolimus treatment line (≤2nd; HR, 0.27; p0.001), and presence of primary tumor resection (yes; HR, 0.33; p =0.005). Conclusions The effectiveness of everolimus in the management of G3/NEC types and prognoses tended to be poorer than those associated with the G1/G2 types. Everolimus combined with metformin and early-line treatment with everolimus may be effective for managing advanced PNENs.

Recent advances in chiral sulfide-catalyzed asymmetric halocyclizations are summarized.

Socially anxious adolescents commonly experience impaired interpersonal functioning with unfamiliar, same-age peers. Yet, we lack short screening tools for assessing peer-related impairments. Recent work revealed that a parent-reported, three-item screening tool produced scores that uniquely related to social anxiety concerns. However, this tool ought to go beyond linking impairments to service needs (i.e., social anxiety symptoms). This tool should also inform the goals of services, in particular by linking impairments to key domains relevant to therapeutically addressing adolescents' anxiety-related needs, such as social skills when interacting with unfamiliar peers. This requires an assessment approach that involves strategic selection of informants who vary in their expertise for observing anxiety-related needs, as well as the therapeutic goals for addressing anxiety-related impairments (e.g., social skills within peer interactions). We leveraged parents' reports to link impairments to social anxiety-related needs. To link impairments to social skills, we leveraged informants (i.e., unfamiliar untrained observers [UUOs]) who observed adolescents within tasks designed to simulate interactions with same-age, unfamiliar peers. We tested this approach using a mixed-clinical/community sample of 134 adolescents, ages 14- to 15 years old. We leveraged multi-informant survey reports to assess adolescent social anxiety, and trained independent observers rated adolescents' social skills within unfamiliar peer interactions. Parents' reports performed best when distinguishing adolescents on referral status and predicting survey-reported social anxiety, whereas only UUOs' reports predicted independent observers' social skills ratings. These findings inform the strategic selection of informants for assessing impairments that commonly prompt the need for adolescents to access mental health services for social anxiety.

Water-soluble λ-carrageenan–benzophenone complexes retained their properties of crystallization-induced phosphorescence of benzophenones at room temperature in aqueous solutions.

Thermoresponsive behavior of stereoisomers of a dense triazole polymer was studied; mixtures of the isotactic one underwent thermoresponsive gel-to-sol transition, and aqueous solutions of the syndiotactic one underwent LCST-type phase transition.

12(S)-hydroxyheptadecatrienoic acid (12-HHT) is a bioactive fatty acid synthesized from arachidonic acid via the cyclooxygenase pathway and serves as an endogenous ligand for the low-affinity leukotriene B4 receptor 2 (BLT2). Although the 12-HHT/BLT2 axis contributes to the maintenance of epithelial homeostasis, 12-HHT metabolism under physiological conditions is unclear. In this study, 12-keto-heptadecatrienoic acid (12-KHT) and 10,11-dihydro-12-KHT (10,11dh-12-KHT) were detected as 12-HHT metabolites in the human megakaryocytic cell line MEG01s. We found that 12-KHT and 10,11dh-12-KHT are produced from 12-HHT by 15-hydroxyprostaglandin dehydrogenase (15-PGDH) and prostaglandin reductase 1 (PTGR1), key enzymes in the degradation of prostaglandins, respectively. The 15-PGDH inhibitor SW033291 completely suppressed the production of 12-KHT and 10,11dh-12-KHT in MEG01s cells, resulting in a 9-fold accumulation of 12-HHT. 12-KHT and 10,11dh-12-KHT were produced in mouse skin wounds, and the levels were significantly suppressed by SW033291. Surprisingly, the agonistic activities of 12-KHT and 10,11dh-12-KHT on BLT2 were comparable to that of 12-HHT. Taken together, 12-HHT is metabolized into 12-KHT by 15-PGDH, and then 10,11dh-12-KHT by PTGR1 without losing the agonistic activity.

Objetivo: apresentar atividades vivenciadas por estudantes universitários participantes do projeto de extensão Saber Cuidar, voltadas ao fortalecimento das redes de apoio social às pessoas diagnosticadas com câncer ou sobreviventes. Métodos: relato de experiência, centrado em interações dialógicas entre extensionistas e comunidade da periferia da região Sudeste de São Paulo, realizadas durante o ano de 2019. Resultados: realizaram-se 07 visitas domiciliares, 03 encontros na associação de moradores, e 30 reuniões pedagógicas e de planejamento. O engajamento dos participantes propiciou para além da construção de estratégia para identificação das redes de apoio do sistema formal e informal, uma dinâmica transformadora das próprias relações, formando Redes Vivas. Considerações finais: o alicerce do projeto extensionista na perspectiva de educação freiriana proporcionou não só fortalecimento, mas também valorização da rede de apoio social como instrumento do cuidar.

BACKGROUND Elliptical shape of the aortic annulus has been associated with an increased risk of device failure after transcatheter aortic valve implantation (TAVI) compared with a circular annular shape. AIMS To assess the impact of annulus ellipticity on procedural outcomes and device performance in patients undergoing TAVI. METHODS In a prospective TAVI registry, aortic annulus ellipticity was assessed by preprocedural multidetector computed tomography. The annulus ratios, defined by the ratio of minimum and maximum annulus diameters measured in a transverse double oblique plane, were split into tertiles for comparisons between groups. RESULTS A total of 1732 patients undergoing TAVI between August 2007 and June 2020 were included in the present analysis. Patients in the tertile with the most elliptical shape of the annulus were more likely to be female (59.7% vs. 47.9%; p

Kinetic analysis of intracellular calcium (Ca