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Shiraki T., Ichibori Y., Ohtani T., et al. Pathophysiological evaluations of initial plaque development after heart transplantation via serial multimodality imaging and cytokine assessments. Journal of Heart and Lung Transplantation 41, 877 (2022); https://doi.org/10.1016/j.healun.2022.03.007., Background: Detailed morphological characteristics of de novo and donor-transmitted plaques and the association of serum T-lymphocyte cytokine levels with plaque progression of coronary allograft vasculopathy within 1 year after heart transplantation are unknown. Methods: In this retrospective analysis of data in a prospectively maintained database, 40 heart transplant recipients were included. We performed serial 3 vessel optical coherence tomography and intravascular ultrasound analyses, at the 8 week (baseline) and 12 month post-transplantation follow-ups, and serum cytokine measurements (n = 23). The correlation between serum cytokines and Δplaque burden (between baseline and follow-up) was evaluated depending on plaque morphology. Results: Thirteen de novo plaques (maximum intimal thickness ≥0.5 mm at the 12 month follow-up without plaques at baseline) were identified in 8 recipients, and 31 donor-transmitted plaques (maximum intimal thickness ≥0.5 mm at baseline) were detected in 17 recipients. Compared with donor-transmitted plaques, the Δplaque burden in the de novo plaques, with mainly fibrous morphology, was high (38.8% [29.6%–41.2%] vs 8.7% [1.33%–13.6%], p < 0.001). Stratification of the morphology of donor-transmitted plaques revealed that the Δplaque burden in fibrous plaques (10.6% [7.0%–18.0%]) was similar to that in fibroatheroma (10.3% [8.7%–23.8%]). Serum interleukin-31 levels at baseline correlated with fibrous plaque proliferation (r = 0.73, p = 0.007) even under immunosuppressive conditions, whereas other cytokines (interleukin-1β, interleukin-17, and interferon-gamma) were mostly undetectable. Conclusions: Intimal fibrous proliferation contributed to the progression of donor-transmitted and de novo plaques. Serum interleukin-31 levels at baseline may contribute to intimal fibrous proliferation within 1 year after heart transplantation.

Antiplatelet therapy after percutaneous coronary intervention (PCI) has been changing in parallel with the development of drug-eluting stents (DES) and antiplatelet agents. The recommendation of dual antiplatelet therapy duration is getting shorter due to the decreased risk of stent thrombosis in new-generation DES, the use of a P2Y

In-hospital bleeding is associated with poor prognosis in patients with acute myocardial infarction (AMI). We sought to investigate whether a combination of pre-procedural blood tests could predict the incidence of in-hospital major bleeding in patients with AMI.A total of 1684 consecutive AMI patients who underwent primary percutaneous coronary intervention (PCI) were recruited and randomly divided into derivation (n = 1010) and validation (n = 674) cohorts. A risk-score model was created based on a combination of parameters assessed on routine blood tests on admission. In the derivation cohort, multivariate analysis revealed that the following 5 variables were significantly associated with in-hospital major bleeding: hemoglobin level 12 g/dL (odds ratio [OR], 3.32), white blood cell count10,000/μL (OR, 2.58), platelet count150,000/μL (OR, 2.51), albumin level 3.8 mg/dL (OR, 2.51), and estimated glomerular filtration rate 60 mL/min/1.73 mOur novel laboratory-based bleeding risk model could be useful for simple and objective prediction of in-hospital major bleeding events in patients with AMI.

BACKGROUND In-stent restenosis (ISR), especially for neoatherosclerosis, is still a major problem of percutaneous coronary intervention (PCI) even in the drug-eluting stent (DES) era. AIMS The purpose of this study was to investigate the impact of neoatherosclerosis on prognosis after PCI for ISR. METHODS Between March 2009 and December 2017, 313 ISR lesions in patients undergoing an OCT-guided PCI in five hospitals were retrospectively enrolled. Neoatherosclerosis was defined as a lipid neointima or calcified neointima. We examined the association between neoatherosclerosis and the clinically driven target lesion revascularisation (CD-TLR) rates. RESULTS In 313 ISR lesions, 64 lesions (20.4%) had bare metal stents and 241 lesions (77.0%) had drug-eluting stents (DES). Among them, 47.0% of lesions (147 lesions) had neoatherosclerosis. A multivariate logistic regression analysis demonstrated that eGFR (odds ratio [OR] 0.986, 95% confidence interval [CI]: 0.974-0.998; p=0.023), the time from PCI to the ISR (OR 1.13, 95% CI: 1.06-1.22; p

Differences in guiding catheters (GCs) manipulations and selections among different access sites are currently unclear. We examined the differences in the routes of GCs for the left coronary artery (LCA) among the right radial, left radial, and femoral approaches. We used a combined angiography-computed tomography (CT) system that enabled to perform CT scans during percutaneous coronary intervention (PCI). We enrolled 88 patients who underwent CT scans during LCA PCI or percutaneous transluminal septal myocardial ablation. To evaluate the route of GCs, we analyzed the positions of the catheter’s contact point on the contralateral aortic wall to the LCA ostium, which were expressed by the angle formed by the vertical line and the diagonal line from the GC shaft to the center of the aorta. The procedures were performed via the right radial in 47 cases, left radial in 20, and femoral approach in 21. The positions of the catheter’s contact point were significantly different depending on the approaches (interquartile range − 3.7 [− 14.3 to 7.8], − 46.5 [− 76.9 to − 9.3], and − 30.7 [− 39.4 to − 22.4] degrees, respectively; p

Recently developed coronary angiography with intraprocedural 320-row computed tomography can be performed in a catheterization laboratory (XACT) by injecting contrast medium from a place close to the coronary arteries, thereby requiring a minimal amount of contrast medium. However, its clinical application has not yet been established. This study aimed to evaluate the diagnostic accuracy of XACT angiography with a minimal volume of contrast medium in patients with suspected coronary artery disease (CAD). A total of 167 coronary segments were analyzed in 14 patients (9 males, median age 70 years) with suspected CAD by XACT angiography with 7.5 ml of contrast medium and invasive coronary angiography (ICA) with standard techniques. The segmental-based diagnostic accuracy of XACT angiography in detecting stenosis of ≥ 50% and ≥ 75% and visualized by ICA was good (sensitivity: 74% and 62%, specificity: 99% and 99%, positive predictive value: 93% and 80%, and negative predictive value: 97% and 97%, respectively). These results suggest that XACT angiography with a very low amount of contrast medium may have strong clinical utility for screening coronary arteries in patients with renal dysfunction or undergoing clinical procedures such as pacemaker implantation.

Background Stent thrombosis (ST) remains a significant medical issue. In particular, longer‐term mortality and clinical predictors after ST occurrence have yet to be elucidated. Methods and Results This was a multicenter, retrospective, observational study. A total of 187 definite ST cases from January 2008 to December 2017 were enrolled, and the long‐term clinical outcomes were investigated. The primary outcome measure was the cumulative mortality after ST occurrence. In addition, independent predictors of mortality were assessed. Among the stent types causing ST, bare‐metal stent, first‐generation drug‐eluting stent, second‐generation drug‐eluting stent, and third‐generation drug‐eluting stent comprised 31.0%, 19.3%, 36.9%, and 6.4% of cases, respectively. Median duration from stent implantation to ST was 680.5 (interquartile range, 33.8–2450.5) days. Cumulative mortality was 14.6%, 17.4%, 21.2%, 24.4%, and 33.8% at 1, 2, 3, 5 and 10 years, respectively. The cumulative mortality did not significantly differ by type of stent, and mortality of late ST was higher than that of early ST and very late ST; however, it did not reach statistical significance after the multivariate analysis. Independent predictors of mortality were hemodialysis (hazard ratio [HR], 7.80; 95% CI, 3.07–19.81; P P =0.008), culprit lesions in the left coronary artery (HR, 2.77; 95% CI, 1.10–6.96; P =0.030), and peak creatine kinase (HR, 1.017; 95% CI, 1.011–1.022; P Conclusions The 10‐year cumulative mortality after ST reached 33.8%. Close follow‐up is thus mandatory for patients with ST, especially with hemodialysis, culprit lesions in the left main trunk and left coronary artery, and high peak creatine kinase.

We report our experience with a 69-year-old man who had different types of Kounis syndrome over a short time frame, caused by two episodes of bee sting anaphylaxis. After his first allergic reaction to a bee sting, he experienced a non–ST-segment elevation myocardial infarction; he was treated with percutaneous coronary intervention for near-occlusion of his right coronary artery. This episode was deemed type 2 Kounis syndrome. Four weeks later, we electively treated the nonculprit residual stenosis in his left anterior descending artery. Unfortunately, 2 weeks after this elective procedure, he experienced anaphylactic shock due to a second bee sting. Electrocardiography showed ST elevation in the anterior leads, and emergent coronary angiography showed thrombotic occlusion of the newly implanted stent in the left anterior descending artery. This second episode was deemed type 3 Kounis syndrome. LEARNING OBJECTIVES: This is a rare example of different types of Kounis syndrome resulting from repeated exposures to an allergic source, an example that deepens our understanding of Kounis syndrome. This patient's experience illustrates the need for careful evaluation of the indications for revascularization of nonculprit lesions in patients with a history of Kounis syndrome.

PurposeRotational atherectomy (RA) and orbital atherectomy (OA) are effective procedures for severe calcified coronary artery disease. Nonetheless, vessel perforation remains an adverse complication of these procedures. This study aimed to evaluate factors affecting elastic material damage caused by RA and OA.MethodsAn in vitro assessment was conducted in which the damage to the rubber latex, an elastic material, after RA was evaluated under various conditions, including burr rotational speed (100,000–220,000 rotations per minute), approaching curve, burr size (1.25 mm, 1.75 mm, and 2.0 mm), and fluid viscosity (water and low-molecular weight dextran). Similarly, the rubber latex damage after OA was evaluated in the same experimental system under various conditions, including crown rotational speed, approaching curve, and fluid viscosity.ResultsIn RA, the rubber latex was damaged at lower rotational speeds (p = 0.003), tighter approaching curves (p < 0.0001), and lower fluid viscosity (p = 0.03). In OA, the rubber latex was generally severely damaged.ConclusionA higher rotational speed, coaxial approach for the wall, and higher viscosity contributed to lesser elastic material damage in RA. The safety mechanism for elastic material in OA proved less effective.

We propose novel third-order less oscillatory and less diffusive compact stencil-based upwind schemes for the approximation of the continuity equation. The proposed schemes are based on the constrained interpolation profile-conservative semi-Lagrangian schemes. An important feature of the proposed schemes is that the interpolation functions are constructed using only variables within one upwind cell (a cell average and two boundary values). Furthermore, the proposed schemes have third-order accuracy and are also less oscillatory, less diffusive, and fully conservative. The proposed schemes are validated through various benchmark problems and comparisons with experiments of two droplets collision/separation and droplet splashing. The numerical results have shown that the proposed schemes have third-order accuracy for smooth solution, and capture discontinuities and smooth solutions simultaneously without numerical oscillations. The proposed schemes can capture the secondary vorticity of lid-driven cavity flow of Re = 7500 with a Cartesian grid of 64 × 64. The numerical results of two droplets collision/separation of We = 40 show that the proposed schemes can reproduce droplets collision/separation with quite coarse grids. These numerical results of droplet splashing have demonstrated that proposed schemes can reduce numerical diffusions well against existing schemes and robust.

Low serum albumin (SA) on admission in patients with acute myocardial infarction (AMI) has been reported to be associated with adverse cardiovascular events. The relation between low SA and post-AMI bleeding events is presently unknown. We analyzed 1,724 patients with AMI enrolled in the HAGAKURE-ACS registry who underwent primary percutaneous coronary intervention from January 2014 to December 2018. To assess the influence of low SA at admission, patients were divided into 3 groups according to the albumin tertiles: the low SA group (3.8 g/100 ml), the middle SA (MSA) group (3.8 to 4.1 g/100 ml), and the normal SA (NSA) group (≥4.2 g/100 ml). The primary end point was the incidence of Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries moderate/severe bleeding. The cumulative 3-year incidence of the primary end point was significantly higher in the low SA group than in the MSA and NSA groups (30.8% and 11.9% vs 7.7%; p0.001). In the landmark analysis at 30 days, the cumulative incidences of the primary end point were also significantly higher in the low SA group than in the MSA and NSA groups, both within and beyond 30 days (20.1% and 6.1% vs 3.5%; p0.001, and 12.4% and 6.2% vs 4.5%; p0.001, respectively). After adjusting for confounders, the low SA group showed excess risk of bleeding events relative to NSA (hazard ratio 1.56; 95% confidence interval 1.06 to 2.30; p = 0.026), whereas risk of bleeding was neutral in MSA relative to NSA (hazard ratio 0.94; 95% confidence interval 0.63 to 1.34; p = 0.752). In conclusion, low SA at admission was independently associated with higher risk for bleeding events in patients with AMI undergoing percutaneous coronary intervention.

Objective We investigated whether or not a history of multiple percutaneous coronary interventions (PCIs) is associated with clinical outcomes after surgery for ischemic mitral regurgitation. Methods A total of 309 patients with chronic ischemic mitral regurgitation and left ventricular ejection fraction ≤40% who underwent restrictive mitral annuloplasty were classified as follows: patients with no or 1 previous PCI (nonmultiple PCI group [n = 211]) and patients with 2 or more previous PCIs (multiple PCIs group [n = 98]). Mean follow-up duration was 53 ± 40 months. Results Before surgery, there were no intergroup differences in patient demographic characteristics except for lower estimated glomerular filtration rate in patients with multiple PCIs. These patients underwent concomitant coronary artery bypass grafting less frequently with a lower number of distal anastomoses (P Conclusions In patients with ischemic mitral regurgitation, a history of previous multiple PCIs was associated with increased risk of long-term postoperative mortality, with less improvement in left ventricular ejection fraction.

First, a new reconstruction strategy is proposed to improve the accuracy of the fifth-order weighted essentially non-oscillatory (WENO) scheme. It has been noted that conventional WENO schemes still suffer from excessive numerical dissipation near-critical regions. One of the reasons is that they tend to under-use all adjacent smooth substencils thus fail to realize optimal interpolation. Hence in this work, a modified WENO (MWENO) strategy is designed to restore the highest possible order interpolation when three target substencils or two target adjacent substencils are smooth. Since the new detector is formulated under the original smoothness indicators, no obvious complexity and cost are added to the simulation. This idea has been successfully implemented into two classical fifth-order WENO schemes, which improve the accuracy near the critical region but without destroying essentially non-oscillatory properties. Second, the tangent of hyperbola for interface capturing (THINC) scheme is introduced as another reconstruction candidate to better represent the discontinuity. Finally, the MWENO and THINC schemes are implemented with the boundary variation diminishing algorithm to further minimize the numerical dissipation across discontinuities. Numerical verifications show that the proposed scheme accurately captures both smooth and discontinuous flow structures simultaneously with high-resolution quality. Meanwhile, the presented scheme effectively reduces numerical dissipation error and suppresses spurious numerical oscillation in the presence of strong shock or discontinuity for compressible flows and compressible two-phase flows.

Background Cardiac allograft vasculopathy is a combination of the development of de novo plaque and the progression of donor-transmitted plaque. Purpose This study aimed to evaluate the development of de novo plaque and the progression of donor-transmitted plaque within 12-month after heart transplantation (HTx) using serial intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The association between inflammatory cytokines and plaque progression was also examined. Methods We prospectively enrolled 40 recipients to conduct serial three-vessel IVUS and OCT analysis at 8-week and 12-month after HTx. De novo plaque was defined as having maximum intimal thickness (MIT) ≥0.5 mm at 12-month in the absence of donor-transmitted plaques (MIT ≥0.5 mm at 8-week). Serum cytokines were screened with a bead-based multiplex assay. Results A total of 13 de novo plaques (fibrous, n=10; fibroatheroma, n=3) were detected in eight recipients. Serum interleukin (IL)-31 at 8-week was associated with the development of de novo plaques (p=0.009). A total of 31 donor-transmitted plaques (fibrous, n=12; fibroatheroma, n=11; fibrocalcific, n=8) were detected in 17 recipients. Multiple regression analysis revealed that fibrous (p=0.026) and fibroatheroma (p=0.012) observed at 8-week were significantly associated with subsequent plaque progression within 12-month after HTx. ΔPlaque burden was significant higher in de novo plaque than donor-transmitted plaque (38.8% [29.6–41.2] versus 8.7% [1.3–13.6], p Conclusions In de novo plaques, fibrous plaque was the most common and macrophage accumulation was rarely observed. In donor-transmitted plaque, fibrous and fibroatheroma were independent predictor for the subsequent plaque progression. Serum interleukin-31 surge at subacute phase may play pathogenic role in cardiac allograft vasculopathy. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Grants-in-Aid for Scientific Research (KAKENHI)

Application of numerical simulations are desired to improve the quality of powder products and to optimize the production process in powder die-filling. In the powder die-filling, complex gas-solid interaction should be simulated since the solid particles are significantly influenced by the gas flow under moving wall boundary. The discrete element method (DEM) coupled with computational fluid dynamics (CFD) has been widely utilized in the simulation of gas-solid flows, and the adequacy has been proved through countless studies. On the other hand, the existing DEM-CFD method is extremely difficult to simulate the gas-solid flow where the wall boundary is moving. Besides, in the existing DEM-CFD method, huge number of computational particles cannot be simulated on a single PC. Hence, numerical simulations of the industrial powder die-filling becomes a challenging topic from a viewpoint of evolution of the DEM-CFD method, because modeling of the moving wall boundary as well as modeling of large number of computational particles should be considered simultaneously. Very recently, the authors' group has developed the Integrated DEM-CFD method including the arbitrary shape wall boundary model and the scaling law model. In the Integrated DEM-CFD method, the wall boundary is modeled by the signed distance functions and the immersed boundary method, and besides the coarse graining DEM is employed as the scaling law model. Adequacy of the Integrated DEM-CFD method has been proved through verification tests. In the current study, applicability of the Integrated DEM-CFD method is examined in the powder die-filling. Adequacy of the Integrated DEM-CFD method is shown by agreement between the original particle system and the coarse graining particle system in the powder die-filling. Through the verification tests, macroscopic characteristics of the powder die-filling are shown to be reproduced by the Integrated DEM-CFD method. Consequently, the Integrated DEM-CFD method is illustrated to be effective for the simulation of the industrial powder die-filling systems.

A 34-year-old man underwent heart transplantation because of ischemic cardiomyopathy. Coronary angiography after the transplantation showed no significant stenosis in his coronary trees except for mild stenosis in the proximal left anterior descending (LAD) artery. However, 6 years later, coronary

Motivated by the enlightenment that diminishing the jump at the cell boundary can effectively reduce numerical dissipation near the critical region, and a novel constrained interpolation profile conservative semi-Lagrangian method is proposed based on a newly designed boundary variation diminishing algorithm. First, a constrained interpolation profile conservative semi-Lagrangian scheme with the piecewise tangent of hyperbola for interface capturing scheme is proposed as one candidate to represent jump-like discontinuities. Second, the constrained interpolation profile conservative semi-Lagrangian scheme with a fourth-order weighted essentially non-oscillatory limiter is used as another candidate to keep the high-order and non-oscillatory reconstruction for smooth solutions. The selection criterion of these two candidates is designed by minimizing the total variations of the first derivative at cell boundaries. A unified pressure-based projection formulation with a fractional step procedure is implemented with the proposed scheme to simulate both compressible and incompressible flows. A variety of numerical tests are studied, including linear and nonlinear scalar wave transport problems and compressible and incompressible flow problems. Results show that the proposed method can effectively eliminate numerical oscillation and diffusion, suggesting it has great potential to be applied to various types of engineering problems including both compressible and incompressible flows.

During percutaneous coronary intervention (PCI) procedures, there are cases in which different types of guiding catheters (GCs) are needed depending on different approach sites. However, it is not clear how the approach site affects GC engagement. At our hospital it is possible to perform

In this letter we study the splashing behaviour of droplets upon impact onto a variety of substrates with different wetting properties, ranging from hydrophilic to super-hydrophobic surfaces. In particular, we study the effects of the dynamic contact angle on splashing. The experimental approach uses high-speed imaging and image analysis to recover the apparent contact angle as a function of the spreading speed. Our results show that neither the Capillary number nor the so-called splashing parameter are appropriate to characterise the splashing behaviour under these circumstances. However, we show that the maximum dynamic advancing contact angle and the splashing ratio β adequately characterise the splashing behaviour.

We propose a fully conservative high-order upwind multi-moment method for the conservation equation. The proposed method is based on a third-order polynomial interpolation function and semi-Lagrangian formulation, and is a variant of the CIP-CSL3 (constrained interpolation profile–conservative semi-Lagrangian scheme with third-order polynomial function) method. The third-order interpolation function is constructed based on three constraints in the upwind cell (two boundary values and a cell average) and a constraint in the downwind cell (a cell center value). The proposed method shows 4th-order accuracy in a benchmark problem (sine wave propagation). We also propose a less oscillatory formulation of the proposed method. The less oscillatory formulation can minimize numerical oscillations. These methods were validated through scalar transport problems, and compressible flow problems (shock tube and 2D explosion problems).

To select the best revascularization strategy a correct understanding of the ischemic territory and the coronary anatomy is crucial. Stress myocardial perfusion single photon emission computed tomography (SPECT) is the gold standard to assess ischemia, however, SPECT has important limitations such as lack of coronary anatomical information or false negative results due to balanced ischemia in multi-vessel disease. Angiographic scores are based on anatomical characteristics of coronary arteries but they lack information on the extent of jeopardized myocardium. Cardiac computed tomography (CCT) has the ability to evaluate the coronary anatomy and myocardium in one sequence, which is theoretically the ideal method to assess the myocardial mass at risk (MMAR) for any target lesion located at any point in the coronary tree. In this study we analyzed MMAR of the three main coronary arteries and three major side branches; diagonal (Dx), obtuse marginal (OM), and posterior descending artery (PDA) in 42 patients with normal coronary arteries using an algorithm based on the Voronoi method. The distribution of MMAR among the three main coronary arteries was 44.3 ± 5.6 % for the left anterior descending artery, 28.2 ± 7.3 % for the left circumflex artery, and 26.8 ± 8.6 % for the right coronary artery. MMAR of the three major side branches was 11.3 ± 3.9 % for the Dx, 12.6 ± 5.2 % for the OM and 10.2 ± 3.4 % for the PDA. Intra- and inter-observer analysis showed excellent correlation (r = 0.97; p

Aims Snaring has recently been reported as being effective in catching the retrograde guidewire (GW) in retrograde percutaneous coronary intervention (PCI) for chronic total occlusion. However, commercially available snares and previously reported homemade snares have a number of drawbacks, such as additional cost, limited size adjustability, risk of vessel injury and difficult handling. We report here a novel method to create easily an inexpensive, safe and size-adjustable snare. Methods and results Our newly developed homemade snare consists of a conventional 0.014" GW, a PCI balloon, and a guiding catheter (GC). In most cases, no extra cost is needed. As the snare is created by the soft wire tip, vascular injury is negligible. To adjust the size of the snare loop, the snare wire is simply pulled backwards and pushed forwards. Using this snare technique, we succeeded in the total revascularisation of a CTO in the left main trunk with a retrograde approach. Conclusions We report a novel method to create easily an inexpensive, safe and size-adjustable snare, and demonstrate its use in a retrograde CTO intervention. In some cases where a conventional snare is indicated, such as removal of intravascular iatrogenic foreign bodies, this novel homemade snare would be preferable because of its advantages.

In this work we propose a new formulation for high-order multi-moment constrained finite volume (MCV) method. In the one-dimensional building-block scheme, three local degrees of freedom (DOFs) are equidistantly defined within a grid cell. Two candidate polynomials for spatial reconstruction of third-order are built by adopting one additional constraint condition from the adjacent cells, i.e. the DOF at middle point of left or right neighbour. A boundary gradient switching (BGS) algorithm based on the variation-minimization principle is devised to determine the spatial reconstruction from the two candidates, so as to remove the spurious oscillations around the discontinuities. The resulted non-oscillatory MCV3-BGS scheme is of fourth-order accuracy and completely free of case-dependent ad hoc parameters. The widely used benchmark tests of one- and two-dimensional scalar and Euler hyperbolic conservation laws are solved to verify the performance of the proposed scheme in this paper. The MCV3-BGS scheme is very promising for the practical applications due to its accuracy, non-oscillatory feature and algorithmic simplicity.

We propose a fully conservative and less oscillatory multi-moment scheme for the approximation of hyperbolic conservation laws. The proposed scheme (CIP-CSL3ENO) is based on two CIP-CSL3 schemes and the essentially non-oscillatory (ENO) scheme. In this paper, we also propose an ENO indicator for the multimoment framework, which intentionally selects non-smooth stencil but can efficiently minimize numerical oscillations. The proposed scheme is validated through various benchmark problems and a comparison with an experiment of two droplets collision/separation. The CIP-CSL3ENO scheme shows approximately fourth-order accuracy for smooth solution, and captures discontinuities and smooth solutions simultaneously without numerical oscillations for solutions which include discontinuities. The numerical results of two droplets collision/separation (3D free surface flow simulation) show that the CIP-CSL3ENO scheme can be applied to various types of fluid problems not only compressible flow problems but also incompressible and 3D free surface flow problems.

Hidehiro Kaneko, Masahiko Hara, Kazuki Mizutani, Minoru Yoshiyama, Kensuke Yokoi, Daijiro Kabata, Ayumi Shintani, and Tetsuhisa Kitamura. Improving Outcomes of Witnessed Out‐of‐Hospital Cardiac Arrest After Implementation of International Liaison Committee on Resuscitation 2010 Consensus: A Nationwide Prospective Observational Population‐Based Study. Journal of the American Heart Association. 2017; 6., Background--The International Liaison Committee on Resuscitation (ILCOR) periodically updates the consensus recommendations for cardiopulmonary resuscitation to improve the outcomes of out-of-hospital cardiac arrest (OHCA). However, little is known about the differences in outcomes of witnessed OHCA following the publication of the ILCOR 2010 and the ILCOR 2005 recommendations. Methods and Results--We enrolled 241 990 adults who experienced witnessed OHCA between 2007 and 2013 from a prospective, nation-wide, population-based cohort database in Japan. We compared neurologically favorable 1-month survival and 1-month survival rates post-OHCA by dividing the study period into 2 categories: the ILCOR 2005 period and ILCOR 2010 period. The associations between guideline periods and outcomes were estimated using multivariable logistic regression analysis and reported as adjusted odds ratio and 95% CI. Among 241 990 patients examined in this study, OHCA was witnessed in 44 706 patients (18%) by emergency medical service personnel and in 197 284 patients (82%) by citizens. Compared with the ILCOR 2005 period, the neurologically favorable 1-month survival rate improved from 4.6% to 5.2% (adjusted odds ratio, 1.54; 95% CI, 1.42-1.67; P < 0.001), and the 1-month survival rate improved from 9.0% to 9.7% (adjusted odds ratio, 1.34; 95% CI, 1.27-1.42; P < 0.001) in the ILCOR 2010 period. These improvements were also shown in patients receiving conventional versus compression-only cardiopulmonary resuscitation. Conclusions--Outcomes of witnessed OHCA were better in the ILCOR 2010 period than those in the ILCOR 2005 period. Our results can provide baseline data for many future prospective studies.

We investigated discretization strategies of the conservation equation in volume/surface integrated average-based multi-moment method (VSIAM3) which is a numerical framework for incompressible and compressible flows based on a multi-moment concept. We investigated these strategies through the lid-driven cavity flow problem, shock tube problems, 2D explosion test and droplet splashing on a superhydrophobic substrate. We found that the use of the constrained interpolation profile-conservative semi-Lagrangian with rational function (CIP-CSLR) method as the conservation equation solver is critically important for the robustness of incompressible flow simulations using VSIAM3 and that numerical results are sensitive to discretization techniques of the divergence term in the conservation equation. Based on these results, we proposed efficient implementation techniques of VSIAM3.

There are very few epidemiological studies on Japanese patients with deep vein thrombosis (DVT). In particular, mortality rate differences in Japanese DVT patients with and without malignancy have rarely been evaluated. To elucidate these differences, we enrolled 211 patients who had been diagnosed with de-novo acute DVT of the pelvis or lower extremities between January 2012 and December 2015. The clinical characteristics, treatment information, and follow-up data were retrospectively assessed. We compared these variables in patients with (n = 120) and without (n = 91) concomitant malignancies. The median age of patients was 67 years, 33.7% were male, and 82.9% patients were treated with oral anticoagulants including direct oral anticoagulants. The clinical characteristics and treatment provided were almost identical in the two groups with some exceptions. Three-year survival rates of the total population, patients with malignancy, and patients without malignancy were 80.6, 67.6, and 97.6%, respectively (log-rank p

Using a novel combined angiography computed tomography (CT) system, we evaluated the impact of the intra-aortic root position of a right coronary artery (RCA) catheter on its coaxiality. We retrospectively enrolled 19 patients who underwent CT scans during bilaterally engaged percutaneous coronary intervention. Coaxiality was defined as the angle between the RCA and the RCA catheter. The coaxiality was better when the RCA catheter was placed anterior to the left main coronary artery catheter (median 27.0° vs 53.7°, p = 0.02). The position of the RCA catheter had a significant impact on the coaxiality of it, with a coaxiality improvement ratio of 0.506 (95% confidence interval 0.294 to 0.871, p = 0.017). Three-dimensional reconstructed CT images of the right anterior oblique projection could determine the position of catheters in all cases. In conclusion, the RCA catheter should be placed anterior, rather than posterior, to the left main coronary artery catheter for better coaxiality during bilaterally engaged percutaneous coronary intervention. The right anterior oblique projection is useful for determining the catheter position.