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While the expansion of basic education opportunities has progressed to guarantee quality education for all, disparities in school enrollment have become apparent. There is an urgent need to support marginalized children to build a society of diversity and inclusion. The purpose of this study is to identify the actual enrollment status and determinants of women's enrollment in school in Kenya. Using the 2014 Kenya Demographic Health Survey, this study examines （1） the characteristics of out-of-school （never-attend and dropout） status and （2） the determinants of school enrollment among women aged 15-17. The significance of this paper is to examine （1） the identification of social groups that need intensive support among marginalized children and（ 2） the identification of the key factor of school attendance. Women in need of intensive assistance are most likely to be unschooled women living nomadic lives in rural areas. They are 70% from the poorest families, and about half of the mothers of out-of-school children are uneducated. Although they represent 2.3% of the age group, they are considered the most marginalized group. Among those who are not in school, dropout is a common occurrence, and it is distributed across all socio-demographic groups. The determinants of non-continuation of schooling were significant for variables related to early marriage, lack of educational resources, employment status, and family and community environment, and were generally consistent with the findings of previous studies. On the other hand, the tendency of those from the wealthiest households to be out of school is a new finding. In addition, the fact that the synchronous pressure in favor of county average circumcision was significant also provides the possibility that factors that cannot be explained by economic constraints alone may be important. On the other hand, a limitation of this study is that it does not fully examine the educational experiences and diverse abilities of the women in the analysis. Since information on contraceptive decision-making, knowledge of HIV/AID prevention, and health-related values and behaviors exist in the KDHS, we plan to examine ways to effectively utilize this information in the future. And verification of parental involvement and expectations was also insufficient. The influence of mothers' educational level and mothers' values on school attendance can be supplemented by analysis of children in the early childhood and primary education stages.

Sperm acrosomal membrane proteins, such as Izumo sperm–egg fusion 1 (IZUMO1) and sperm acrosome-associated 6 (SPACA6), play essential roles in mammalian gamete binding or fusion. How their biosynthesis is regulated during spermiogenesis has largely remained elusive. Here, we show that 1700029I15Rik knockout male mice are severely subfertile and their spermatozoa do not fuse with eggs. 1700029I15Rik is a type-II transmembrane protein expressed in early round spermatids but not in mature spermatozoa. It interacts with proteins involved in N -linked glycosylation, disulfide isomerization, and endoplasmic reticulum (ER)–Golgi trafficking, suggesting a potential role in nascent protein processing. The ablation of 1700029I15Rik destabilizes non-catalytic subunits of the oligosaccharyltransferase (OST) complex that are pivotal for N -glycosylation. The knockout testes exhibit normal expression of sperm plasma membrane proteins, but decreased abundance of multiple acrosomal membrane proteins involved in fertilization. The knockout sperm show upregulated chaperones related to ER-associated degradation (ERAD) and elevated protein ubiquitination; strikingly, SPACA6 becomes undetectable. Our results support for a specific, 1700029I15Rik-mediated pathway underpinning the biosynthesis of acrosomal membrane proteins during spermiogenesis.

Sperm acrosomal membrane proteins, such as IZUMO1 and SPACA6, play an essential role in mammalian sperm–egg fusion. How their biosynthesis is regulated during spermiogenesis has largely remained unknown. Here, we show that the 1700029I15Rik knockout male mice are severely subfertile and their spermatozoa do not fuse with eggs. 1700029I15Rik encodes a type-II transmembrane protein that is expressed in early spermatids but not in mature spermatozoa. 1700029I15Rik is associated with proteins involved in N-glycosylation, disulfide isomerisation, and ER– Golgi trafficking, suggesting its involvement in nascent protein processing. 1700029I15Rik knockout testis has a normal level of sperm plasma membrane proteins, but decreased expression of multiple acrosomal membrane proteins. The knockout sperm exhibit elevated ubiquitinated proteins and upregulated ER-associated degradation; strikingly, SPACA6 becomes undetectable. Our results support for a specific, 1700029I15Rik-mediated pathway in spermiogenesis for the assembly of acrosomal membrane proteins.Significance StatementIn sexually reproducing species, life begins with the fusion between a sperm and an egg. Multiple sperm acrosomal membrane proteins have been reported indispensable for sperm–egg fusion in mammals, yet the mechanism underlying their biosynthesis remains unknown. The present study demonstrates the existence of a 1700029I15Rik-mediated pathway specifically coordinating the processing and assembly of acrosomal membrane proteins. It represents an intriguing paradigm where the biosynthesis of proteins destined for various subcellular compartments might be orchestrated in a spatiotemporal manner. Given 1700029I15Rik is highly conserved in human, our findings provide potential insights into the aetiology of idiopathic male infertility and the development of a novel contraceptive approach involving molecular interventions in the maturation of gamete fusion-required acrosomal proteins.

Local control of sperm maturation Newly produced spermatozoa within the testis do not have fertilizing ability but become fully functional when they mature in the epididymis. The development of the epididymis itself is dependent on testicular factors arriving via luminal flow. Improper signaling between the testis and epididymis is hypothesized to result in male infertility. Kiyozumi et al. identified NELL2 as a testicular luminal protein that binds to its receptor, ROS1, on the luminal epididymis surface and induces epididymal differentiation (see the Perspective by Lord and Oatley). In turn, differentiated epididymis secretes a fertility-essential protease, ovochymase-2, to make spermatozoa fully mature and functional. Thus, testis-epididymis interorgan communication by this “lumicrine” regulation ensures mammalian reproduction. Science , this issue p. 1132 ; see also p. 1053

As the world population continues to increase to unsustainable levels, the importance of birth control and the development of new contraceptives are emerging. To date, male contraceptive options have been lagging behind those available to women, and those few options available are not satisfactory to everyone. To solve this problem, we have been searching for new candidate target proteins for non-hormonal contraceptives. Testis-specific proteins are appealing targets for male contraceptives because they are more likely to be involved in male reproduction and their targeting by small molecules is predicted to have no on-target harmful effects on other organs. Using in silico analysis, we identified Erich2, Glt6d1, Prss58, Slfnl1, Sppl2c, Stpg3, Tex33, and Tex36 as testis-abundant genes in both mouse and human. The genes, 4930402F06Rik and 4930568D16Rik, are testis-abundant paralogs of Glt6d1 that we also discovered in mice but not in human, and were also included in our studies to eliminate the potential compensation. We generated knockout (KO) mouse lines of all listed genes using the CRISPR/Cas9 system. Analysis of all of the individual KO mouse lines as well as Glt6d1/4930402F06Rik/4930568D16Rik TKO mouse lines revealed that they are male fertile with no observable defects in reproductive organs, suggesting that these 10 genes are not required for male fertility nor play redundant roles in the case of the 3 Glt6D1 paralogs. Further studies are needed to uncover protein function(s), but in vivo functional screening using the CRISPR/Cas9 system is a fast and accurate way to find genes essential for male fertility, which may apply to studies of genes expressed elsewhere. In this study, although we could not find any potential protein targets for non-hormonal male contraceptives, our findings help to streamline efforts to find and focus on only the essential genes., Ten testis-enriched genes are dispensable for male fertility, as determined by phenotypic analyses of knockout mice.

The &alpha, &prime, martensite of Ti-15mass%Nb alloy exhibits high internal friction with high damping properties. However, its structure is smoother than the &alpha, + &beta, structure. Therefore, a hardened surface layer is required for abrasion resistance. This study fabricated a martensite structure inside the nitriding layer by quenching, after gas nitriding at 1023 and 1223 K. Vickers hardness test, X-ray diffraction, scanning electron microscopy (SEM), and SEM-energy dispersive X-ray (SEM-EDX) measurements from the surface to the inside were made after the heat treatment process. In addition, the Young&rsquo, s modulus and internal friction were calculated from the damping analysis. The &alpha, TiN0.3 and &beta, phase region was formed at approximately 80 &micro, m from the surface at 1023 and 1223 K, and it was hardened. The internal friction of the gas nitriding and quenching specimens at 1023 and 1223 K was relatively high, though it did not reach that of the as-quenched specimen owing to the influence of the surface structure. From these results, it is considered that these material property values of the alloy can be controlled using the nitriding and quenching processes.

This study presents a statistical analysis for evaluating the cyclic unconfined compressive strength of cement-treated soils. In laboratory tests on cement-treated soils, the strength of the specimens varies to some extent even though they are prepared in the laboratory. Therefore, the influence of the variation in specimen strength on the cyclic loading test results should be assessed in order to obtain the cyclic strength precisely. Moreover, the variability of the specimen strength results in non-failure specimen data even at a large number of loading cycles. In the present study, the binary regression approach is adopted for analyzing the cyclic loading test results to take into account the non-failure specimen data. In the binary regression approach, the cyclic loading test results are treated as having one of two possible forms, namely, ‘failure’ or ‘non-failure’, at prescribed cycles. The parameters in the binary regression model are related to the variability of the cyclic strength and the ratio of the cyclic strength to the unconfined compressive strength. The binary regression analysis results reveal that the variability of the cyclic strength approximately corresponds to the variability of the specimen strength. The non-failure specimen data is properly treated in evaluating the cyclic strength by adopting the binary regression analysis. Using the binary regression analysis approach proposed in this study, an unnecessarily large number of cycles to failure is not required in the cyclic loading tests. This reduces the experimental cost for obtaining the deterioration property of the materials.

It has recently been recognized that inflammatory cytokines, such as tumor necrosis factor-&alpha, (TNF-&alpha, ), upregulate the secretion of matrix metalloproteinase-9 (MMP-9) from cancer cells and thereby promote peritoneal dissemination. In this study, we found that TNF-&alpha, also stimulated peritoneal mesothelial cells to secrete MMP-9 as assessed by zymography. MMP-9 gene expression in mesothelial cells induced by TNF-&alpha, was confirmed by quantitative RT-PCR analysis. We then utilized the reconstituted artificial mesothelium, which was composed of a monolayer of mesothelial cells cultured on a Matrigel layer in a Boyden chamber system, to examine the effects of TNF-&alpha, on carcinoma cell invasion. The transmigration of MKN1 human gastric carcinoma cells through the reconstituted mesothelium was promoted by TNF-&alpha, in a dose-dependent manner. The increased MKN1 cell migration was partially inhibited by the anti-&alpha, 3 integrin antibody, indicating that the invasion process involves an integrin-dependent mechanism. Finally, we observed that the invasion of MMP-9-knockdown MKN1 cells into Matrigel membranes was potentiated by the exogenous addition of purified proMMP-9. These results suggest that TNF-&alpha, induced MMP-9 secretion from mesothelial cells plays an important role in the metastatic dissemination of gastric cancer.

The Synergy Between PCI With TAXUS and Cardiac Surgery (SYNTAX) score is effective in predicting clinical outcome after percutaneous coronary intervention (PCI). However, its prediction ability is low because it reflects only the coronary characterization. We assessed the predictive value of combining the ankle-brachial index (ABI) and SYNTAX score to predict clinical outcomes after PCI. The ABI-SYNTAX score was calculated for 1,197 patients recruited from the Shinshu Prospective Multi-center Analysis for Elderly Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention (SHINANO) registry, a prospective, observational, multicenter cohort study in Japan. The primary end points were major adverse cardiovascular and cerebrovascular events (MACE; all-cause death, myocardial infarction, and stroke) in the first year after PCI. The ABI-SYNTAX score was calculated by categorizing and summing up the ABI and SYNTAX scores. ABI ≤ 0.49 was defined as 4, 0.5 to 0.69 as 3, 0.7 to 0.89 as 2, 0.9 to 1.09 as 1, and 1.1 to 1.5 as 0; an SYNTAX score ≤ 22 was defined as 0, 23 to 32 as 1, and ≥ 33 as 2. Patients were divided into low (0), moderate (1 to 2), and high (3 to 6) groups. The MACE rate was significantly higher in the high ABI-SYNTAX score group than in the lower 2 groups (low: 4.6% vs moderate: 7.0% vs high: 13.9%, p = 0.002). Multivariate regression analysis found that ABI-SYNTAX score independently predicted MACE (hazards ratio 1.25, 95% confidence interval 1.02 to 1.52, p = 0.029). The respective C-statistic for the ABI-SYNTAX and SYNTAX score for 1-year MACE was 0.60 and 0.55, respectively. In conclusion, combining the ABI and SYNTAX scores improved the prediction of 1-year adverse ischemic events compared with the SYNTAX score alone.

Formin is one of the two major classes of actin binding proteins (ABPs) with nucleation and polymerization activity. However, despite advances in our understanding of its biochemical activity, whether and how formins generate specific architecture of the actin cytoskeleton and function in a physiological context in vivo remain largely obscure. It is also unknown how actin filaments generated by formins interact with other ABPs in the cell. Here, we combine genetic manipulation of formins mammalian diaphanous homolog1 (mDia1) and 3 (mDia3) with superresolution microscopy and single-molecule imaging, and show that the formins mDia1 and mDia3 are dominantly expressed in Sertoli cells of mouse seminiferous tubule and together generate a highly dynamic cortical filamentous actin (F-actin) meshwork that is continuous with the contractile actomyosin bundles. Loss of mDia1/3 impaired these F-actin architectures, induced ectopic noncontractile espin1-containing F-actin bundles, and disrupted Sertoli cell–germ cell interaction, resulting in impaired spermatogenesis. These results together demonstrate the previously unsuspected mDia-dependent regulatory mechanism of cortical F-actin that is indispensable for mammalian sperm development and male fertility., Author summary Paternal genetic information is transmitted to the offspring via sperm. The unique cell morphology of the sperm plays essential roles in sperm transport through the female reproductive tract and in fertilization with oocytes. Sertoli cells are somatic cells located in the seminiferous tubules of the testis and are known to contribute to the development of sperm. While many studies have analyzed sperm development, the mechanisms underlying its morphogenesis remain obscure. In this work, we showed that the interaction between developing sperm and Sertoli cells is critical for sperm morphogenesis. We further unraveled that this interaction is strongly dependent on the cortical F-actin meshwork and contractile actomyosin bundles of Sertoli cells, and that two actin polymerization and nucleation factors of the formin family, mDia1 and mDia3, are involved in the generation of both actin-based structures. Loss of these formins in mice result in disrupted Sertoli cell actin structures, abnormal sperm morphology, and male infertility. We conclude that mDia1 and mDia3 play a role in sperm development through the regulation of the actin cytoskeletal architecture of Sertoli cells and that defects in these proteins might contribute to male infertility.

Background: CHADS2 or CHA2DS2-VASc score is used for prediction of stroke in patients with atrial fibrillation (AF). Recently, CHADS2 score is reported to have prognostic value in acute coronary syndrome without AF. However, clinical validation of CHA2DS2-VASc score for prognostic stratification in coronary heart disease (CHD) without AF remains uncertain. In this study, we evaluate whether CHA2DS2-VASc score could predict clinical outcome in CHD without known AF. Methods: SHINANO registry was a prospective, observational, multicenter cohort study, enrolling 1923 consecutive patients with CHD from August 2012 to July 2013. Two hundred nine patients were excluded because of known AF. We calculated CHA2DS2-VASc score in the remaining 1714 patients (mean age 70 ± 11 years, 23% female) without known AF. To assess the clinical validation of CHA2DS2-VASc score, we divided patients into 3 groups according to the tertiles (score 0–2, 3–4, and ≥5). The primary endpoint was MACE including death, nonfatal myocardial infarction, and ischemic stroke at 1 year. Results: One-year follow-up was completed in 1632 patients (95.2%). Cumulative incidence of MACE was 139 cases. In Kaplan–Meier analysis, incidence of MACE was significantly higher in patients with CHA2DS2-VASc score ≥5 compared to 3–4 and 0–2 (14.6% vs. 6.8% vs. 5.3%, p

Background: The clinical outcomes of elderly patients (≥80 years old) undergoing percutaneous coronary intervention (PCI) has not been well established, despite recent advances in both devices and techniques. Methods and Results: We recruited patients from the SHINANO Registry, a prospective, observational, multicenter, cohort study. From August 2012 to July 2013, a total of 1,923 consecutive patients with 2,250 elective/urgent PCIs (2,105 admissions) (mean age, 71±11 years; ≥80 years, 23%; men, 77%) were enrolled. The primary endpoint was procedural success. The secondary endpoints were in-hospital death and in-hospital major adverse cardiovascular events (MACE). The procedural success rate was significantly lower (83.7% vs. 89.1%, P=0.0001), and the rates of in-hospital mortality and MACE were significantly higher in elderly than in non-elderly patients (3.6% vs. 1.5%, P=0.005; 4.4% vs. 2.3%, P=0.016, respectively). For elective PCI, the rates of procedural success and in-hospital MACE were similar between groups (90.3% vs. 91.3%, P=0.65, 2.3% vs. 1.2%, P=0.2, respectively). On multivariate analysis, being elderly was not an independent predictor of procedural failure (OR, 1.15; CI, 0.81–1.61; P=0.43). Conclusions: In elderly patients, PCI is safe and feasible. The presence of comorbidities is a more important factor than age alone. (Circ J 2014; 78: 1097–1103)

The growth of nanocrystalline diamond films having an appropriate surface smoothness for nanoscaled ultrafine patterning was investigated. The surface smoothness of polycrystalline diamond films was controlled by introducing nitrogen (N2) gas at concentrations ranging from 0 to 1.0% into the gas mixtures of methane (CH4) and hydrogen (H2) on microwave plasma-assisted chemical vapor deposition (MPCVD). The added 1.0% N2 with 10% CH4 in the gas phase yielded the desired diamond film with the smoothest surface among the conditions. An N-doped nanocrystalline diamond film was fabricated by nanoscaled ultrafine patterning by e-beam lithography followed by reactive ion etching (RIE). As a mask material in RIE, we found that a chemical vapor-deposited amorphous silicon nitride film is appropriate. A mixture consisting of oxygen and a small amount of tetrafluoro carbon was used as the etching gas. We succeeded in achieving a minimum line width of 100 nm in the N-doped nanocrystalline diamond film with our fabrication process.

We present a patient with Brugada syndrome and paroxysmal atrial fibrillation who underwent circumferential pulmonary vein isolation. His electrocardiogram showed normal sinus rhythm and first-degree AV block (P-R 280 ms) with coved-type ST elevation in V1–2 (+2.0 mm) before ablation. During ablation around the left pulmonary vein ostium, atrial fibrillation, progression of ST elevation (+4.5 mm), and T wave alternans occurred. After right pulmonary vein encirclement was complete, ST elevation improved to +1.0 mm. The following day, the ST segments remained lower than baseline levels.

信州大学博士（医学）・学位論文・平成24年1月30日授与（甲第923号）・嶋田健太郎, Background: Atrial fibrillation (AF) is the most common supraventricular arrhythmia, often occurring during hemodialysis (HD). Prolongation of the total filtered P-wave duration (PWD) and reduction of the root mean square voltages for the last 20 ms of the P wave (RMS20) on a P-wave signal-averaged electrocardiogram (P-SAECG) are predictors of AF. We investigated whether HD induces alterations of P-SAECG, and determined the influential factors. Methods and Results: Thirty-three end-stage kidney disease patients (66.7 +/- 12.6 years, 23 males) undergoing maintenance HD were enrolled in this study. Digital ambulatory P-SAECG monitoring and laboratory examination of serum proteins and ions were carried out before, during, and after the HD sessions. Data were analyzed by multiple regression analysis. PWD was significantly prolonged, and RMS20 significantly reduced, during HD. These values recovered after completion of HD. Multiple regression analysis showed that prolongation of PWD significantly correlated with HD duration and the rate of removal of body fluid. On the other hand, RMS20 significantly correlated with HD duration and blood urea nitrogen variation. Conclusions: HD resulted in prolongation of PWD and reduction of RMS20, indicating the vulnerability of HD patients to AF. These P-SAECG changes correlated with HD duration and the rate of removal of the body fluid. These findings underline the importance of the control of dialysis variables in the prevention of atrial arrhythmias following HD. (Circ J 2012; 76: 612-617), Article, CIRCULATION JOURNAL. 76(3):612-617 (2012)

UNIRED II is the high performance inference processor for the parallel inference machine PIE64. It is designed for the committed choice language Fleng, and for use as an element processor of parallel machines. Its main features are: 1) a tag architecture, 2) three independent memory buses (instruction fetching, data reading, and data writing), 3) a dedicated instruction set for efficient execution of Fleng, 4) multi-context processing for reducing pipeline interlocking and overhead of interprocessor synchronization. With the multi-context processing mechanism, the internal pipeline is shared by several independent instruction streams (contexts), and which contexts are to be executed is determined cycle by cycle. So, UNIRED II acts as a shared-pipeline MIMD processor. In this paper, several architectural features including the multi-context processing and the instruction set are described. Performance measurement results by simulation are also presented. On a 10MHz UNIRED II, 920K Reduction Per Second has been achieved, and it is shown that the multi-context processing mechanism is very effective for improved performance.

We previously reported that the adhesion of gastric carcinoma cells to the peritoneum mediated by the alpha3beta1 integrin-laminin interaction is a key step in the initial process of peritoneal metastatic dissemination. Carcinoma cells subsequently invade through the intercellular gaps of mesothelial linings. In this study, we examined the role of the interaction of carcinoma cells with laminin-5, which is a major component of submesothelial basement membranes and serves as a high-affinity ligand for alpha3beta1 integrin, in carcinoma cell invasion. Human gastric carcinoma cell lines (MKN1, GT3TKB, and NUGC-4) adhered in an alpha3beta1 integrin-dependent manner to the extracellular matrix deposited by peritoneal mesothelial cells. An in vitro invasion assay using the Boyden chamber system revealed that MKN1 cell migration through the membranes increased when the membranes were coated with matrices produced by mesothelial cells or with laminin-5-containing Matrigel as compared to Matrigel alone. The cell migration promoted by laminin-5-containing Matrigel was inhibited by the presence of anti-alpha3 integrin antibody. When MKN1 cells were cultured in a laminin-5-coated plate, these cells were promoted to produce matrix metalloproteinase (MMP)-9, as assessed by gelatin zymography, enzyme-linked immunosorbent assay, and reverse transcription-polymerase chain reaction. These results suggest that the production of MMP-9 by MKN1 cells was potentiated by the alpha3beta1 integrin-laminin-5 interaction, which facilitated their invasion via degradation of the matrix.

A 48-year-old woman who had abused alcohol admitted to our hospital because of fever and chest pain. Laboratory data presented inflammation and liver dysfunction. Chest X-ray films revealed multiple mass lesions with air fluid levels. We diagnosed multiple lung abscesses and started treatment with antibiotics. However, her fever did not improve and mass lesions increased. On day 6 of hospitalization, three drainage tubes were inserted percutaneously into the mass lesions under computed tomography (CT) guidance, and alpha-hemolytic streptococcus, peptostreptococcus sp. and neutrophils were isolated from the drainage fluid. Abcesses and inflammation were improved by administration of the antibiotics selected according to the result of fluid culture. Because all multiple abcesses were located near the pleura, we successfully treated them with simultaneous percutaneus thoracic drainage.

The bone marrow derived endothelial progenitor cells (EPCs) are considered to originate from haematopoietic stem cells, which are positive for CD34.1 Human CD34 expressing cells (CD34+ cells) injected into nude mice and rats undergoing neovascularisation caused by hindlimb ischaemia are incorporated into the neovasculature and express endothelial antigens. We recently reported that transplantation of autologous bone marrow cells, including CD34+ cells, improved ischaemia in patients with critical limb ischaemia.2 Moreover, increased neovascularisation by bone marrow derived CD34+ cells was shown to improve cardiac function. Recently, a mobilisation of EPCs into circulation from bone marrow was reported in patients with acute myocardial infarction and acute coronary syndrome,3,4 but little is known about the regulation of EPC mobilisation in patients with stable coronary artery disease (CAD). In the present study, we investigated the number of circulating CD34+ cells in patients with CAD and the influence of atherosclerotic risk factors on this number. Thirty four patients (mean (SEM) age …

The superionic transitions of protonated K3H(SO4)2 and deuterated K3D(SO4)2 insulators are investigated using Raman scattering and differential scanning calorimetry (DSC) measurements. DSC indicates that the superionic transition temperature of K3D(SO4)2 is approximately 9 K lower than that of K3H(SO4)2. This confirms the negative isotope effect on the superionic transition temperature of this compound and suggests that the bonding strength of D bonds is lower than that of H bonds. Raman scatterings from K3H(SO4)2 and K3D(SO4)2 show that the ν1-normal vibration mode of the SO4 tetrahedra consists of two rather than one band, despite the symmetry of the vibration mode. The oscillation frequency of the ν1-mode for SO4 tetrahedra in K3D(SO4)2 is higher than that for K3H(SO4)2, which is thought to be closely related to the negative isotope effect on the transition temperature.

Ankle-Brachial Index (ABI) is used for an arteriosclerotic noninvasive index widely, and the patient with low ABI value has poor prognosis. However, little is known about relationship between ABI and coronary artery disease (CAD) complexity. The goal of the study was to evaluate the relationship