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Resumen Introduccion y objetivos En la obtencion de imagenes de angiografia por cardiotomografia (ACT) es importante escoger una ubicacion adecuada para inyectar el medio de contraste (p. ej., el brazo o la pierna) a fin de evitar la formacion de artefactos que este provoca. En este estudio se comparan los valores de tomografia computarizada (TC) y las puntuaciones de visualizacion de las imagenes tridimensionales (3 D) de los lumenes de los vasos sanguineos del brazo y la pierna durante la ACT en pacientes neonatos y lactantes. Pacientes o materiales y metodos Entre los meses de enero de 2017 y enero de 2020 se evaluaron 253 pacientes de forma consecutiva para determinar su inclusion en el estudio. Se utilizaron las puntuaciones de propension estimadas en funcion de los datos demograficos, incluidos la edad, el peso corporal y la ubicacion de la inyeccion (lado derecho o izquierdo) en el brazo (n = 58) y la pierna (n = 58) de los pacientes neonatos y lactantes. A continuacion, se compararon los valores medios de TC de la arteria pulmonar, la aorta ascendente y la vena cava superior izquierda; las relaciones contraste-ruido (RCR); y las puntuaciones de visualizacion del brazo y la pierna como lugares de inyeccion. Resultados Los valores medios de TC durante la ACT para el brazo y la pierna fueron de 479,4 y 461,3 UH en la aorta ascendente, de 464,2 y 448,1 UH en la arteria pulmonar y de 232,8 y 220,1 UH en la vena cava superior izquierda, respectivamente. Los valores medios de ruido de la imagen (DE) y de RCR fueron, respectivamente, de 38,9 y 12,1 UH para el brazo y de 39,1 y 12,3 UH para la pierna. Las puntuaciones medias de visualizacion de la representacion del volumen de las imagenes 3 D fueron de 3,0 y 3,0 para los lugares de inyeccion del brazo y la pierna, respectivamente. No se observaron diferencias significativas en los valores medios de TC de la aorta ascendente, la arteria pulmonar y la vena cava superior izquierda; el valor de DE; la RCR; y las puntuaciones de visualizacion del brazo y la pierna. Conclusiones Los valores de TC del lumen de los vasos sanguineos y las puntuaciones de visualizacion de las imagenes 3 D observados durante la realizacion de una ACT en pacientes neonatos y lactantes con cardiopatias congenitas son los mismos, independientemente de si el lugar de inyeccion es el brazo o la pierna.

Obtaining CCTA images with optimal injection location such as the arm or leg is important to avoid the artifacts caused by the CM. This study compares the computed tomography (CT) numbers and visualization scores of the three-dimensional (3D) images of the lumens of the blood vessels in the arm or leg during cardiac computed tomography angiography (CCTA) in neonatal and infant patients.Between January 2017 and January 2020, 253 consecutive patients were considered for inclusion. We used the estimated propensity scores as a function of the demographic data, including age, body weight, and injection location (right or left side) in the arm (n = 58) and leg (n = 58) of neonatal and infant patients. We compared the mean CT numbers of the pulmonary artery, ascending aorta, and left superior vena cava; contrast-noise ratios (CNR); and visualization scores between the arm and leg as the injection locations.The mean CT numbers during CCTA for the arm and leg were 479.4 and 461.3 HU in the ascending aorta, 464.2 and 448.1 HU in the pulmonary artery, and 232.8 and 220.1 HU in the left superior vena cava, respectively. The mean image noise (SD) and CNR values, respectively, were 38.9 HU and 12.1 for the arm as the injection location and 39.1 HU and 12.3 for the leg as the injection location. The median visualization scores of volume rendering of the 3D images were 3.0 and 3.0 for the arm and leg injection sites, respectively. There were no significant differences in the mean CT numbers of the ascending aorta, pulmonary artery, and left superior vena cava; SD value; CNR; and visualization scores between the arm and leg injection locations.The CT numbers of the lumen of the blood vessel and visualization scores of the 3D images of the arm and leg injection locations are equal during CCTA in neonatal and infant patients with congenital heart disease.

The aim of this study was to evaluate the efficacy of intra-arterial chemoradiotherapy with docetaxel and nedaplatin for T4 maxillary sinus squamous cell carcinoma (MSSCC). Data were retrospectively analysed for 22 consecutive patients with T4 MSSCC who underwent intra-arterial chemoradiotherapy. Participants received intensity-modulated radiotherapy (70 Gy in 35 fractions) concomitantly with docetaxel (60 mg/m

To compare the computed tomography (CT) number for paediatric cardiac computed tomography angiography (CCTA) and visualisation score of the three-dimensional (3D) images using the conventional T-shaped extended tube (T-tube) and spiral flow-generating extended tube (spiral-tube) connected between the contrast injector and cannula.In total, 108 patients suspected to have congenital heart disease (CHD) were considered for inclusion. We utilised the T-tube for intravenous contrast and spiral-tube in 54 patients each. Observers individually inspected randomized volume rendering images of the internal thoracic artery, each acquired from the with or without spiral-tube groups, using a four-point scale. We compared the mean CT number of the ascending aorta (AAO) and pulmonary artery (PA), contrast noise ratio (CNR), CT number for the AAO and PA enhancement ratio, and the visualisation scores between the groups.There were no significant differences in patient characteristics between the with or without spiral-tube groups (p 0.05). The mean CT number ±standard deviation for the AAO and PA, and the CNR without or with spiral-tube groups were 441.2 ± 89.2 and 489.8 ± 86.1 HU for the AAO, 436.3 ± 100.6 and 475.3 ± 85.2 HU for the PA, and 9.5 ± 2.2 and 10.8 ± 2.4 for the CNR, respectively (p 0.05). In the spiral-tube group, the CT number, CNR, and visualisations score of the 3D images were significantly higher for the AAO and PA than those in the T-tube group (p 0.05).The spiral-tube proved to be beneficial in improving the CT number for the AAO and PA, CNR, and visualisation score compared with the conventional T-tube during paediatric CCTA.The spiral-tube may allow the visualisation of smaller blood vessels than those visualised by the conventional T-tube for paediatric patients in CCTA.

Samples of the carbonaceous asteroid Ryugu were brought to Earth by the Hayabusa2 spacecraft. We analyzed 17 Ryugu samples measuring 1 to 8 millimeters. Carbon dioxide–bearing water inclusions are present within a pyrrhotite crystal, indicating that Ryugu’s parent asteroid formed in the outer Solar System. The samples contain low abundances of materials that formed at high temperatures, such as chondrules and calcium- and aluminum-rich inclusions. The samples are rich in phyllosilicates and carbonates, which formed through aqueous alteration reactions at low temperature, high pH, and water/rock ratios of

ITER envisages the use of two heating neutral beam injectors plus an optional one as part of the auxiliary heating and current drive system, to reach the desired performances during its various phases of operation. The 16.5 MW expected neutral beam power per injector is several notches higher than worldwide existing facilities.In order to enable such development, a Neutral Beam Test Facility (NBTF) was established at Consorzio RFX, exploiting the synergy of two test beds, called SPIDER and MITICA. SPIDER is dedicated developing and char-acterizing large efficient negative ion sources at relevant parameters in ITER-like conditions: source and accel-erator located in the same vacuum where the beam propagates, immunity to electromagnetic interferences of multiple radio-frequency (RF) antennas, avoidance of RF-induced discharges on the outside of the source. Three years of experiments on SPIDER have addressed to the necessary design modifications to enable full perfor-mances. The source is presently under a long shut-down phase to incorporate learnings from the experimental campaign, in particular events/issues occurred during operation, which led to the identification of improvement opportunities/necessities (e.g. RF discharges, local burns, water leaks, other damages, configuration/design upgrades to maximize chances/margin to quest target parameters).Parallelly, developments on MITICA, the full-scale prototype of the ITER Neutral Beam Injector (NBI) featuring a 1 MV accelerator and ion neutralization, are underway including manufacturing of the beam source, accel-erator and the beam line components, while power supplies and auxiliary plants, already installed, are under final testing and commissioning.Integration, commissioning and tests of the 1 MV power supplies are essential for this first-of-kind system, unparalleled both in research and industry field. 1.2 MV dc insulating tests of high voltage components were successfully completed. The integrated test to confirm 1 MV output by combining invertor systems, DC gener-ators and transmission lines extracted errors/accidents in some components. To realize a concrete system for ITER, said events have been addressed and solutions for the repair and the improvement of the system were developed.Hence, NBTF is emerging as a necessary facility, due to the large gap with existing injectors, effectively dedicated to identify issues and find solutions to enable successful ITER NBI operations in a time bound fashion. The lessons learned during the implementation on NBTF and future perspectives are here discussed.

Ballistic range experiments were performed for a hemisphere-flare-cylinder model at supersonic Mach numbers in the transitional Reynolds number range at Nagoya University. The free-flight portion was modelled as axisymmetric in ANSYS Fluent® V.19.0. Projectile deceleration was included in the simulation as a function of the drag force over an approximate flight Mach number range 2.0–1.90. The projectile deceleration magnitude averaged approximately 700g and 1550g (g = 9.81 m s $$^{-2}$$ ) for two experiment cases. The Reynolds number (Re $$_\mathrm{d}$$ ) for each case based on the initial flight Mach number was Re $$_\mathrm{d}$$ = 90,000 and 177,000 respectively. The flow field, separation shock angle, averaged deceleration magnitude and averaged drag coefficient were compared between experiment and simulation. Agreement of these parameters was consistent for the Re $$_\mathrm{d}$$ = 177,000 case. This result contributed towards validation of the numerical acceleration technique. Differences for the Re $$_\mathrm{d}$$ = 90,000 case are explained with reference to experiment and simulation data.

Introduction With intra-arterial digital subtraction angiography (DSA) considered as the gold standard, we compared the diagnostic value of computed tomography angiography (CTA) and computed tomography-digital subtraction angiography (CT-DSA in hemodialysis (HD) patients suspected of having lower limb peripheral artery disease (PAD). Methods In this retrospective study, we enrolled 220 HD patients with suspected PAD. CT-DSA images were obtained by subtracting unenhanced images from enhanced images. The research team calculated the area under the curve (AUC), sensitivity, specificity, positive and negative predictive value (PPV, NPV), and recorded the diagnostic accuracy between the CTA and CT-DSA images using the DSA as gold standard. Visual evaluation of calcifications in the peripheral arteries were also compared between CTA and CT-DSA images. Results At the above-knee level, the CTA AUC [95% confidence interval (CI)] was 0.68 (CI 0.64–0.72), sensitivity and specificity were 60 and 81%, PPV and NPV were 85 and 53%, and accuracy was 67%. Below the knee, these values were 0.66 (CI 0.62–0.70), 71 and 79%, 79 and 47%, and 66%. For CT-DSA, above-knee, the AUC [95% CI] was 0.88 (CI 0.85–0.91), sensitivity and specificity were 84 and 92%, PPV and NPV were 89 and 97%, and accuracy was 93%. Below the knee, these values were 0.95 (CI 0.93–0.97), 95 and 93%, 96 and 83%, and 93%. The scores for the visualization of calcification in the peripheral arteries was significantly higher for CT-DSA than CTA (p Conclusions CT-DSA helps to assess stenotic PAD with high calcification in the lower extremities of HD patients. Implications for practice On CT-DSA images, the severity of vascular calcification can be assessed for HD patients suspected of PAD of the lower extremities.

Study question Does the migration speed of nucleolar precursor bodies (NPBs) in male and female pronuclei (mPN and fPN) affect in vitro fertilization (IVF)-derived embryo ploidy status? Summary answer The NPB migration speed in mPN impacts the IVF-derived human embryo ploidy status and this indicator could be an attractive marker for noninvasive embryo selection. What is known already NPBs are not considered as simple nucleolar components transmitted from an oocyte to an embryo, and they could participate in genome remodeling during embryo development. NPBs are essential only shortly after fertilization, suggesting that they may actively participate in centromeric chromatin establishment. A previous study demonstrated that NPBs migrated faster in intracytoplasmic sperm injection-derived zygotes having the potential to develop into a blastocyst and eventually into a baby (Inoue et al., 2021). However, the relationship between NPB migration speed and IVF-derived embryo ploidy status is unclear. Study design, size, duration The relationship between the NPB migration speed and embryo ploidy status was retrospectively analyzed in patients with recurrent assisted reproductive technology failure (euploid n =18; aneuploid n =19; and total = 219 NPBs). Archived time-lapse videos (images were recorded every 5 min; Geri+) from incubation after IVF were retrieved after the patients were identified for the study, and the NPB migration speed was analyzed. The retrospective analyses were performed with the patient’s identities masked. Participants/materials, setting, methods mPN and fPN were identified by appearance location in a zygote (fPN appearance is just below the polar bodies). The mPN, fPN, and 2–3 NPBs/PN central coordinates were measured by Kinovea (motion capture software). Their central coordinates were confirmed/revised every image and were decided. The migration distance of NPBs between two sequential images was calculated as the standard of the central PN coordinates. Thereafter, the migration speed of NPBs was calculated. Main results and the role of chance Both NPB speeds were significantly faster in the euploid than in the aneuploid groups (mPN: 4.08±0.61 vs. 3.54±0.54 µm/h, P =0.003, power [1-β]: 0.999, fPN: 4.03±0.89 vs. 3.26±0.45 µm/h, P Limitations, reasons for caution The NPB migration in the z-axis direction could not be analyzed. NPB tracking could not be performed when NPBs were large in number or drastically moved. Our findings should help in elucidating the relationship, although they did not completely explain the relationship between NPB migration and embryo development. Wider implications of the findings The migration speed of NPBs impacts human embryo ploidy status. NPB migration speed may add clinical value for embryo selection, which may be associated with live birth, and consequently, the time of the live birth could be shorter. The indicator could be an attractive marker for noninvasive embryo selection. Trial registration number Not applicable

Ectopic enrichment of oral microbes in the gut is a notable alteration in gut microbial balance. These microbes are likely delivered from the oral cavity with saliva and food; however, evidence of oral–gut microbial transmission is insufficient and needs further investigation. In this observational study, we examined 144 pairs of saliva and stool samples collected from community-dwelling adults to verify the oral–gut microbial link and identify the relevant influencing factors on the increased abundance of oral microbes within the gut. The bacterial composition of each sample was determined using PacBio single-molecule long-read sequencing of the full-length 16S ribosomal RNA gene and amplicon sequence variant (ASV) analysis. Although the bacterial compositions of salivary and gut microbiota were distinctly different, at least 1 ASV was shared between salivary and gut microbiota in 72.9% of subjects. Shared ASVs accounted for 0.0% to 63.1% (median 0.14%) of the gut microbiota in each subject and frequently included abundant Streptococcus salivarius and Streptococcus parasanguinis. Their total relative abundance in the gut was significantly higher in older subjects or those with dental plaque accumulation. The gut microbiota with ≥5% of shared ASVs displayed a higher abundance of Streptococcus, Lactobacillus, and Klebsiella and a lower abundance of Faecalibacterium, Blautia, Megamonas, and Parabacteroides. Our study presents evidence for the translocation of oral bacteria to the gut in community-dwelling adults and suggests that aging and dental plaque accumulation contribute to an increased abundance of oral microbes in the gut, which might be relevant to the compositional shift in the gut commensals.

To evaluate 1.5 T magnetic resonance imaging (MRI) brain images with denoising procedures using deep learning-based reconstruction (dDLR) relative to the original 1.5 and 3 T images.Eleven volunteers underwent MRI at 3 and 1.5 T. Two-dimensional fast spin-echo T2-weighted imaging (T2WI), fluid-attenuated inversion recovery (FLAIR) imaging and diffusion-weighted imaging (DWI) sequences were performed. The dDLR method was applied to the 1.5 T data (dDLR-1.5 T), then the image quality of the dDLR-1.5 T data relative to the original 1.5 T and 3 T data was qualitatively and quantitatively assessed based on the structure similarity (SSIM) index; the signal-to-noise ratios (SNRs) of the grey matter (GM) and white matter (WM); and the contrast-to-noise ratios (CNRs) between the GM and WM (CNRgm-wm) and between the striatum (ST) and WM (CNRst-wm).The perceived image quality, and SNRs and CNRs were significantly higher for the dDLR-1.5 T images versus the 1.5 T images for all sequences and almost comparable or even superior to those of the 3 T images. For DWI, the SNRs and CNRst-wm were significantly higher for the dDLR-1.5 T images versus the 3 T images.The dDLR technique improved the image quality of 1.5 T brain MRI images. With respect to qualitative and quantitative measurements, the denoised 1.5 T brain images were almost equivalent or even superior to the 3 T brain images.

The double splint method is considered the gold standard for maxillary repositioning, but the procedure is lengthy and prone to error. Recent splintless methods have shown high repositioning accuracy; however, high costs and technical demands make them inaccessible to many patients. Therefore, a new cost-effective method of mandible-independent maxillary repositioning using pre-bent locking plates is proposed. Plates are bent on maxillary models in the planned position prior to surgery. The locations of the plate holes are replicated during surgery using osteotomy guides made from thermoplastic resin sheets. Pre-bent plates are subsequently fitted onto the maxilla, and plate holes are properly set to reposition the maxilla. The purpose of this study was to evaluate the accuracy of this method for maxillary repositioning and the reproducibility of the plate holes. Fifteen orthognathic surgery patients were evaluated retrospectively by superimposing preoperative simulations over their postoperative computed tomography models. The median deviations in maxillary repositioning and plate hole positioning between the preoperative plan and postoperative results were 0.43mm (range 0-1.55mm) and 0.33mm (range 0-1.86mm), respectively. There was no significant correlation between these deviations, suggesting that the method presented here allows highly accurate and reliable mandible-independent maxillary repositioning.

BACKGROUND AND PURPOSE: Deep brain stimulation electrodes induce massive artifacts on CT images, deteriorating the diagnostic value of examinations. We aimed to investigate the usefulness and potential limitations of a single-energy metal artifact reduction algorithm in head CT performed in patients with implanted deep brain stimulation devices. MATERIALS AND METHODS: Thirty-four patients with deep brain stimulation (bilateral, n = 28) who underwent head CT on a 320–detector row scanner and whose images were reconstructed with and without single-energy metal artifact reduction at the examinations were retrospectively included. The severity of artifacts around electrodes was assessed objectively using SDs and an artifact index. Two radiologists subjectively evaluated the severity of artifacts from electrodes, the visibility of electrode localization and surrounding structures, and overall diagnostic confidence on 4-point scales. Background image quality (GM-WM contrast and image noise) was subjectively and objectively assessed. The presence and location of artifacts newly produced by single-energy metal artifact reduction were analyzed. RESULTS: Single-energy metal artifact reduction provided lower objective and subjective metal artifacts and improved visualization of electrode localization and surrounding structures and diagnostic confidence compared with non-single-energy metal artifact reduction images, with statistical significance (all, P

Highly efficient carrier doping into the spin-orbit coupled Mott insulator ${\mathrm{Sr}}_{2}{\mathrm{IrO}}_{4}$ is achieved by low-energy hydrogen ion beam irradiation at low temperature. We demonstrate that heavy doping of hydrogen into a ${\mathrm{Sr}}_{2}{\mathrm{IrO}}_{4}$ epitaxial thin film induces a large increase in conductivity by band-filling control via electron doping, which is confirmed by Hall effect measurements. The introduction of a large amount of hydrogen and its distribution along the depth direction are clarified by nuclear reaction analysis. The doped interstitial and substitutional hydrogens act as electron donors with minimum perturbation to the lattice, as evidenced by crystal structural analysis and first-principles calculations of the defect formation energy for doped hydrogen. The hydrogen-doping method offers a strategy toward realization of novel quantum phases in strongly correlated spin-orbit entangled systems.

Regulatory T cells (Tregs) and tumour-associated macrophages (TAMs) contribute to the tumour microenvironment by inhibiting anti-tumour immune responses. This study was performed to investigate the roles of Tregs and TAMs in oral squamous cell carcinoma (OSCC) and oral epithelial precursor lesions (OEPL). The expression of Treg markers CD25 and FoxP3 and TAM markers CD163 and CD204 was investigated in 82 OSCC and 45 OEPL specimens, and their associations with clinicopathological parameters were analyzed. Correlations were found among CD25, FoxP3, CD163, and CD204 levels (P 0.001), and these targets were up-regulated in OSCC compared to OEPL (P 0.001). In OSCC, infiltration of Tregs and/or M2 TAMs was associated with sex and clinicopathological features, such as tumour size, nodal metastasis, tissue differentiation, stromal reaction, invasive behaviour, and invasive depth. In OEPL, CD25, FoxP3, CD163, and CD204 immunoreactivities were significantly associated with sex, postoperative recurrence, and cancerization to OSCC. This study is novel in showing that the infiltration of Tregs and M2 TAMs is significantly associated with the progression of premalignant lesions to OSCC. This suggests that these cells represent prognostic biomarkers for premalignant lesion progression and that immunotherapeutic approaches to control Treg/M2 TAM numbers could protect against progression to malignancy.

We perform the first multi-model intercomparison of the impact of nudged meteorology on the stratospheric residual circulation using hindcast simulations from the Chemistry–Climate Model Initiative (CCMI). We examine simulations over the period 1980–2009 from seven models in which the meteorological fields are nudged towards a reanalysis dataset and compare these with their equivalent free-running simulations and the reanalyses themselves. We show that for the current implementations, nudging meteorology does not constrain the mean strength of the stratospheric residual circulation and that the inter-model spread is similar, or even larger, than in the free-running simulations. The nudged models generally show slightly stronger upwelling in the tropical lower stratosphere compared to the free-running versions and exhibit marked differences compared to the directly estimated residual circulation from the reanalysis dataset they are nudged towards. Downward control calculations applied to the nudged simulations reveal substantial differences between the climatological lower-stratospheric tropical upward mass flux (TUMF) computed from the modelled wave forcing and that calculated directly from the residual circulation. This explicitly shows that nudging decouples the wave forcing and the residual circulation so that the divergence of the angular momentum flux due to the mean motion is not balanced by eddy motions, as would typically be expected in the time mean. Overall, nudging meteorological fields leads to increased inter-model spread for most of the measures of the mean climatological stratospheric residual circulation assessed in this study. In contrast, the nudged simulations show a high degree of consistency in the inter-annual variability in the TUMF in the lower stratosphere, which is primarily related to the contribution to variability from the resolved wave forcing. The more consistent inter-annual variability in TUMF in the nudged models also compares more closely with the variability found in the reanalyses, particularly in boreal winter. We apply a multiple linear regression (MLR) model to separate the drivers of inter-annual and long-term variations in the simulated TUMF; this explains up to ∼75 % of the variance in TUMF in the nudged simulations. The MLR model reveals a statistically significant positive trend in TUMF for most models over the period 1980–2009. The TUMF trend magnitude is generally larger in the nudged models compared to their free-running counterparts, but the intermodel range of trends doubles from around a factor of 2 to a factor of 4 due to nudging. Furthermore, the nudged models generally do not match the TUMF trends in the reanalysis they are nudged towards for trends over different periods in the interval 1980–2009. Hence, we conclude that nudging does not strongly constrain long-term trends simulated by the chemistry–climate model (CCM) in the residual circulation. Our findings show that while nudged simulations may, by construction, produce accurate temperatures and realistic representations of fast horizontal transport, this is not typically the case for the slower zonal mean vertical transport in the stratosphere. Consequently, caution is required when using nudged simulations to interpret the behaviour of stratospheric tracers that are affected by the residual circulation.

Background Nipple-sparing mastectomy (NSM) is an alternative procedure to skin-sparing mastectomy (SSM) for selected patients who undergo immediate reconstruction. However, the evidence of long-term oncologic safety of NSM has not been established. In this study, we aimed to compare the prognosis of breast cancer patients who underwent NSM to those who underwent SSM with immediate reconstruction. Methods The clinicopathological factors including recurrence site, pathologic stage, nipple-tumor distance, histological type, lymphovascular invasion, margin status, ER, PgR and HER2 status of stage 0–III primary breast cancer patients who underwent NSM or SSM with immediate primary reconstruction with tissue expander from our breast center database was retrospectively assessed. Patients with a nipple tumor distance of Results The median follow-up period was 71 months (range: 10 - 131 months) for the NSM group and 79 months (range: 9 - 140 months) for the SSM group. There were no significant difference of clinicopathological factors between the NSM group and the SSM group, except of the larger diameter of tumor in the SSM group. NSM was performed for 60 patients (32%) with stage 0, 71 patients (37%) with stage I, and 59 patients (31%) with stage II/III. SSM was performed for 185 patients (26%) with stage 0, 268 patients (37%) with stage I, and 276 patients (37%) with stage II/III. Local recurrence was found in 11 (5.8%) patients in the NSM group and in 44 (6.0%) patients in the SSM group. In the NSM group, only one (0.5%) patient had local recurrence in the nipple areola complex. In terms of DFS and overall survival (OS) rate, there was no difference between the NSM group and the SSM group (DFS; 89.5% vs 89.2%, HR, 1.044; p = 0.8992; 95% CI, 0.5116–1.9519, and OS; 98.4% vs 96.4%, HR, 0.963; p = 0.9116; 95% CI, 0.473–1.793). According to breast cancer subtype, in the NSM group, all of the 11 patients (100%) who developed local recurrence in the NSM group was hormone receptor (HR)-positive/HER2-negative breast cancer. 29 of the 44 patients (65.9%) who developed local recurrence in the SSM group was HR-positive/HER2-negative, 6 patients (13.6%) was HR-negative/HER2-positive, and 7 patients (15.9%) was triple-negative breast cancer. Among patients who had received neoadjuvant chemotherapy, the NSM group (3 of 14 patients, 21.4%) had a trend for higher local recurrence rate than the SSM group 7 of 116 patients (6.0%) (p = 0.0813). However, no local recurrence in the nipple areola complex was observed for the NSM group. In addition, there was no difference of OS between the NSM group (92.9%) and the SSM group (90.5%) (HR, 0.903; p = 0.9943; 95% CI, 0.049-4.739). Conclusions Our results suggested that NSM with immediate reconstruction might be safe as well as SSM for breast cancer with the nipple–tumor distance of >1 cm with respect to their prognosis and local control regardless of breast cancer subtype or invasiveness. Further studies with a large sample size to assess the risk of local recurrence for NSM after neoadjuvant chemotherapy. Citation Format: Yamashita Y, Hayashi N, Nagura N, Kajiura Y, Yoshida A, Takei J, Suzuki K, Tsunoda H, Yamauchi H. Long-term oncologic safety of nipple-sparing mastectomy with immediate reconstruction [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-14-17.

To reach fusion conditions and control the plasma configuration in ITER, the next step in tokamak fusion research, two neutral beam injectors (NBIs) will supply 16.5 MW each, by neutralizing accelerated negative hydrogen or deuterium ions. The requirements of ITER NBIs (40A/1 MeV D- ions for ≤1 h, 46A/870 keV H- ions for ≤1000 s) have never been simultaneously attained. So in the Neutral Beam Test Facility (NBTF, Consorzio RFX, Italy) the operation of the full-scale ITER NBI prototype (MITICA) will be tested and optimised up to full performances, focussing on accelerator (including voltage holding), beam optics, neutralisation, residual ion removal. The NBTF includes also the full-scale prototype of the ITER NBI source with 100 keV particle energy (SPIDER), for early investigation of: negative ion production and extraction, source uniformity, negative ion current density and beam optics. This paper will describe the main results of the first two years of SPIDER operation, devoted to characterizing plasma and beam parameters, including investigation of RF-plasma coupling efficiency and magnetic filter field effectiveness in reducing co-extracted electrons. SPIDER is progressing towards the first caesium injection, which aims at increasing the negative ion density. A major shutdown, planned for 2021, to solve the issues identified during the operation and to carry out programmed modifications, will be outlined. The installation of each MITICA power supply and auxiliary system is completed; in-vessel mechanical components are under procurement by Fusion for Energy (F4E). Integration, commissioning and test of the power supplies, procured by F4E and QST, as the Japanese Domestic Agency (JADA), will be presented. In particular, 1.0MV insulating tests were carried out step-by-step and successfully completed. In 2020 integrated tests of the power supplies on the accelerator dummy load started, including the assessment of their resilience to accelerator grid breakdowns using a short-circuit device located in vacuum. The aggressive programme, to validate the NBI design at NBTF and to meet ITER schedule (requiring NBIs in operation in 2032), will be outlined. Unfortunately, in 2020 the coronavirus disease infection affected the NBTF activities. A solution to proceed with integrated power tests despite the coronavirus is presented.

Funding Acknowledgements Type of funding sources: None. Background Right heart failure has been shown to portend poor prognosis. The pathophysiology of right heart function is complex, as right ventricular (RV) function is easily affected by preload and afterload. Purpose To test the hypothesis that machine learning would detect heterogeneity in right heart function and improve risk stratifications in a heart failure population Methods This study included 403 heart failure patients who had a history of hospitalization for decompensation. Patients were excluded if they had primary heart valve disease or pericardial disease or a previous cardiac surgery. Hierarchical clustering was undertaken on right heart variables (RV strain, right ventricular systolic pressure (RVSP), vena contracta of tricuspid regurgitation (TR) and diameter of inferior vena cava) to identify homogenous groups of patients with similar profiles of the variables. Cox hazard analysis was used to elucidate the benefit of clustering over each variable for prognosticating heart failure. Endpoint was hospitalization for worsening heart failure. Results Cluster analysis identified three groups with distinct right heart function. Cluster 1 (n = 191) represented patients with preserved RV function and low RVSP (figure A). On the other hand, cluster 2 (n = 144) had reduced RV function and low RVSP, while cluster 3 (n = 68) had preserved RV function and high RVSP, associated with severe TR and high central venous pressure. The latter 2 clusters carried worse outcome than cluster 1 (p Conclusion Cluster analysis identified two distinct phenotypes of right heart failure that were associated with adverse outcomes. This data-driven phenotyping can help in categorizing right heart failure and better prognosticating heart failure. Abstract Figure.

The objective of this study is to clarify the effects of web position on the shear resistance mechanism of Ultra High Strength Fiber Reinforced Concrete (UFC) beams. Four-point bending tests were conducted on total three beams with different web positions, i.e. centered web, two webs arranged at the quarter of the flange and two webs at the edge of the flange. The results revealed the structural performances such as shear capacity, flexural rigidity, displacement at the shear failure and post peak behavior differed in each specimen. The different structural performances can be explained by the difference in the area resisting the shear force, which is determined by the existence of flange overhang and whether webs were distributed in the flange.

We report searches for B0→invisible and B0→invisible+γ decays, where the energy of the photon is required to be larger than 0.5 GeV. These results are obtained from a 711 fb-1 data sample that contains 772×106BB¯ pairs and was collected near the ϒ(4S) resonance with the Belle detector at the KEKB e+e- collider. We observe no significant signal for either decay and set upper limits on their branching fractions at 90% confidence level of B(B0→invisible)

To compare the radiation dose, diagnostic accuracy, and the resultant ablation procedures using 80 and 120-kVp cardiac computed tomography angiography (CCTA) protocols with the same contrast-to-noise ratio in patients scheduled for atrial fibrillation (AF) ablation.This retrospective study was performed following institutional review board approval. We divided 140 consecutive patients who had undergone CCTA using a 64-MDCT scanner into two equal groups. Standard deviation (SD) of the CT number was set at 25 Hounsfield units (HU) for the 120-kVp protocol. To facilitate a reduction in radiation dose it was set at 40 HU for the 80 kVp protocol. We compared the two protocols with respect to the radiation dose, the diagnostic accuracy for detecting left atrial appendage (LAA) thrombi, matching for surface registration, and the resultant ablation procedures.At 120 kVp, the dose length product (DLP) was 2.2 times that at 80 kVp (1269.0 vs 559.0 mGy cm, p 0.01). The diagnostic accuracy for thrombus detection was 100% using both protocols. There was no difference between the two protocols with respect to matching for surface registration. The protocols did not differ with respect to the subsequent time required for the ablation procedures and the ablation fluoroscopy time, and the radiation dose (p = 0.54, 0.33, and 0.32, respectively).For the same CNR, the DLP at 80 kVp (559.0 mGy cm) was 56% of that delivered at 120 kVp (1269.0 mGy cm). There was no reduction in diagnostic accuracy.Maintaining CNR allows for a reduction in the radiation dose without reducing the image quality.

The current method for averaging model ensembles, which is to calculate a multi model mean, assumes model independence and equal model skill. Sharing of model components amongst families of models and research centres, conflated by growing ensemble size, means model independence cannot be assumed and is hard to quantify. We present a methodology to produce a weighted model ensemble projection, accounting for model performance and model independence. Model weights are calculated by comparing model hindcasts to a selection of metrics chosen for their physical relevance to the process or phenomena of interest. This weighting methodology is applied to the Chemistry-Climate Model Initiative (CCMI) ensemble, to investigate Antarctic ozone depletion and subsequent recovery. The weighted mean projects an ozone recovery to 1980 levels, by 2056 with a 95 % confidence interval (2052–2060), 4 years earlier than the most recent study. Perfect model testing and out-of-sample testing validate the results and show a greater projective skill than a standard multi model mean. Interestingly, the construction of a weighted mean also provides insight into model performance and dependence between the models. This weighting methodology is robust to both model and metric choices and therefore has potential applications throughout the climate and chemistry-climate modelling communities.

The combination of catalysts from the fields of organocatalysis and biocatalysis toward chemoenzymatic one-pot syntheses is an attractive concept for enabling efficient enantioselective synthetic processes for chiral building blocks without the need for isolation of intermediates, thus avoiding time-consuming as well as waste-producing work-up steps.

We propose an epoxy resin-based optical phantom containing six dyes, which approximates the absorption spectrum of human tissue over the wavelength range of 700–850 nm.