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Background Left Main Stem Disease (LMS) has historically been treated with coronary artery bypass surgery (CABG). However, not all patents with LMS are candidates for CABG due to co-morbidities. There is limited long-term follow-up of patients undergoing PCI in the real world. The primary objective of this study was to investigate the long-term mortality following LMS PCI. Methods We conducted a retrospective study of patients who had undergone PCI for LMS disease at our hospital over a 11-year period between July 2010-July 2021. Data was collected from electronic medical records and analyzed using Kaplain-Meier survival analysis. Follow-up was obtained through linkage with the Office of National Statistics. Results 498 patients underwent LMS PCI (5.1% of the total PCI cases). The overall survival rate was 70%. Median survival following PCI was 1,196 days (IQR = 1,796). The mean age of the patients was 70.7 years; 70.5% were males. 70.9% of patients underwent PCI for Acute Coronary Syndrome (ACS), and 15.3% had STEMI. 33.7% of patients had a history of diabetes, 8% had stroke, 8.2% had COPD, and 8.8% had PVD. 51 patients went into cardiogenic shock, and 25 died prior to discharge. Survival of the ACS group was significantly lower than the stable group (67% vs 77%, p60 years (80% vs 68%; p35% (22% vs 29%, p Conclusion Our results show that the real world 10-year mortality rate following LMS PCI is influenced by multiple factors including age, shock, and LV function. The high mortality rate was potentially due to the significant number of acute cases (70.1%) in non-operable patients. While factors such as age and past medical history are considered in the decision-making process regarding CABG vs PCI, we saw that specific subgroups within these factors may have decreased the effectiveness of PCI as a treatment for LMS disease, suggesting that deeper analysis into these risk factors is required when deciding between CABG and PCI for LMS disease management. Funding Acknowledgement Type of funding sources: None.

Early Iron Age pastoralists of the Eurasian steppes relied heavily on copper for weapons and ornaments, and new analysis of metal composition enables long-distance networks to be identified. Primary circulation from source areas where copper was mined can be distinguished alongside the secondary circulation of alloy types with high proportions of tin-bronze or leaded tin-bronze. The relative presence of trace elements, depleted during recycling events, provides a proxy for the flow of metal between regions. The localised seasonal movements characteristic of these mobile steppe societies underlie some of these patterns, but the evidence also indicates more extensive transfers, including the direct movement of finished objects over considerable distances.

Large urban emissions of greenhouse gases result in large atmospheric enhancements relative to background that are easily measured. Using CO2 mole fractions and Δ14C and δ13C values of CO2 in the Los Angeles megacity observed in inland Pasadena (2006–2013) and coastal Palos Verdes peninsula (autumn 2009–2013), we have determined time series for CO2 contributions from fossil fuel combustion (Cff) for both sites and broken those down into contributions from petroleum and/or gasoline and natural gas burning for Pasadena. We find a 10 % reduction in Pasadena Cff during the Great Recession of 2008–2010, which is consistent with the bottom-up inventory determined by the California Air Resources Board. The isotopic variations and total atmospheric CO2 from our observations are used to infer seasonality of natural gas and petroleum combustion. The trend of CO2 contributions to the atmosphere from natural gas combustion is out of phase with the seasonal cycle of total natural gas combustion seasonal patterns in bottom-up inventories but is consistent with the seasonality of natural gas usage by the area's electricity generating power plants. For petroleum, the inferred seasonality of CO2 contributions from burning petroleum is delayed by several months relative to usage indicated by statewide gasoline taxes. Using the high-resolution Hestia-LA data product to compare Cff from parts of the basin sampled by winds at different times of year, we find that variations in observed fossil fuel CO2 reflect seasonal variations in wind direction. The seasonality of the local CO2 excess from fossil fuel combustion along the coast, on Palos Verdes peninsula, is higher in autumn and winter than spring and summer, almost completely out of phase with that from Pasadena, also because of the annual variations of winds in the region. Variations in fossil fuel CO2 signals are consistent with sampling the bottom-up Hestia-LA fossil CO2 emissions product for sub-city source regions in the LA megacity domain when wind directions are considered.

For the last 180 years, scientists have been attempting to determine the ‘provenance’ (geological source) of the copper used in Bronze Age artefacts. However, despite advances in analytical technologies, the theoretical approach has remained virtually unchanged over this period, with the interpretative methodology only changing to accommodate the increasing capacity of computers. This book represents a concerted effort to think about the composition of Bronze Age metal as the product of human intentionality as well as of geology. It considers the trace element composition of the metal, the alloying elements, and the lead isotopic composition, showing how a combination of these aspects, along with archaeological context and typology, can reveal much more about the life history of such artefacts, expanding considerably upon the rather limited ambition of knowing where the ore was extracted. Beyond Provenance serves as a ‘how-to handbook’ for those wishing to look for evidence of human intentionality in the chemical patterning observed in bronzes.

In recent years, several research groups have concluded that traditional ‘provenance studies’ of metals, in which an object is linearly related to a single source, do not represent the reality of many archaeological assemblages. This paper sets out a new systematic approach to metal chemistry designed to characterize, using trace elements and isotopes in an assemblage of material, the underlying circulation of metal. When applied in China to the use of leaded tin bronze to cast the large and numerous ritual vessels of the Shang (c. 1500-1045 BC) and the Zhou dynasties (c. 1045-771 BC), the methodology reveals the complexity of the copper sources on which the major late Shang capital at Anyang depended for its bronze workshops. This has been recognised by many in the past, but has yet to prompt a full reassessment of the organisation of the Shang bronze industry. Here we point out the possibility of a need to transport copper from distant regions in the south, on the Yangzi, and even from far to the north, in northeast China. Using lead isotope data, presented in a new format, we attempt to enlarge the understanding of this organisation, demonstrating that, while the Zhou took over some of the range of copper available to the middle Anyang period, the lead sources exploited in early and middle Anyang phases differed from those taken up by the Zhou. The methodology enables a further understanding of the network on which the major dynasties depended for supplies of copper, lead and tin, and can thus lead us towards one of the major objectives of the new interpretational system - to give equal weight to archaeological and chemical data.

The present study proposed several scenario simulations of flood disaster according to the historical flood event and planning requirement in Ba-Ma Creek Watershed located in Nantou County, Taiwan. The simulations were made using the FLO-2D model, a numerical model which can compute the velocity and depth of flood on a two-dimensional terrain. Meanwhile, the calculated data were utilized to estimate the possible damage incurred by the flood disaster. The results thus obtained can serve as references for disaster prevention. Moreover, the simulated results could be employed for flood disaster estimation using the method suggested by the Water Resources Agency of Taiwan. Finally, the conclusions and perspectives are presented.

In the article by Pollard et al. (2017), Figure 2 was incorrectly duplicated as Figure 5.

The Los Angeles megacity, which is home to more than 40% of the population in California, is the second largest megacity in the United States and an intense source of anthropogenic greenhouse gases (GHGs). Quantifying GHG emissions from the megacity and monitoring their spatiotemporal trends are essential to be able to understand the effectiveness of emission control policies. Here we measure carbon dioxide (CO2) and methane (CH4) across the Los Angeles megacity using a novel approach – ground-based remote sensing from a mountaintop site. A Fourier Transform Spectrometer (FTS) with agile pointing optics, located on Mount Wilson at 1.67 km above sea level, measures reflected near infrared sunlight from 29 different surface targets on Mount Wilson and in the Los Angeles megacity to retrieve the slant column abundances of CO2, CH4 and other trace gases above and below Mount Wilson. This technique provides persistent space and time resolved observations of path-averaged dry-air GHG concentrations, XGHG, in the Los Angeles megacity and simulates observations from a geostationary satellite. In this study, we combined high sensitivity measurements from the FTS and the panorama from Mount Wilson to characterize anthropogenic CH4 emissions in the megacity using tracer : tracer correlations. During the period between September 2011 and October 2013, the observed XCH4 : XCO2 excess ratio, assigned to anthropogenic activities, varied from 5.4 to 7.3 ppb CH4 (ppm CO2)−1, with an average of 6.4 ± 0.5 ppb CH4 (ppm CO2)−1 compared to the value of 4.6 ± 0.9 ppb CH4 (ppm CO2)−1 expected from the California Air Resources Board (CARB) bottom-up emission inventory. Persistent elevated XCH4 : XCO2 excess ratios were observed in Pasadena and in the eastern Los Angeles megacity. Using the FTS observations on Mount Wilson and the bottom-up CO2 emission inventory, we derived a top-down CH4 emission of 0.39± 0.06 Tg CH4 year−1 in the Los Angeles megacity. This is 18–61% larger than the state government's bottom-up CH4 emission inventory and consistent with previous studies.

The transformational approach is a formal method for program construction that allows refinement to be carried out using mechanical manipulations. The authors describe an alternative idea for supporting transformations that emphasizes the use of integrated tools instead of individual rules. These tools provide the mechanism for coordinating a generic design concept with the use of transformation rules. In particular, they allow the user to combine the formulation of a design and its application during the refinement process. The authors describe the tools and give examples illustrating their application. A brief description of the methodology and specification notation is also provided. >

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Infective larvae of Wuchereria bancrofti from laboratory-raised Culex pipiens fatigans and Aedes togoi mosquitoes fed on human volunteers in Jakarta, Indonesia (J strain) and Kinmen Island, China (K strain) were introduced into Taiwan monkeys (Macaca cyclopis) by subcutaneous inoculation, by foot puncture, or by permitting infected mosquitoes to feed weekly on the monkeys. Some animals were splenectomized and others were treated with varying regimens of immunosuppressants. Necropsy was done on monkeys that died or were killed and the entire bodies were examined for worms. A total of 78 monkeys (43 males and 35 females) were exposed to infection and parasites were found in 29% of the females and 63% of males. In infections of 38 days or less worms were recovered from the testes of males and the pelt, carcass and lymph nodes of both sexes, but after 42 days of infection most worms were in the testes of males, and a few were recovered from lymph nodes and carcasses of females. Worms recovered at 8-11 days were third-stage, those found between 14 and 38 days fourth-stage, and ones found between 42 and 103 days were young adults. After 148 days most were adults and microfilariae were seen in the uteri of female worms at 160 days and later. The parasites continued to grow in size with time. Microfilariae were detected in the blood of nine monkeys between 8 and 18 months and the patent period varied from 5-21 months. Microfilarial densities were low and erratic, and periodicity could not be determined. The effectiveness of methods of administering infections and the value of various treatment regimens seem uncertain; monkey antilymphocytic sera, however, appeared to have some influence. Parasites were found in 36% of the Taiwan monkeys given the J strain and 54% of those given the K strain. A limited number of M. mulatta (3), M.irus (fascicularis) (3) and Aotus trivirgatus (4) were also given infective larvae and adult W. bancrofti were recovered from the testes of one male M. mulatta and one male M. irus; uterine microfilariae were found in one female worm from the latter monkey. A. trivirgatus were negative. Low numbers of infective larvae recovered from mosquitoes fed on patent monkeys were introduced intermittently into seven clean monkeys and one became microfilaremic between 11 and 17 months postinoculation.

Knowledge of gland-like inclusions in pelvic lymph nodes has existed since 1897. The histogeneses proposed to explain such alterations have included congenital rests, endometriosis, metastatic neoplasia, and mesothelial metaplasia. The correct interpretation of the lymph node involvement is important in order to institute appropriate therapy. In the present study, there were 12 examples of benign mesothelial inclusions found in routine sections from pelvic lymph nodes removed in the treatment of 337 cases of gynecologic cancer. In an additional 4 cases, an intraabdominal neoplasm was present. The variations in the histologic patterns are described as is the clinical course of the disease.

A decidual reaction may occur in the pelvic lymph nodes during normal pregnancy. This reaction may be replaced by the same type of benign metaplastic reaction that gives rise to leiomyomatosis peritonealis disseminata. The occurrence of this apparent smooth muscle in the pelvic lymph nodes may result in an erroneous diagnosis of metastatic leiomyosarcoma, or of benign metastasizing leiomyoma.

Future large space based facilities, such as Space Station, will require energy management systems capable of transporting tens of kilowatts of heat over a hundred meters or more. This represents better than an order of magnitude improvement over current technology. Two-phase thermal systems are currently being developed to meet this challenge. Condensation heat transfer plays a very important role in this system. The present study attempts an analytic solution to the set of linearized partial differential equations. The axial velocity and temperature functions were found to be Bessel functions which have oscillatory behavior. This result agrees qualitatively with the experimental evidence from tests at both NASA Goddard Space Flight Center and elsewhere.

Silicon on insulator (SOI) substrate is a key materials for nano-scaling IC device and the requirement for its crystal structure and quality is really high. Nanothick silicon thin film can be transferred onto a handle wafer from a donation wafer to form a SOI wafer after this process including hydrogen implantation of donation wafer, wafer bonding, and thermal treatment at moderately high temperatures of 400 to 600 degree centigrade. The expansion of the hydrogen molecular evolving from the implanted hydrogen ions interacting with silicon dangling bonds and trapped inside the microcavities located near the ion projected range resulted in exfoliation of the silicon thin film in the final heating step. The hydrogen molecules inside the microcavities tend to expand along the bonded interface rather than radially to form individual blisters. Finally, the fracture failure of ion implanted area parallel to the bonded interface near the projected ion range is formed by the sideway expansion of the cavities due to the diffusion supply of implanted hydrogen excited by thermal energy. Microwave processing can lower the activity energy to speed the chemical reaction so that it leads the format of microcavities occurring at low temperature by directly exciting the implanted hydrogen ions by microwave energy and also results in decreasing the critical dosage for layer splitting. However, microwave irradiation alone at room temperature causes the formation of lots of nucleus sites of micro-voids filled by hydrogen molecule which is immobility in silicon resulting in the issue of uniformity of transferred layer. In this study, the hydrogen implanted silicon substrate was irradiated by microwave at low temperature (200 degree centigrade) rather than microwave alone to co-activate the implanted hydrogen ions in silicon to increase not only kinetic energy but also mobility to successfully achieve a completely transferred layer in a short time.