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The impact of delaying atrial fibrillation catheter ablation (AFCA) for antiarrhythmic drug (AAD) management on the disease course remains unclear. This study investigated AFCA rhythm outcomes based on the diagnosis‐to‐ablation time (DAT) and AAD responsiveness in participants with persistent AF (PeAF). We included data from 1038 AAD‐resistant PeAF participants, all of whom had a clear time point for AF diagnosis, especially PeAF at diagnosis time, and had undergone an AFCA for the first time. Participants who experienced recurrences of paroxysmal type on AAD therapy were analyzed as a cohort of AAD‐partial responders; those maintaining PeAF on AAD were AAD‐non‐responders. We determined the DAT cutoff for best discriminating long‐term rhythm outcomes using a maximum log‐likelihood estimation method based on the Cox proportional hazard regression model. Of the participants (79.8% male; median age 61), 806 (77.6%) were AAD‐non‐responders. AAD‐non‐responders had a higher body mass index and a larger left atrial diameter than AAD‐partial‐responders. They also had a higher incidence of AF recurrence after AFCA (adjusted hazard ratio 1.75, 95% confidence interval 1.33–2.30; log‐rank p< .001) compared to AAD‐partial‐responders. The maximum log‐likelihood estimation showed bimodal cutoffs at 22 and 40 months. The optimal DAT cutoff rhythm outcome was 22 months, which discriminated better in the AAD‐partial‐responders than in the AAD‐non‐responders. Both DAT and AAD responsiveness influenced AFCA rhythm outcomes. Delaying AFCA to a DAT of longer than 22 months was inadvisable, particularly in the participants in whom PeAF was changed to paroxysmal AF during AAD therapy. AAD‐non‐responders had a higher incidence of AF recurrence after AFCA compared to AAD‐partial‐responders. The maximum log‐likelihood estimation showed bimodal cutoffs at 22 and 40 months. The optimal DAT cutoff rhythm outcome was 22 months, which discriminated better in the AAD‐partial‐responders than in the AAD‐non‐responders.

Developing robust oxygen evolution reaction (OER) electrocatalysts is crucial for advancing anion exchange membrane water electrolysis (AEMWE). In this study, we present a catalyst optimizing the synergistic effect of Co and Fe by creating a CoFe-based layer on a Fe-based electrode (Fe@CoFe). The Fe@CoFe exhibits an overpotential of 168 mV at 10 mA cm–2under half-cell conditions and a current density of 10 A cm–2at 2 V in the AEMWE system with 1 M KOH. Moreover, it showcases a degradation rate of 76 μV h–1for 2000 h at 500 mA cm–2in the single-cell system. This study demonstrates the feasibility of achieving efficient and durable water electrolysis using a transition metal-based catalyst exclusively fabricated via electrodeposition.

Hypertrophic cardiomyopathy (HCM) is frequently associated with atrial fibrillation (AF). We compared clinical, echocardiographic, and electrophysiological parameters between HCM subtypes and those without HCM at AF catheter ablation (AFCA) and analyzed post‐AFCA reverse remodeling and AF recurrence based on HCM presence and subtype. Among 5161 consecutive patients who underwent de novo AFCA, we included HCM patients and control patients who were age‐, gender‐, and AF type‐matched. Between AF‐HCM patients and controls, we compared baseline values for left atrium (LA) wall thickness (LAWT), reverse remodeling at 1‐year follow‐up, and procedural outcomes over the course of follow‐up between two groups. A total of 122 AF‐HCM patients and 318 control patients were included. AF‐HCM patients had more frequent heart failure and higher LA diameter, E/Em, and LA pressure (all, p< .001). However, LAWT did not differ from control group. A year after AFCA, degree of LA reverse remodeling was significantly lower in AF‐HCM than in control group (ΔLA dimension, p= .025). Nonapical HCM (HR 1.71; 95% CI 1.05–2.80), persistent AF (HR 1.46; 95% CI 1.05–2.04), and LA dimension (HR 1.04; 95% CI 1.01–1.06) were independent risk factors for AF recurrence. During 78.0 months of follow‐up, nonapical HCM patients showed higher AF recurrence rate than both apical HCM (log‐rank p= .005) and control patients (log‐rank p= .002). The presence of HCM, particularly nonapical HCM, displayed increased LA hemodynamic loading with diastolic dysfunction and had poorer rhythm outcomes after AFCA compared to both apical HCM and control group. Comparison of LA hemodynamic and structural parameters between AF‐HCM and control groups and the difference of LA reservoir strain according to the type of HCM with rhythm outcome after AFCA in three groups.

Plastic pollution poses a serious risk globally and is having a major adverse impact on nearly every marine and freshwater ecosystem on the planet. The plastic trash collected from the marine environment, can harm marine ecosystems and humans. While there are several challenges to manufacture products from recycled marine plastics, including a high price and consumer demand for high-quality recycled materials, efforts, and research to recycle marine plastics are critical. One promising application of recycled marine plastics is blending recycled polyethylene terephthalate (re-PET) with other polymers, such as polycarbonate (PC), to reproduce desired physical properties in composites. In this study, we investigated the optimal ratio of PC and ocean-bound plastic (OBP), recycled PET (re-PET) as a composite material suitable for sustainable electronic device covers, and analyzed its physicochemical properties. The results showed that PC/re-PET5 composites containing 5% re-PET recycled from OBP had the most suitable properties for electronic device covers. Developing composite materials using recycled plastics represents a promising stride towards advancing the principles of a circular economy and fostering sustainable product design.

Although extra‐pulmonary vein (PV) triggers (ExPVTs) play a role in atrial fibrillation (AF) recurrence after catheter ablation (AFCA), the mechanism is unknown. We explored whether the locations of ExPVTs were associated with low‐voltage scar areas (LVAs). Among 2255 consecutive patients who underwent a de novo AFCA, 1696 (male 72.1%, median 60 years old, paroxysmal 64.7%) were included who underwent isoproterenol provocation and voltage mapping of the left atrium (LA) during their procedures. We investigated the associations between ExPVTs and their mean LA voltage and colocalization of ExPVTs within LVAs (<0.2 mV). We observed ExPVTs in 181 (10.7%) patients (60 in the LA, 99 in the right atrium [RA], 16 biatrial, and 6 unmappable). A lower mean LA voltage was independently associated with the existence of ExPVTs (OR 0.77 per 1 SD mV increase, 95% CI 0.60–0.99, p= .039). Among 76 patients who had ExPVTs[LA], 43 (56.6%) had ExPVTs within LVAs. During a median of a 42‐month follow‐up, patients with ExPVTs had a higher AF recurrence than those without (HR 1.87, 95% CI 1.48–2.37, Log‐rank p< .001), but colocalization of ExPVTs and LVAs (Log‐rank p= .544) and the anatomical location of ExPVTs (Log‐rank p= .084) did not affect the rhythm outcome. The presence of ExPVTs was associated with low LA voltage and poor rhythm outcome post‐AFCA, but the colocalization of ExPVTs and LVA in LA did not affect rhythm outcome. The presence of an ExPVT was associated with a low LA voltage and poor rhythm outcome after AFCA, but the electroanatomical location of the ExPVT was not.

High‐power short‐duration (HPSD) ablation creates wide, shallow lesions using radiofrequency (RF) heating. It is uncertain if adjusting RF energy based on atrial wall thickness provides extra benefits. We studied the safety and effectiveness of tailored HPSD energy based on left atrial (LA) wall thickness (LAWT) for circumferential pulmonary vein isolation (CPVI) in patients with paroxysmal atrial fibrillation (PAF). We enrolled 212 patients (68.4% male, mean age: 59.5 ± 11.0 years) and randomly assigned them to two groups: LAWT‐guided CPVI (WT, n= 108) and conventional CPVI (control, n= 104). Both groups used an open irrigated‐tip deflectable catheter to apply 50 W for 10 s to the posterior LA, while controls used 60 W for 15 s on other LA regions. RF delivery time in WT was titrated (15 s at LAWT > 2.1 mm, 13 s at 1.4–2.1 mm, and 11 s at <1.4 mm) according to the computed tomogram‐myocardial thickness color map. After a mean follow‐up of 13.4 ± 7.0 months, the WT and control groups showed no significant difference regarding clinical recurrence rate (13.9% vs. 5.8%, respectively; p= .061) and major complication rate (4.6% vs. 3.8%, respectively; p> .999). The total procedure time, cardioversion rate, and post‐procedural AAD prescription rates did not significantly differ between the groups. The LAWT‐guided energy titration strategy did not result in improved procedural safety and efficacy compared to the conventional 50–60 W‐HPSD CPVI in patients with PAF. Overview of the methods and results of our study. The clinical recurrence rate between WT‐guided ablation and control groups did not significantly differ.

Driving assistance modules are important components to improving driver safety in driving environments, which can create overloaded multisensory information. This article introduces the concept of a head-up haptic display that assists drivers in keeping their visual attention focused, and then offers a haptic actuator that may be used as the main component in the head-up haptic display. We selected magneto-rheological elastomer (MRE) as the base material and adopted a porous structure to reduce its initial stiffness. Furthermore, we fabricate a haptic actuator based on an MRE having a porous structure (pMRE) and a solenoid. The current to the solenoid generates a magnetic field that causes the pMRE to stiffen, thereby increasing the resistive force. As soon as the current input is removed, the pMRE becomes soft again. We simulated the solenoid coil and the magnetic path to further maximize the magneto-motive force generated by the solenoid coil and experimentally optimized the pMRE. We showed that the proposed haptic actuator creates not only a sufficient resistive force but also vibration to generate various haptic sensations. Moreover, we constructed a head-up haptic display using four haptic actuators and demonstrated the possibility of utilizing a new user interface to increase driving safety.

Objective To determine age-related risk factors for chronic rhinosinusitis (CRS) with asthma.Methods Data were obtained from a national survey of non-hospitalized civilians conducted by the Korean Center for Disease Control and Prevention. CRS diagnosis was based on the guidelines of the European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Asthma was judged based on whether the patient had been diagnosed with asthma in the past. Of the 45,811 survey participants, 26,335 were included in the cross-sectional study. Participants included in the study were divided into the control, CRS, and CRS with asthma groups. Age-related risk factors were analyzed in patients aged < 60 or > 60 years. Univariate logistic analyses were performed to evaluate the relationship between groups. Risk factors included age, sex, household income, residence, education level, occupation, and body mass index (BMI).Results Education level (Odds Ratio [OR]: 0.342, P = .0003), BMI (OR: 1.09, P = .0082), and total IgE (TIgE) levels (OR: 5.582, P = .003) were significantly different between the control and the CRS with asthma group. Education level (OR: 0.478, P = .0016) and TIgE levels (OR: 4, P = .0218) were significantly different between the CRS and CRS with asthma groups under 60 years of age. BMI (OR: 1.087, P = .0443; OR: 1.104, P = .0224) showed a significant difference between all three groups with age > 60 years.Conclusion Progression to CRS with asthma is influenced by education level, occupation, and TIgE levels in patients under 60 years of age. BMI was the only influencing factor associated with the progression to CRS with asthma in those aged > 60 years.

Amorphous titanyl phosphate (a-TP) overlaid on TiO2is strategically designed to actively promote H2O2production via water oxidation reaction (WOR). Beyond conformally covered amorphous overlayer, a-TP/TiO2exhibited enhanced H2O2production and Faraday efficiency.

The stability of n-type organic and hybrid thermoelectric materials is limited in terms of their practical application to p–n parallel thermoelectric devices. We demonstrate the ambient stability of an n-type single-walled carbon nanotube/organic small-molecule (SWNT/OSM) hybrid by deepening the lowest occupied molecular orbital energy level. This hybrid exhibited the best figure of merit (0.032) among n-type SWNT/OSM hybrid thermoelectrics and an enhanced power factor of 291.0 μW m–1K–2. Furthermore, we observed that the n-type thermoelectric stability of a hybrid of SWNT and pipcontaining two N-ethylpiperidinyl groups on both sides of a naphthalenediimide core was retained at 87% over 7 months (220 days) under ambient conditions without encapsulation.

A polystyrene phantom was developed following the guidance of the International Atomic Energy Association (IAEA) for gamma knife (GK) quality assurance. Its performance was assessed by measuring the absorbed dose rate to water and dose distributions. The phantom was made of polystyrene, which has an electron density (1.0156) similar to that of water. The phantom included one outer phantom and four inner phantoms. Two inner phantoms held PTW T31010 and Exradin A16 ion chambers. One inner phantom held a film in the XY plane of the Leksell coordinate system, and another inner phantom held a film in the YZ or ZX planes. The absorbed dose rate to water and beam profiles of the machine-specific reference (msr) field, namely, the 16 mm collimator field of a GK Perfexion™ or Icon™, were measured at seven GK sites. The measured results were compared to those of an IAEA-recommended solid water (SW) phantom. The radius of the polystyrene phantom was determined to be 7.88 cm by converting the electron density of the plastic, considering a water depth of 8 g/cm2. The absorbed dose rates to water measured in both phantoms differed from the treatment planning program by less than 1.1%. Before msr correction, the PTW T31010 dose rates (PTW Freiberg GmbH, New York, NY, USA) in the polystyrene phantom were 0.70 (0.29)% higher on average than those in the SW phantom. The Exradin A16 (Standard Imaging, Middleton, WI, USA) dose rates were 0.76 (0.32)% higher in the polystyrene phantom. After msr correction factors were applied, there were no statistically significant differences in the A16 dose rates measured in the two phantoms; however, the T31010 dose rates were 0.72 (0.29)% higher in the polystyrene phantom. When the full widths at half maximum and penumbras of the msr field were compared, no significant differences between the two phantoms were observed, except for the penumbra in the Y-axis. However, the difference in the penumbra was smaller than variations among different sites. A polystyrene phantom developed for gamma knife dosimetry showed dosimetric performance comparable to that of a commercial SW phantom. In addition to its cost effectiveness, the polystyrene phantom removes air space around the detector. Additional simulations of the msr correction factors of the polystyrene phantom should be performed.

Background: Recurrence of the hallux valgus deformity has various causes, and the incomplete reduction of sesamoids may be one of the important issues. However, we have seen several patients with postoperative lateral sesamoid displacement on anteroposterior (AP) standing radiographs who did not experience hallux valgus recurrence. Therefore, we hypothesized that lateral displacement of the sesamoid on AP standing radiographs does not cause hallux valgus recurrence.Methods: The study included 269 feet (185 patients) with hallux valgus treated with distal chevron metatarsal osteotomy. Mean patient age was 64.26 (range, 15-80) years. Patients were followed up for an average of 33.85 (range, 12-228) months between April 2002 and December 2019. The patients were divided into 4 groups, according to the presence or absence of hallux valgus recurrence and sesamoid reduction.Results: During outpatient follow-up, we discovered 99 feet (42.1%) in which hallux valgus did not recur despite lateral sesamoid displacement (grade IV-VII) on AP standing radiographs. Hallux valgus angle (HVA, 2.7 to 7.9 degrees), intermetatarsal angle (IMA, 4.6 to 6.2 degrees), and sesamoid grades (2.1 to 3.5) all deteriorated over time after surgery, and each indicator was statistically significantly altered, and changes in the 3 indicators had a statistically significant positive correlation. Changes in HVA and IMA between feet with and without sesamoid reduction on AP standing radiographs increased over time, with the differences in HVA (2.9 degrees) and IMA (0.9 degrees) being significant at final follow-up (P< .05 for each). Regardless of whether sesamoid reduction was achieved on AP standing radiographs, the final analysis showed that HVA and IMA in both groups worsened over time. Further, there were no differences between the 2 groups in the patterns of change over time.Conclusion: In our cohort, postoperative sesamoid position on AP standing radiographs was not associated with hallux valgus recurrence based on radiographic criteria.Level of Evidence: Level III, retrospective comparative study.

ObjectiveThe risk of recurrence after atrial fibrillation (AF) catheter ablation (AFCA) is higher in women than in men. However, it is unknown whether a sex difference exists in antiarrhythmic drug (AAD) responsiveness among patients with recurrence.MethodsAmong 2999 consecutive patients (26.5% women, 58.3±10.9 years old, 68.1% paroxysmal AF) who underwent de novo AFCA, we compared and evaluated the sex differences in rhythm outcome in 1094 patients with recurrence and in 788 patients who subsequently underwent rhythm control with AAD.ResultsDuring a follow-up of 48.2±34.9 months, 1094 patients (36.5%) had AF recurrence after AFCA, and 508 of 788 patients (64.5%) had AF recurrence under AAD. Although the rhythm outcome of a de novo AFCA was worse (log-rank p=0.041, HR 1.28, 95% CI 1.02 to 1.59), p=0.031) in women, AAD response after postprocedural recurrences was better in women than in men (log-rank p=0.003, HR 0.75, 95% CI 0.59 to 0.95, p=0.022), especially in women older than 60 years old (log-rank p=0.003). In 249 patients who underwent repeat procedure after AAD use, the pulmonary vein (PV) reconnection rate (62.7% vs 76.8%, p=0.048) was lower in women than in men but not the existence of extra-PV trigger (37.8% vs 25.4%, p=0.169).ConclusionsAlthough women showed worse rhythm outcomes than men after AFCA, the post-AFCA AAD response was better in elderly women than in men.Trial registration numberNCT02138695.

Fluorinated polymers are a significant class of functional materials in the field of polymer chemistry. Endowed with remarkable properties, such as high chemical and solvent resistance, enhanced electrical properties, high thermal and electrochemical stability, and low surface energy, they find potential applications in various fields such as chemical processing, electrical/electronic industries, automotive/aircraft industries, medical instrumentations, consumer products, and energy storage or conversion devices. Among a wide variety of commercially significant fluorinated polymers, perfluoropolyether (PFPE) plays a substantial role in energy applications because of its super-hydrophobicity, non-crystallinity, non-flammability, low toxicity, and gas-permeability features. This review briefly confers the properties, production, and significant studies of perfluoropolyether as electrolytes in batteries, followed by a detailed discussion on their role as solid electrolyte interphase (SEI) in metal-ion batteries, oxygen selective membrane (OSM) in metal–air batteries, and as a hydrophobic coating for gas diffusion electrodes in fuel cell applications. Besides, other energy-related applications of PFPE that open up the future scopes of perfluoropolyether in the field of energy storage and conversion devices are also presented.

Although numerous thermoelectric materials based on single-walled carbon nanotubes (SWNTs) and organic semiconductors have been reported during the past decade, the correlation between energy levels of organic semiconductors and thermoelectric performances of their hybrids is still ambiguous. In this study, we demonstrate that simultaneous modulation of the bandgap and highest occupied molecular orbital levels in organic small molecules (OSMs) largely improves the Seebeck coefficient and thus maximizes the figure of merit (ZT) of SWNT/OSM hybrids. SWNT/CzSwith an enlarged bandgap and reduced barrier energy exhibited a synergistic increment in the Seebeck coefficient (108.7 μV K–1) and power factor (337.2 μW m–1K–2), with the best ZTof 0.058 at room temperature among dopant-free carbon nanotube-hybridized thermoelectrics. The efficient charge carrier transport and reduced thermal conductivity of SWNT/CzSprovided enhanced thermoelectric performance. Our strategy based on energy level modulation could be broadly applied for performance enhancement of organic and hybrid thermoelectric materials.

Introduction: Central compartment atopic disease (CCAD) has recently been suggested as a phenotype of chronic rhinosinusitis (CRS). This study aims to investigate the prevalence of the radiologic CCAD phenotype in CRS within a pediatric population and identify its ability to predict comorbid allergy and asthma.Methods: Computed tomography and endoscopic examination were conducted on pediatric patients with CRS either with or without nasal polyps. Allergen sensitization was determined with the multiple-allergen simultaneous test and skin prick test. Serum total immunoglobulin E (IgE), peripheral blood eosinophil percentage, and presence of asthma were also evaluated.Results: A total of 82 pediatric patients were enrolled. Overall, 55 (67.1%) of the participants demonstrated aeroallergen sensitization, and 31 (18.9%) of the 164 sides of sinuses were radiologically defined to fit the CCAD phenotype. Patients having CRS with the CCAD phenotype had a higher prevalence of aeroallergen sensitization (87.1% vs 62.4%, P= .008), particularly house dust mite (74.2% vs 53.4%, P= .035), and a higher incidence of asthma (16.1% vs 3.8%, P= .010). Additionally, patients having CRS with the CCAD phenotype demonstrated a high serum total IgE levels (51.6% vs 30.1%, P= .023) in comparison to patients having CRS without CCAD.Conclusion: In pediatric CRS, the radiological CCAD phenotype was associated with allergen sensitization and asthma. Furthermore, the CCAD phenotype was associated with high serum total IgE levels, suggesting allergy etiology should be considered with this type of pediatric patients with CRS.

• The Ce- and Ce-La-substitution for Nd in Nd-Fe-B magnets hinder the texture development and grain boundary phase formation during the hot-deformation process. • The decrease in volume fraction of RE-rich liquid in the grain boundaries by Ce- and Ce-La substitution is a critical reason for the deterioration of magnetic and microstructural properties of Ce- and Ce-La-substituted Nd-Fe-B hot-deformed magnets. • Based on the results, a method to increase both the coercivity and remanence of the Ce- and Ce-La-substituted Nd-saving hot-deformed magnets was developed: intermediate infiltration (I-infiltration). In this study, the influence of Ce- and Ce-La-substitution for Nd in Nd-Fe-B magnets on their magnetic and microstructural changes in the course of the hot-deformation process was investigated to gain insight into further reducing the Nd content in fine-grained Nd-Fe-B hot-deformed magnets. We found that the [001] texture and microstructure of the RE-rich grain boundary phases, which are the factors that determine the remanence and coercivity of hot-deformed magnets, were deteriorated by the Ce- and Ce-La-substitution. This is because the volume fraction of the RE-rich liquid formed in the grain boundaries during the hot-press and hot-deformation decreased due to the Ce- and Ce-La-substitution, thereby increasing the friction between the 2:14:1 grains while the c -axes of grains were aligned by grain rotation and decreasing the RE concentration of grain boundary phases. In particular, the Ce-La-co-substitution further prevented the liquid formation within the grain boundaries of the magnets during hot-press and hot-deformation because the wettability of the RE-rich liquid on the 2:14:1 grains became poor when La was substituted for Nd in the 2:14:1 grains. These results indicate that there is room for further improvement in both the remanence and coercivity of the Ce- and Ce-La-substituted magnets by introducing additional liquid into the grain boundaries prior to hot-press and hot-deformation. By applying the Nd-Cu infiltration process to the melt-spun ribbons (intermediate infiltration, I-infiltration), both the remanence and coercivity of the Nd-saving (Nd 0.7 Ce 0.3)-Fe-B and (Nd 0.7 Ce 0.225 La 0.075)-Fe-B hot-deformed magnets were successfully improved. [ABSTRACT FROM AUTHOR]

Background Air pollution is a serious health concern and affects inflammatory sinonasal diseases such as allergic rhinitis (AR) and chronic rhinosinusitis (CRS). Clarifying the relationship between air pollutants and upper respiratory diseases could help the patients.Objective To evaluate the association between the concentration of air pollutants and the prevalence of AR and CRS among South Koreans.Methods In this cross-sectional study, nationwide data were reviewed for participants of the Korean National Health and Nutrition Examination Survey (KNHANES) 2008 to 2012. Participants were surveyed with health questionnaires, examined with endoscopies by otolaryngologists, and tested with serum immunoglobulin E levels. The concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and particulate matter with aerodynamic diameters ≤10 µm (PM10) were measured in 16 areas of South Korea. Air pollutant concentrations of geographic districts were matched to each participant's residence. Logistic regression analysis was performed.Results Among 27 863 eligible adults, 3359 and 1606 participants had AR or CRS, respectively. In multivariable logistic regression analysis for AR, PM10showed statistically significant results (odds ratio [OR] = 1.145, 95% confidence interval [CI] = 1.042–1.258). No air pollutants showed statistically significant differences in the prevalence of CRS. In AR, PM10(OR = 1.458, 95% CI = 1.201–1.770) was associated with endoscopic findings of watery rhinorrhea, whereas SO2(OR = 1.202, 95% CI = 1.100–1.313) was associated with pale mucosa.Conclusion The prevalence of AR was significantly associated with PM10concentration. In patients with AR, endoscopic findings of watery rhinorrhea were associated with PM10. However, CRS was not associated with the air pollutant concentrations. Lower concentration of PM10might help managing the clinical symptoms in patients of AR.

To compare unilateral versus bilateral antegrade cerebral perfusion (ACP) techniques on cerebral protection during acute type A aortic dissection repair.