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Percutaneous coronary intervention (PCI) of calcified coronary arteries is associated with poor outcomes. Poorly modified calcified lesion hinders the stent delivery, disrupts drug-carrying polymer, impairs drug elution kinetics and results in under-expanded stent (UES). UES is the most common cause of acute stent thrombosis and in-stent restenosis after PCI of calcified lesions. Angiography has poor sensitivity for recognition and quantification of coronary calcium, thereby mandating the use of intravascular imaging. Intravascular imaging, like intravascular ultrasound and optical coherence tomography, has the potential to accurately identify and quantify the coronary calcium and to guide appropriate modification device before stent placement. Available options for the modification of calcified plaque include modified balloons (cutting balloon, scoring balloon and high-pressure balloon), atherectomy devices (rotational atherectomy and orbital atherectomy) and laser atherectomy. Coronary intravascular lithotripsy (IVL) is the newest addition to the tool box for calcified plaque modification. It produces the acoustic shockwaves, which interact with the coronary calcium to cause multiplanar fractures. These calcium fractures increase the vessel compliance and result in desirable minimum stent areas. Coronary IVL has established its safety and efficacy for calcified lesion in series of Disrupt CAD trials. Its advantages over atherectomy devices include ease of use on workhorse wire, ability to modify deep calcium, no debris embolization causing slow flow or no-flow and minimal thermal injury. It is showing promising results in modification of difficult calcified lesion subsets such as calcified nodule, calcified left main bifurcation lesions and chronic total occlusion. In this review, authors will summarize the mechanism of action for IVL, its role in contemporary practice, evidence available for its use, its advantages over atherectomy devices and its imaging insight in different calcified lesion scenarios.

Introduction: The increase in atmospheric CO2 concentration, which mainly is attributed to fossil-fuel combustion and deforestation, is often suggested as one of the prime causative factors toward accelerated global warming. This commends for sequestration of atmospheric carbon under terrestrial systems to partially offset fossil-fuel emissions. Concerning the same, agricultural sector presents an extensive opportunity, especially for countries such as India where over 55% of the population is engaged in the agriculture sector. Methods: Sequestering atmospheric carbon in agriculture requires the adoption of climate-resilient alternative agriculture practices without compromising food security. The deliberated study highlights the options of alteration in current conventional farming practices and its economic evaluation for sequestrating carbon under two Climate Change (CC) scenarios, viz., RCP 4.5 and 8.5, over three temporal scales, i.e., 2020, 2030, and 2050. Considering the current landuse pattern and existing growth rate in land-use shifting, three land-use policies, namely, Business as Usual (BaU), Optimistic, and Pessimistic scenario, integrated with CC scenarios were contemplated. Six possible futuristic scenarios were generated for the assessment of carbon sequestration and its valuation following the Integrated Valuation of Ecosystem Services and Tradeoff (InVEST) model. Results: The results suggested that across the studied region adopting an optimistic policy over BaU and pessimistic scenario, carbon can sequestrate an additional 0.64 to 1.46 Mt. (2.35 to 5.36 million ton CO2e) having an economic value of 193.4 to 504.8 million USD. Results: Moreover, the outcomes of the study are advocated for the policy of carbon credit in the agriculture sector, which shall contribute toward meeting various nationally determined contributions (NDCs) and sustainable development goals (SDGs) as well. [ABSTRACT FROM AUTHOR]

Introduction: Research indicates that the immobilisation mask required for radiation therapy (RT) for head and neck cancers can provoke intense anxiety. However, little is known about the rates of this anxiety, whether it changes over a course of treatment and how it is managed in clinical practice. This study aimed to describe the rates and patterns of situational anxiety in patients undergoing RT for head and neck cancer and the use of anxiety management interventions in current clinical practice in a major regional cancer setting in New South Wales, Australia. Methods: Situational anxiety rates and patterns were assessed at five time points using the State‐Trait Anxiety Inventory prior to treatment planning (SIM), the first three treatment sessions (Tx 1, Tx 2 and Tx 3) and treatment 20 (Tx 20). Sessions were observed to record the use of general supportive interventions (music and support person) and anxiety‐specific interventions (break from the mask, relaxation techniques and anxiolytic medication). Sociodemographic and clinical information was extracted from the medical record. Results: One hundred and one patients were recruited. One‐third had clinically significant anxiety at any of the first three time points (33.3–40%), and a quarter at Tx 3 (26.4%) and Tx 20 (23.4%). Of the sample, 55.4% had available data for categorisation into one of four pattern groups: 'No Anxiety' (46.4%); 'Decreasing Anxiety' (35.7%); 'Increasing Anxiety' (7.1%); and 'Stable High Anxiety' (10.7%). Most participants had social support present at SIM (53.5%) and listened to music during treatment (86.7–92.9%). Few participants received relaxation techniques alone (1.2–2.3%). Anxiolytic medication was provided for 10% of patients at some stage during the treatment journey and 5% required a break from the mask at SIM, with frequency decreasing throughout the treatment course. Conclusions: In this regional cancer setting, situational anxiety was common, but generally decreased throughout treatment. Some patients experience persistent or increasing anxiety, with up to 10% of patients receiving specific anxiety management interventions. [ABSTRACT FROM AUTHOR]

Background: Gastric adenocarcinoma in Indian patients’ is on the rise. A high level of plasma von Willebrand factor (vWF) is associated not only with the development of cancer-associated thrombosis but also with the degree of malignancy, the rate of metastasis, and cancer prognosis. Aims and Objectives: The aim of this study was to study the association of vWF with tumor location, TNM staging, and grades of tumor differentiation in gastric adenocarcinoma and to assess the usefulness of circulating vWF levels as a potential biomarker for gastric adenocarcinoma. Materials and Methods: This study is a prospective observational study done in the Department of Surgical Gastroenterology, Madurai Medical College, Madurai, over a period of 2 years between September 2020 and August 2022. Fifty cases of gastric cancer and 50 controls were recruited and vWF levels were analyzed. Results: Among the 50 gastric cancer patients, 8% belonged to Stage II, 62% belonged to Stage III, and 30% belonged to Stage IV. vWF was elevated in Gastric Cancer patients compared to control group. Mean value of vWF in Cases and Control population was 3.68 ng/ml and 0.58 ng/ml respectively (p value 0.0005). Pertaining to Stage, the vWF value was, Stage II – 4.7, Stage III – 3.3, and Stage IV – 4.1 ng/mL. With respect to tumor differentiation, the vWF values were, poorly differentiated – 4.7, moderately differentiated – 3.0, and well differentiated – 3.9 ng/mL. Conclusion: vWF values were significantly elevated in gastric cancer patients. Based on the results, vWF can be used as a surrogate marker to predict the tumor differentiation in patients, thereby prognosticating the disease. Stage-wise, there was no significant difference in the vWF values. [ABSTRACT FROM AUTHOR]

Quasi-2D thin film of TI material TlBiSe2, as well as TlBiSe2/GaN configuration, have been fabricated employing the thermal evaporation technique. Raman peaks of vibrational modes were analyzed in a TlBiSe2/GaN heterojunction showing a substrate-induced signal for the surface phonon mode (SPM). The study of ultrafast kinetics of charge carriers and transient absorption spectroscopy (TAS) gave excited-state spectrum characteristics and exciton dynamics in TlBiSe2/GaN heterojunction. The electrical characterization showed that the heterojunction device exhibited a good diode nature with an excellent rectification ratio of 160. The photodetection capabilities were examined by optical power varying from 2.37 µW to 3.78 µW in the ultraviolet to near-infrared region (300–900 nm). It demonstrated maximum photoresponse at 500 nm in forward and reverse bias. The current conduction mechanism and enhancement in current under light impact were explained using energy band modeling. The present work is important in regarding the development of photodetectors of succeeding generations with a topological insulator material. [ABSTRACT FROM AUTHOR]