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The article discusses a study which investigated the seroprevalence of brucellosis and parvo virus infections in two organized pig herds of North-East India. Based on the Enzyme Linked Immuno Sorbant Assay (ELISA), prevalence of brucella was higher followed by porcine parvovirus (PPV). Results suggest that pigs in the region has been exposed to causative agents at one time or other. The breeding boars were also found positive for Brucella abortus antibodies. They may have picked up infection from infected sows because of natural breeding practice adopted in the farms.

The article examines the distribution and histomorphology of the Peyer's patches (PP) in the small intestine of indigenous goats of Assam. The procedure for the counting of the number of Peyer's patches present in duodenum, jejunum and ileum, and the preparation of tissue samples for microscopic assessment are discussed. The location of the PP, the interval of distribution, and the presence of intra-epithelial lymphocytes are mentioned.

The article presents the study which examined the case of diarrhoea in piglets due to Escherichia coli (E. coli) and rotavirus (RV). In the study, a diagnosis was conducted through isolation and identification of E. coli and the detection of RV. The method used in the study is sandwich enzyme-linked immunosorbent assay (ELISA).

Bifunctional electrode materials are highly desirable for meeting increasing global energy demands and mitigating environmental impact. However, improving the atom-efficiency, scalability, and cost-effectiveness of storage systems, as well as optimizing conversion processes to enhance overall energy utilization and sustainability, remains a significant challenge for their application. Herein, we devised an optimized, facile, economic, and scalable synthesis of large area (cm 2 ), ultrathin (∼2.9 ± 0.3 nm) electroactive nanosheet of β-Ni(OH) 2, which acted as bifunctional electrode material for charge storage and oxygen evolution reaction (OER). The β-Ni(OH) 2 nanosheet electrode shows the volumetric capacity of 2.82 Ah.cm -3 (0.82 µAh.cm -2 ) at the current density of 0.2 mA.cm -2 . The device shows a high capacity of 820 mAh.cm -3 with an ultrahigh volumetric energy density of 0.33 Wh.cm -3 at 275.86 W.cm -3 along with promising stability (30,000 cycles). Furthermore, the OER activity of ultrathin β-Ni(OH) 2 exhibits an overpotential (η 10 ) of 308 mV and a Tafel value of 42 mV dec -1 suggesting fast reaction kinetics. The mechanistic studies are enlightened through density functional theory (DFT), which reveals that additional electronic states near the Fermi level enhance activity for both capacitance and OER., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Electrocatalytic nitrogen oxidation reaction (N 2 OR) offers a sustainable alternative to the conventional methods such as the Haber-Bosch and Ostwald oxidation processes for converting nitrogen (N 2 ) into high-value-added nitrate (NO 3 ) under mild conditions. However, the concurrent oxygen evolution reaction (OER) and inefficient N - absorption/activation led to slow N 2 absorption/activation led to slow N 2 OR kinetics, resulting in low Faradaic efficiencies and NO 3 - ) as an efficient N 2 -O v ) as an efficient N 2 OR electrocatalyst, achieving an impressive Faradaic efficiency (FE) of 54.2% and a notable NO 3 - yield rate (22.05 µg h -1 mg cat -1 ) at 1.7 V versus reversible hydrogen electrode (RHE) in 0.1 m Na 2 , correlating with enhanced N 4 . Experimental results indicate that SnO 2 -O v at a relatively low overpotential is due to reduced thermodynamic barrier for the oxidation of *N 2 to *N 2 OR performance. Computational findings suggest that the superior performance of SnO 2 -O v at a relatively low overpotential is due to reduced thermodynamic barrier for the oxidation of *N 2 to *N 2 OH during the rate-determining step, making this step energetically favorable than the oxygen adsorption step for OER. This work demonstrates the feasibility of ambient nitrate synthesis on the soft acidic Sn active site and introduces a new approach for rational catalyst design., (© 2024 Wiley‐VCH GmbH.)

Electrochemical nitrogen reduction reaction (e-NRR) is an eco-friendly alternative approach to generate ammonia under ambient conditions, with very low power supply. But, developing of an efficient catalyst by suppressing parallel hydrogen evolution reaction as well as avoiding the catalysts poisoning either by hydrogen or electrolyte ion is an open question. So, in order to screen the single atom catalysts (SACs) for the e-NRR, we proposed a descriptor-based approach using density functional theory (DFT) based calculations. We investigated total 24 different SACs of types TM-Pc, TM-N 3 C 1 , TM-N 2 C 2 , TM-NC 3 and TM-N 4 , considering transition metal (TM). We have considered mainly BF 3 ion to understand the role of electrolyte and extended the study for four more electrolyte ions, Cl, ClO 4 , SO 4 , OH. Herein, to predict catalytic activity for a given catalyst we have tested 16 different electronic parameters. Out of those, electronic parameter d xz ↓ occupancy, identified as electronic descriptor, is showing an excellent linear correlation with catalytic activity (R 2 =0.86). Furthermore, the selectivity of e-NRR over HER is defined by using an energy parameter ▵G *H -▵G *NNH . Further, the electronic descriptor (d xz ↓ occupancy) can be used to predict promising catalysts for e-NRR, thus reducing the efforts on designing future single atom catalysts (SACs)., (© 2024 Wiley-VCH GmbH.)

The increasing demand for clean hydrogen production over fossil fuels necessitates the development of sustainable piezoelectrochemical methods that can overcome the limitations of conventional electrocatalytic and photocatalytic approaches. In this regard, existing piezocatalysts face challenges related to their low piezoelectricity or active site coverage for hydrogen evolution reaction (HER). Driven by global environmental concerns, there is a compelling push to engineer practical materials for highly efficient HER. Herein, monoelemental 2D tellurium (Te) is presented as a class of layered chalcogenide with a non-centrosymmetric crystal structure (P3 1 21 space group). The refined Te nanosheets demonstrate an unprecedented highly efficient H 2 production rate ≈9000 µmol g -1  h -1 under ultrasonic mechanical vibration due to built-in piezo-potential in the system. The remarkable piezocatalytic performance of Te nanosheets arises from a synergistic interplay between their semi-metallic nature, favorable free energy landscape, enhanced electrical conductivity and outstanding piezoelectricity. As a proof of concept, the theoretical approach based on Density Functional Theory (DFT) validates the findings due to the gradual exposure of active sites on the Te nanosheets leading to a self-optimized catalytic performance for hydrogen generation. Therefore, mechanically driven Te emerges as a promising piezocatalyst with the potential to revolutionize highly efficient and sustainable technology for futuristic applications., (© 2024 Wiley‐VCH GmbH.)

Purpose of Review: To provide a comprehensive summary of relevant studies and evidence concerning the utilization of different pharmacotherapeutic and revascularization strategies in managing coronary artery disease and acute coronary syndrome specifically in the older adult population., Recent Findings: Approximately 30% to 40% of hospitalized patients with acute coronary syndrome are older adults, among whom the majority of cardiovascular-related deaths occur. When compared to younger patients, these individuals generally experience inferior clinical outcomes. Most clinical trials assessing the efficacy and safety of various therapeutics have primarily enrolled patients under the age of 75, in addition to excluding those with geriatric complexities. In this review, we emphasize the need for a personalized and comprehensive approach to pharmacotherapy for coronary heart disease and acute coronary syndrome in older adults, considering concomitant geriatric syndromes and age-related factors to optimize treatment outcomes while minimizing potential risks and complications. In the realm of clinical practice, cardiovascular and geriatric risks are closely intertwined, with both being significant factors in determining treatments aimed at reducing negative outcomes and attaining health conditions most valued by older adults., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Adverse childhood experiences (ACEs) are potentially traumatic events that occur before 18 years of age. Studies emphasize the importance of childhood adversity as a risk factor for developing non-communicable diseases, including type-2 diabetes mellitus (T2DM) in adulthood. This case-control study involved 137 patients with T2DM and 134 non-diabetic adults of both genders (mean age 46.9 and 45.7 years, respectively). In addition to collecting socio-demographic, behavioral, and anthropological data, a 10-item ACE scale was utilized to gather information regarding childhood adversities, while perceived stress was assessed using the perceived stress scale-4. Fasting and 2-hour post glucose load blood sugar levels, HbA1c, and fasting lipid profiles were measured. Both univariable and multivariable binary logistic regression analyses were performed to investigate whether ACE is a potential risk factor for T2DM, with a significance level of 0.05. Around two-thirds of T2DM patients reported having ACE scores of 4 or higher, with the mean ACE score significantly higher in the case group than in the control group (3.96 vs. 3.34; p<0.0001). The logistic regression analysis found that T2DM was linked to female gender, hypertension, dyslipidemia, family history of DM, higher perceived stress, and a higher ACE score of 4 and above. After adjusting for confounding factors, individuals with an ACE score of 4 or higher had a significantly greater risk of developing T2DM (OR: 2.24; 95% CI 1.238-4.061). The study revealed a significant association between higher ACE scores and an increased risk of developing T2DM. As a recommendation, further investigation into the epigenetic mechanisms underlying this relationship is warranted., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Barman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Oxygen vacancy engineering has recently been gaining much interest as the charging effect it induces in a material can be used for varied applications. Usually, semiconductor materials act poorly in electrocatalysis, particularly in the nitrogen reduction reaction (NRR), owing to their inherent charge deficit and huge band gap. Vacancy introduction can be a viable material engineering route to make use of these materials for the NRR. However, a detailed investigation of the vacancy-type and its role for the structural reorientation and charge redistribution of a material is lagging in the field of NRRs. This work thus focuses on the synthesis of oxygen vacancy-engineered SnO 2 with a gradual structural transformation from in-plane (io v ) to bridge-type oxygen vacancy (bo v ) density. Consequently, the electron occupancy of the sp 3 d hybrid orbital changes, leading to an upshifted valence band maxima towards the Fermi level. This has a profound effect on the nature of N 2 adsorption and the extent of NN bond polarization. Sn atoms adjacent to the bo v are found to have a fair density of dangling charges that accomplish the NRR process at a comparatively low overpotential and determine the binding strength of the intermediates on the active site. The obscured yet stable reaction intermediates are thereby identified with in situ ATR-IR studies. A restricted hydrogen evolution reaction Faradaic on the Sn-site (favored over O-atoms) results in a Faradaic efficiency of 48.5%, which is better than that reported in all the literature reports on SnO 2 for the NRR. This study thus unveils sufficient insights into the role of oxygen vacancies in a crystal as well as electronic structural alteration of SnO 2 and the effect of active sites on the rate kinetics of the NRR.

Introduction: Depression can affect oral health as a result of neglecting oral hygiene procedures which leads to an increased risk of dental caries and periodontal disease., Aim: To determine relationship between oral health and depression among elder people residing in old age homes of Mathura city., Materials and Methods: The study was conducted among 500 subjects aged ≥60 years where dental condition, number of missing teeth, removable denture wearing, teeth mobility, periodontal condition, pocket depth, loss of attachment, and depression according to the Patient Health Questionnaire-9 scale were assessed., Results: Regression analysis showed a positive relationship of the PHQ-9 value with DMFT and MT., Conclusion: Among people aged 60 years and over, severity of depression increased with higher number of MT and DT., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Adsorption-mediated methods for environmental pollution control are suitable as they are cost-effective and easy to use. Porous materials can play an important role in adsorption studies. Herein, we synthesized a p-n heterostructure of phosphorene and metal oxide using a simple hydrothermal approach. The synthesized material is porous in nature, with a surface area of 127.44 m 2 /g and pore volume of about 1.73 nm with appreciable thermal stability. As the material is microporous, we used it for the adsorption of CO 2 gas and dye. For CO 2 adsorption, we determined the CO 2 gas uptake according to the mass balance principle of the ideal gas equation, and it was found to be about 21.478 mol/kg. We have also studied different isotherm models to check the adsorption phenomena. Moreover, for dye adsorption, we have chosen the xanthene-derived rose bengal (RB) dye, which shows a removal percentage of about 92.02%. In the case of dye adsorption, the material shows good reusability and significant adsorption up to five cycles.

Objective: High intraocular pressure (IOP) is one of the major modifiable risk factors for glaucoma. The objective was to examine socio-demographic and clinical factors related to IOP., Methods and Analysis: This study was conducted among 3097 adults residing in a rural area of Bangladesh, with all participants undergoing clinical and ophthalmological evaluations. The measurement of IOP was carried out using of a rebound Tonometer called Icare pro. Multiple logistic regression analysis was employed to identify variables associated to IOP levels of 21 mm Hg or above. Adjusted OR (aOR) and 95% CI were reported., Results: This study found that, in total, 9% of the study population had high IOP in one or both eyes. Elevated IOP was significantly associated with respondents who were service holders (aOR 2.52; 95% CI 1.48 to 4.31), had a lower education level (aOR 1.55, 95% CI 1.07 to 2.23), used biomass fuel (aOR 2.00; 95% CI 1.09 to 3.67), belonged to a higher socioeconomic position (aOR 1.55, 95% CI 1.07 to 2.23) and had obesity (aOR 2.00; 95% CI 1.07 to 3.73), hypertension (aOR 1.32; 95% CI 1.01 to 1.73) or history of diabetes (aOR 2.44; 95% CI 1.67 to 3.55), after adjusting for covariates including age, sex, marital status, light source and tobacco consumption, in a multiple regression analysis., Conclusion: Chronic diseases, such as hypertension and diabetes, obesity and sociodemographic characteristics such as high socioeconomic status and use of biomass fuels, have all been linked to elevated IOP. Patients with chronic diseases should undergo for IOP testing regularly., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

African swine fever (ASF) is a highly infectious viral disease of pigs, which causes acute fatal haemorrhage and is a severe concern to the global pork industry. The present study followed computational approaches to identify B- and T-cell epitopes for the p30 and p54 proteins of the African swine fever virus (ASFV) by interacting with the swine leukocyte antigen (SLA) alleles. The amino acid sequences of p30 and p54 were analysed for variability and relative solvent accessibility, and their three-dimensional structures were predicted and validated. Molecular dynamics simulation was performed to study the structural and dynamic properties of the protein. Six and five linear B-cell epitopes have been predicted for p30 and p54, respectively. Four and three discontinuous B-cell epitopes have been predicted for p30 and p54, respectively. Further, the top five T-cell epitopes for SLA-1, 2, and 3 have been listed for both proteins. These results can help us to understand the immunodominant regions in the p30 and p54 proteins of ASFV and potentially assist in designing peptide-based diagnostics and vaccines. Also, the identified T-cell epitopes may be considered for peptide-based vaccine design against ASFV.Communicated by Ramaswamy H. Sarma.

Polymorphism of transcription factor 7-like 2 (TCF7L2) has a link with type 2 diabetes mellitus (T2DM) through β cell dysfunction that causes defect in blood glucose homeostasis. This case-control study recruited 67 T2DM as cases and 65 age-matched healthy individuals as controls to determine whether the polymorphism rs12255372 (G > T) in the TCF7L2 gene have an association with T2DM in Bangladeshi population. Genomic DNA was purified from peripheral whole blood sample and direct Sanger sequencing was done for genotyping of SNP. Bivariate logistic regression was done to find out the association between genetic variant and T2DM. In our study, the minor T allele frequency was significantly more frequent in T2DM group than healthy controls (29.1% vs. 16.9%). After adjusting with confounding factors, heterozygous-genotype GT had higher odds of developing T2DM (OR 2.4; 95% CI: 1.0-5.5; p value = 0.04) and in dominant model, having SNP in TCF7L2 increased the risk of T2DM 2.3 times (95% CI: 1.0-5.2; p value = 0.04). In interaction model, genetic susceptible SNP cases interacted significantly with increasing age and BMI, female gender, and having family history of diabetes mellitus to develop T2DM (p interaction  < 0.001). Having minor T allele either in heterozygous or homozygous variant form of rs12255372 (G > T) TCF7L2 had significant association with T2DM. In conclusion, TCF7L2 gene variant increases risk of developing T2DM among the Bangladeshi population., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Smoking tobacco is most common nowadays among dental students due to stress induced by practical workloads and exams. There is limited data regarding tobacco smoking among dental students. The aim of this study was to determine the prevalence of tobacco smoking among online respondent dental students of a dental college., Methods: This was a descriptive cross-sectional study conducted on dental students from 15 July 2021 to 15 August 2021. Ethical approval was obtained from the Institutional Review Committee of K.D. Dental College and Hospital (Reference number: KDDC/Admin/2021/9990A). Data was collected through a structured questionnaire and responses were gathered using an online Google form survey with informed consent. A convenience sampling method was used. Point estimate and 95% confidence interval were calculated., Results: Among 60 online respondents, the prevalence of tobacco smoking was found to be 11 (18.33%) (17.04-24.56, 95% Confidence Interval). The percentage of participants who wanted to stop smoking now was 11 (18.33%)., Conclusions: The prevalence of tobacco smoking among the online dental respondents of a dental college was similar to the other studies done in similar settings., Keywords: dental students; smoking; tobacco cessation.

Background: ST-segment elevation myocardial infarction (STEMI) is a high-risk patient medical emergency. We developed a secure mobile application, STEMIcathAID, to optimize care for STEMI patients by providing a digital platform for communication between the STEMI care team members, EKG transmission, cardiac catherization laboratory (cath lab) activation and ambulance tracking. The aim of this report is to describe the implementation of the app into the current STEMI workflow in preparation for a pilot project employing the app for inter-hospital STEMI transfer., Approach: App deployment involved key leadership stakeholders from all multidisciplinary teams taking care of STEMI patients. The team developed a transition plan addressing all aspects of the health system improvement process including the workflow analysis and redesign, app installation, personnel training including user account access to the app, and development of a quality assurance program for progress evaluation. The pilot will go live in the Emergency Department (ED) of one of the hospitals within the Mount Sinai Hospital System (MSHS) during the daytime weekday hours at the beginning and extending to 24/7 schedule over 4-6 weeks. For the duration of the pilot, ED personnel will combine the STEMIcathAID app activation with previous established STEMI activation processes through the MSHS Clinical Command Center (CCC) to ensure efficient and reliable response to a STEMI alert. More than 250 people were provisioned app accounts including ED Physicians and frontline nurses, and trained on their user-specific roles and responsibilities and scheduled in the app. The team will be provided with a feedback form that is discipline specific to complete after every STEMI case in order to collect information on user experience with the STEMIcathAID app functionality. The form will also provide quantitative metrics for the key time sensitive steps in STEMI care., Conclusions: We developed a uniform approach for deployment of a mobile application for STEMI activation and transfer in a large urban healthcare system to optimize the clinical workflow in STEMI care. The results of the pilot will demonstrate whether the app has a significant impact on the quality of care for transfer of STEMI patients., Competing Interests: Conflict of interest Dr. Dangas has received consulting fees or honoraria from AstraZeneca, Biosensors, Boston Scientific, and Medtronic; is on the Advisory Board of AbbottLaboratories and Boston Scientific; has received research grants to the institution from Biotronik and Abbott Laboratories; and has equity (entirely divested) in Medtronic. The other authors have nothing to disclose., (Copyright © 2022. Published by Elsevier Inc.)

Purpose of Review: Drug-eluting stents are used in nearly all cases of percutaneous coronary revascularization and have been shown to be superior to balloon angioplasty or bare metal stents. The designs of these stents are continually evolving to maximize efficacy and safety., Recent Findings: This review outlines the important components of a drug-eluting stent and highlights the changes in stent design that have led to the optimization of clinical outcomes. Most stents used in contemporary times are thin strut, durable polymer drug-eluting stents (DES) that elute either everolimus or zotarolimus. Newer DES designs incorporating bioresorbable polymers or ultrathin struts have shown encouraging safety and efficacy profiles. DES are essential for the management of patients with obstructive coronary artery disease and are used in most coronary interventions. Changes in stent designs over the past 30 years reflect the ongoing need to address the limitations of earlier stents aimed to improve patient outcomes., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

There have been no previous attempts to assess coronary plaque morphology in statin-treated patients with combined residual cholesterol and inflammatory risk. The aim of this study was to characterize the morphology using optical coherence tomography (OCT) and to investigate the underlying molecular mechanisms. Two hundred seventy statin-treated patients with stable coronary artery disease who underwent OCT imaging prior to elective percutaneous coronary intervention were included in this single-center retrospective analysis. Subjects were stratified into four groups based on low-density lipoprotein cholesterol (LDL-C) and high-sensitivity C-reactive protein (hs-CRP) levels using 70 mg/dl and 2 mg/L as cut-offs, respectively. OCT images of the target lesions were assessed. For a subset of patients, peripheral blood mononuclear cells (PBMC) were isolated, and gene expression was characterized using microarray analysis. Patients with high LDL-C and high hs-CRP demonstrated a higher frequency of lipid-rich plaques (LRP) (91%, P = 0.03) by OCT. LRPs in these patients had a greater maximal lipid arc (186.6 ± 92.5°, P = 0.047). In addition, plaques from patients who did not achieve dual-target were less frequently calcified (P = 0.003). If calcification was present, it was characterized by a lower maximal arc (P = 0.016) and shorter length (P = 0.025). PBMC gene expression analysis demonstrated functional enrichment of toll-like receptors (TLRs) 1-9 to be associated with high LDL-C and hs-CRP. Obstructive coronary lesions in patients on statin therapy with combined residual cholesterol and inflammatory risk demonstrated a higher prevalence of LRP with greater maximal lipid arcs and more frequent spotty calcifications. PBMC from these patients revealed functional enrichment of TLR 1-9., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Inflammation and procedural complexity are individually associated with adverse outcomes after percutaneous coronary intervention (PCI). We aimed to evaluate the association of high sensitivity C-reactive protein (hsCRP) with adverse events according to PCI complexity. We included patients with available hsCRP levels who underwent PCI at our center from 2012 to 2017. We compared patients with hsCRP ≥3 versus <3 mg/L. Complex PCI was defined as having ≥1 of the following: ≥3 different target vessels, ≥3 lesions treated, ≥3 stents implanted, bifurcation lesion treated with 2 stents, chronic total occlusion as target lesion, or total stent length >60 mm. The primary end point was major adverse cardiac events (MACEs) (composite of all-cause death, myocardial infarction, or target vessel revascularization) at 1 year. A total of 11,979 patients were included, of which 2,840 (24%) underwent complex PCI. In those, 767 (27%) had hsCRP ≥3 mg/L. The 1-year incidence of MACE was 6% (noncomplex PCI, low hsCRP), 10% (noncomplex PCI, high hsCRP), 10% (complex PCI, low hsCRP), and 15% (complex PCI, high hsCRP). Overall, hsCRP ≥3 mg/L was associated with an increased risk of MACE compared with hsCRP <3 mg/L; this was independent of the number of complex PCI features: 0 (adjusted hazard ratio [HR] 1.53; 95% confidence interval [CI] 1.27 to 1.86), 1 (adjusted HR 1.77; 95% CI 1.21 to 2.60), or ≥2 (adjusted HR 1.21; 95% CI 0.80 to 1.83) (p interaction  = 0.42). In conclusion, in patients who underwent PCI, elevated hsCRP is associated with an increased risk of ischemic events. The effect of elevated hsCRP on cardiovascular risk is consistent regardless of PCI complexity., Competing Interests: Declaration of interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Cardiovascular disease constitutes the leading cause of mortality worldwide, irrespective of race/ethnicity. Previous studies have shown that minority patients with acute coronary syndrome have distinct clinical, anatomic, and socioeconomic characteristics which may affect clinical outcomes. We included patients who underwent percutaneous coronary intervention with drug-eluting stents for ST-segment elevation myocardial infarction (STEMI), non-STEMI, or unstable angina in a single center. Patients were stratified into Caucasian, African-American, Hispanic, and Asian. Caucasians were the reference group. The primary end point was major adverse cardiac and cerebrovascular events, composite of death, spontaneous myocardial infarction, or stroke at 1 year. Of 6,800 patients included, 49.7% were Caucasian, 20.7% Hispanic, 17.0% Asian and 12.6% African-American. Caucasians were the oldest, Hispanics and Asians had the highest prevalence of diabetes mellitus whereas African-Americans had more chronic kidney disease. Hispanics and African-Americans had the highest STEMI rates, whereas Asians were more likely to present with unstable angina. Compared with Caucasians, Asians had a lower rate of major adverse cardiac and cerebrovascular events at 1 year (3.9% vs 7.1%; p <0.01) whereas Hispanics (6.2% vs 7.1%; p = 0.17) and African-Americans (8.0% vs 7.1%; p = 0.38) had comparable outcomes. Differences were driven by mortality. Findings remained unchanged after adjustment. In conclusion, in acute coronary syndrome patients who underwent percutaneous coronary intervention, Asian race/ethnicity was associated with favorable cardiovascular outcomes compared with Caucasians. No significant differences were observed for Hispanics and African-Americans., Competing Interests: Disclosures The other authors have no conflicts of interest to declare., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Patients with diabetes mellitus are at increased risk of cardiovascular events. We aimed to analyze the impact of serum HbA1c levels on coronary plaque characteristics in stable coronary disease. Two hundred sixty-one patients who underwent optical coherence tomography (OCT) examination before elective percutaneous coronary intervention for a de novo obstructive lesions were included in this single-center retrospective analysis. Patients were divided into tertiles according to HbA1c level (tertile 1: HbA1c < 6.3%, tertile 2: 6.3 ≤ HbA1c < 7.8%, tertile 3: HbA1c ≥ 7.8%) and OCT findings were compared. Fibrous cap thickness (FCT) was significantly thinner in tertile 3 compared to tertile 1 and tertile 2 (103.9 ± 48.2 µm [tertile 1] vs. 107.5 ± 60.6 µm [tertile 2] vs. 86.2 ± 35.8 µm [tertile 3], p = 0.03). Higher prevalence of thin-cap fibroatheroma (TCFA) was observed in tertile 3 vs tertile 1 and tertile 2 (19.5% [tertile 1] vs. 19.5% [tertile 2] vs. 33.3% [tertile 3], p = 0.04). HbA1c inversely correlated with FCT (beta coefficient - 4.89, 95% confidence interval - 8.40 to - 1.39, p < 0.01). The logistic regression model revealed that the probability of having TCFA was positively associated with HbA1c with a small change in the range of low and medium HbA1c and a big change in the range of high HbA1c. Furthermore, minimal lumen area and reference lumen area were smaller in tertile 3. In patients with stable coronary disease, high serum HbA1c levels are associated with higher plaque burden and thinner FCT on OCT, while low and medium HbA1c levels result in similar plaque vulnerability., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: There is no consensus on the best treatment of undilatable coronary in-stent restenosis (ISR) regardless of the number of stent layers. We aimed to evaluate the procedural and clinical outcomes of rotational atherectomy (RA) to treat undilatable coronary ISR with single or multiple stent layers., Methods: We retrospectively evaluated consecutive patients treated with RA for undilatable ISR with single or multiple stent layers in the Mount Sinai catheterization laboratory between January 2016 and September 2018. Procedural success was defined as angiographic success without in-hospital major adverse cardiac events (MACE): a composite of death, myocardial infarction (MI), and target lesion revascularization (TLR). Clinical outcomes were assessed at one-year post-procedure., Results: A total of 26 patients were included in the study, in which 18 (69.2%) patients were with multiple stent layers. After RA, 9 (34.6%) were received a new drug-eluting stent, and 6 (23.1%) were treated with intravascular brachytherapy. Angiographic success was achieved in 24 (92.3%) patients, and procedural success was achieved in 22 (84.6%) patients. In-hospital MACE occurred in 4 (15.4%) patients, all due to periprocedural non-Q wave MI. Within one year, MACE occurred in 9 (34.6%) patients with 5 (19.2%) TLR., Conclusions: RA for undilatable ISR with single or multiple stent layers was performed with favorable procedural outcomes and a relatively high MACE rate driven by TLR within one year., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Sharma: speaker honoraria from Abbott Vascular, Boston Scientific, Cardiovascular Systems, Inc., (Copyright © 2021. Published by Elsevier Inc.)

Background: Piglet mortality is a real concern to the pig farmers. The major cause is due to the late maturation of the immune system and dietary changes in postweaned piglets. The potential role of probiotic and zinc in the stimulation of the immune system is well established. Hence, the present study was undertaken to evaluate alterations of T and B cells in the small intestine after dietary inclusion of probiotic and zinc in pre and post-weaned piglets., Materials and Methods: A total of 18 healthy Large White Yorkshire (LWY) piglets, irrespective of sex obtained from 3 litters at the age-group of 20, 30 and 60 days. They were divided into a control group fed with basal diet and a treatment group fed with probiotic and zinc supplement along with the basal diet, consisting of three animals in each group. The piglets were weaned at 28 days of age. After sacrificing the animals at day 20, 30 and 60 from both the groups, the abdominal cavity was opened and small intestinal tissue samples were collected, processed and stained by indirect immunofluorescence technique. The slides were evaluated under the fluorescent light microscope. The data were statistically analysed., Results: The different T and B cell subsets were recorded in the lining epithelium, core of villus, crypt area of lamina propria and Peyer's patch area. The number of CD4+, CD8+, IgA+ and IgM+ cells was higher in the treated piglets than the control group of animals, irrespective of segments of intestine and age-group., Conclusions: It can be concluded that the dietary supplementation of probiotic and zinc was found to be good additives as they can stimulate the immune response in piglets, especially during the critical early post-weaning period.

Objectives: To assess the efficacy and safety of excimer laser coronary atherectomy (ELCA), as well as, the long-term outcomes and the factors associated with ELCA failure in uncrossable lesions., Background: Uncrossable lesions constitute a challenge for percutaneous coronary intervention., Methods: This multicenter registry included 126 patients with 126 uncrossable lesions. Study endpoints were ELCA success, technical success and a composite of cardiac death, myocardial infarction (MI), and target-lesion revascularization (TLR) on follow-up. Predictors of ELCA failure were analyzed., Results: Moderate or severe calcification was present in 79 (62.7%) of the lesions and 58 (46%) were a chronic total occlusion. ELCA success was obtained in 103 (81.8%) patients. Rotational atherectomy was attempted as bailout in 21 out of 23 ELCA failure (91.3%), being successful in 14 (66.7%) of them. Finally, technical and procedural success were achieved in 114 (90.5%) and 110 (87.3%) of the patients. Severe calcification was independently associated with ELCA failure (OR: 3.73, 95% CI: 1.35-10.32; p = .011). Two (1.6%) patients died (one after a stroke and another patient because of heart failure), 4 (3.2%) developed a non-Q MI without clinical consequences and 1 (0.8%) patient had a Q-MI. Other complications were ventricular tachycardia/fibrillation (n = 2; 1.6%) and flow-limiting dissection (n = 1, 0.8%). At follow-up (median 424 days), 3 (2.4%) patients died (1 (0.8%) from cardiovascular cause) and 15 (11.9%) required TLR., Conclusions: In our multicenter experience, ELCA use demonstrated to be safe and reasonably effective with a rate of events on follow-up relatively low. Severe calcification was associated with ELCA failure., (© 2020 Wiley Periodicals LLC.)

Objectives: To evaluate and compare characteristics and clinical outcomes of percutaneous coronary intervention (PCI) among target vessel types in patients with a prior coronary artery bypass graft (CABG) surgery., Background: Patients with a prior CABG often require repeat revascularization with PCI. Graft PCI has been associated with worse outcomes compared to native vessel PCI, yet the optimal PCI strategy in prior CABG patients remains unknown., Methods: We stratified prior CABG patients who underwent PCI at a tertiary-care center between 2009 and 2017 by target vessel type: native vessel, venous graft, and arterial graft. The primary outcome of major adverse cardiac events (MACE) was a composite of all-cause death, myocardial infarction, stent thrombosis, or target vessel revascularization up to 1 year post-PCI., Results: Prior CABG patients (n = 3983) represented 19.5% of all PCI interventions during the study period. PCI was most frequently performed on native vessels (n = 2928, 73.5%) followed by venous (n = 883, 22.2%) and arterial grafts (n = 172, 4.3%). Procedural success and complications were similar among the groups; however, slow- and no-reflow phenomenon was more common in venous graft PCI compared to native vessel PCI (OR 4.78; 95% CI 2.56-8.95; p < 0.001). At 1 year, there were no significant differences in MACE or in its individual components., Conclusions: Target vessel choice did not appear to affect MACE at 1 year in a large cohort of patients with prior CABG undergoing PCI. Whether PCI of surgical grafts versus native arteries truly results in similar outcomes warrants further investigation in randomized controlled trials., (© 2021 Wiley Periodicals LLC.)

This study presents the characteristics of ground level atmospheric ozone (O 3 ) over the rural mid-Brahmaputra Valley region of the northeastern India. Ozone and oxides of nitrogen (NO x  = NO + NO 2 ) concentration data were obtained from continuous measurement of O 3 and NO x housed at the MAPAN-AQM station at Tezpur University. The meteorological parameters were obtained from the same station. The diel, monthly, and seasonal variations of O 3 were studied. The O 3 -NO x photostationary state (PS) was carefully examined and it was found that the net O 3 concertation deviated substantially from the PS during the winter season. The deviation could be attributed to local biomass burning, biogenic VOC emission from forest and agriculture, and long-range transport of peroxyacyl nitrate (PAN). The long-range transport has been ascertained by examining the ventilation coefficients (VC), which correlated with the steep growth of net O 3 concentrations in the morning hours. The HYSPLIT air mass back trajectories were used in concentration-weighted trajectory (CWT) analyses of O 3 to assess the long-range regional transport of O 3 precursors, which positively influenced local O 3 concentrations., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Purpose of Review: The catheter-based coronary intervention has become a well-established therapeutic modality for obstructive coronary artery disease. However, in-stent restenosis remains a significant limitation of coronary intervention despite the use of newer devices. Intravascular brachytherapy was introduced to treat recurrent in-stent restenosis but only modestly adopted. This review will discuss the mechanism of intracoronary brachytherapy, available clinical evidence of brachytherapy in recurrent in-stent restenosis treatment, and the future of coronary brachytherapy in coronary intervention., Recent Findings: Drug-eluting stents have an inherent limitation as they leave a permanent metal layer inside an artery when deployed. Recently, drug-coated balloon technology has emerged to treat coronary artery disease as a combination of balloon angioplasty and local drug delivery without leaving a metal layer behind. Recent European guidelines recommended using drug-coated balloons when treating in-stent restenosis treatment, while the US guidelines have not yet addressed the use of drug-coated balloons in such cases. Coronary brachytherapy is a valuable addition to treat these challenging diseases despite several logistic issues. If there are newer technologies with easier setup, such as drug-coated balloons, coronary brachytherapy resurgence is improbable in the contemporary era, although it may not become obsolete., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Women with acute coronary syndrome (ACS) generally present with more comorbidities and experience worse clinical outcomes compared with males. However, it is unclear whether this represents genuine sex-related difference or stems from clinical, procedural and socioeconomic factors., Methods: We analyzed consecutive patients undergoing percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI), non-STEMI or unstable angina at a single tertiary-care center. Exclusion criteria were unknown sex, age < 18 years and PCI with bare metal stent or without stent placement. The study population was stratified according to sex. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE) defined as the composite of death, spontaneous myocardial infarction, or stroke at 1 year. Secondary endpoints were individual components of MACCE, target vessel revascularization (TVR) and clinically significant bleeding., Results: Of the 7362 patients included, 5031 (68.3%) were men and 2331 (31.7%) women. Women were older and presented with a higher burden of comorbidities while men had more complex coronary anatomy. The incidence of 1 year MACCE was significantly higher among women (8.0% versus 5.6%; p < 0.01) compared to men. Women also experienced a higher rate of bleeding (2.3% vs. 1.4%; p = 0.02) while there were no differences between groups in terms of TVR (8.1% vs. 7.8%; p-value = 0.83). Differences in outcomes were attenuated after multivariable adjustment. Findings were consistent across ACS subgroups., Conclusions: In a contemporary ACS population treated with drug-eluting stents, women experienced a higher crude rate of 1-year MACCE. This was no longer apparent after accounting for baseline imbalances., (© 2021 Wiley Periodicals LLC.)

Objectives: We examined the incidence of side branch (SB) compromise after provisional stenting of calcified bifurcation lesions treated with rotational atherectomy (RA) or cutting balloon angioplasty (CBA) and the utility of optical coherence tomography (OCT) to detect functionally significant SB stenoses., Background: The comparative impact of RA versus CBA on SB compromise and functional significance remains poorly characterized., Methods: Seventy-one consecutive patients with 71 calcified bifurcation lesions with angiographically intermediate SB stenoses were randomized to RA (n = 35) or CBA (n = 36). The primary endpoint was SB compromise defined as SB diameter stenosis ≥70%, SB dissection or thrombolysis in myocardial infarction flow grade < 3 after provisional stenting. Secondary endpoints included SB FFR in noncompromised SBs and its correlation with SB ostium area (SBOA) assessed by three-dimensional OCT., Results: SB compromise after provisional stenting was observed in 7 (20.0%) lesions that underwent RA and in 9 (25.0%) lesions treated with CBA (p = .62). Mean SB FFR was 0.83 ± 0.08 and was similar between the study arms. Functionally significant SB stenosis (FFR ≤ 0.80) was detected in 17(30.9%) angiographically noncompromised SBs. SBOA after stenting was an independent predictor of FFR ≤ 0.80 (OR 0.002, 95% CI: 0.00-0.15, p = .002). The optimal cutoff value for SBOA to predict functionally significant SB stenosis was 0.76 mm 2 (sensitivity 82%, specificity 89% and area under the curve 0.92, 95% CI: 0.84-0.99)., Conclusions: The rates of SB compromise and functionally significant stenosis after provisional stenting of calcified bifurcation lesions were similar between two lesion preparation strategies. OCT SBOA can detect SB branches with FFR ≤ 0.80 with high sensitivity and specificity., (© 2020 Wiley Periodicals LLC.)

Background: Both target vessel calcification and target vessel bifurcation are associated with worse outcomes following percutaneous coronary intervention (PCI). Whether these entities in combination interact to influence outcomes after PCI of complex coronary disease is not known., Objectives: This study evaluated the association of target vessel bifurcation and target vessel calcification, alone and in combination, with adverse events following PCI., Methods: Registry data from 21,165 patients who underwent PCI with drug-eluting stents (DES) between January 2009 and December 2017 were analyzed. Patients were divided into four groups according to the presence or absence of target vessel bifurcation and presence of none/mild or moderate/severe target vessel calcification on angiography. Associations between lesion groups and 1 year major adverse cardiac events (MACE) were examined using Cox regression analysis., Results: At 1 year, unadjusted rates of MACE, death, myocardial infarction (MI), as well as stent thrombosis were highest in the group with both bifurcation lesion and moderate/severe calcification. After adjusting for confounders such as age, renal disease, and smoking, hazard ratios for MACE were 1.14 (95%CI 0.99-1.33) for bifurcation with none/mild calcification, 1.21 (95%CI 1.06-1.38) for no bifurcation and moderate/severe calcification, and 1.37 (95%CI 1.14-1.64) for bifurcation and moderate severe calcification, compared to patients with no bifurcation and none/mild calcification., Conclusions: The presence of a bifurcating target vessel with moderate/severe calcification is associated with a higher risk of adverse outcomes than either attribute alone. New approaches are needed to improve outcomes in this subset of patients with complex coronary artery disease., (© 2020 Wiley Periodicals LLC.)