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Topological defects are found ubiquitously in various kinds of matter, such as vortices in type-II superconductors, and magnetic skyrmions in chiral ferromagnets. While knowledge on the static behavior of magnetic skyrmions is accumulating steadily, their dynamics under forced flow is still a widely open issue. Here, we report the deformation of the moving magnetic skyrmion lattice in MnSi under electric current flow observed using small-angle neutron scattering. A spatially inhomogeneous rotation of the skyrmion lattice, with an inverse rotation sense for opposite sample edges, is observed for current densities greater than a threshold value j t  ~ 1 MA m − 2 (10 6 A m − 2 ). Our result show that skyrmion lattices under current flow experience significant friction near the sample edges due to pinning, this being a critical effect that must be considered for anticipated skyrmion-based applications at the nanoscale. Magnetic skyrmions are topological objects that have been recently extensively studied for their particular characteristics and a view to be used in spintronics devices. The authors present a Small Angle Neutron Scattering study of the deformation of magnetic skyrmion lattice propelled by an electric current and find that the skyrmions experience frictional movement at the edges of their sample providing better understanding of the motion of skyrmions.

Introduction This study aims to investigate and fairly compare the oncological therapeutic efficacy of red photodynamic therapy (Red-PDT) and near-infrared photodynamic therapy (NIR-PDT), to support the selection of suitable photosensitizers (PSs) for optimal PDT. Methods Two different representative PSs, trastuzumab-HiLyte Fluor™ 647 conjugate (Tra-HLF647) and trastuzumab-Indocyanine Green conjugate (Tra-ICG), activated by two laser systems at 635 nm and 808 nm, respectively, were used. To ensure a fair comparison, we used the same A4 cell line/tumor model expressing the same target, human epidermal growth factor receptor 2 (HER-2), and employed the same delivery approach. To comprehensively evaluate and compare the potential effects of Tra-HLF647-mediated Red-PDT and Tra-ICG-mediated NIR-PDT, we conducted cell viability imaging assays, intracellular reactive oxygen species (ROS) generation measurements, longitudinal monitoring of tumor volume changes, histological and immunohistochemical (IHC) analyses of tumor sections, and measurements of tumor necrotic depth. Results Both PDTs exerted similar rapid cell death in cell viability imaging assays. There was no significant difference in ROS generation between cells subjected to Red-PDT and NIR-PDT. Both PDTs caused a statistically significant tumor growth delay compared to the control groups; however, no significant difference was detected between the Red-PDT and NIR-PDT groups. The H&E-stained sections of tumors that received Red-PDT and NIR-PDT showed a similar pattern of necrosis-associated features. No conspicuous tissue damage was observed in the control groups. The depth of necrosis, estimated via the coincided accumulation of a fluorescent necrosis marker (AF546-pHLIP) and utilized as an indirect index to approximate laser light penetration, was also nearly identical between tumors treated with Red-PDT and NIR-PDT. Conclusions Target-specific Red-PDT and NIR-PDT, using their respective PSs, demonstrated equivalent therapeutic efficacy in tumor models. These findings suggest that wavelength differences between Red-PS and NIR-PS may not critically impact treatment outcomes, offering flexibility in fluorophore selection for future PS conjugate design.

Introduction Postoperative nadir hemoglobin (Hb) is related to a longer length of stay for geriatric patients undergoing orthopedic surgery. We investigated whether postoperative pulse Hb (SpHb) measurement is useful for avoiding anemia and inappropriate blood transfusion after total hip arthroplasty and total knee arthroplasty. Material and Methods This prospective randomized controlled study included 150 patients randomly assigned to receive blood transfusion, either guided by SpHb monitoring (SpHb group) or based on the surgeons’ experience (control group). The target laboratory Hb value was set to >8 g/dL at postoperative day 1 (POD1). The primary endpoints were the product of total time and degree of SpHb <8 g/dL (area under SpHb 8 g/dL) during the period up to POD1 and the incidence of laboratory Hb <8 g/dL at POD1. The secondary endpoints were the amount of blood transfusion and inappropriate blood transfusion, which was defined as allogeneic blood transfusion unnecessary in a case of SpHb >12 g/dL or delayed transfusion in a case of SpHb <8 g/dL. Results The area under SpHb 8 g/dL was 37.6 ± 44.1 g/dL-min (5 patients) in the control group and none in the SpHb group (P = .0281). There was 1 patient with Hb <8 g/dL at POD1 in the control group. There was no difference in laboratory Hb levels and the amount of blood transfusion. Forty-one patients (19 in the control group and 22 in the SpHb group) received an allogeneic blood transfusion. Among these patients, 7 in the control group and none in the SpHb group received inappropriate blood transfusion (P = .0022). Discussion The SpHb monitoring could reduce unnoticed anemia, which may prevent complications and be useful in avoiding unnecessary and excessive blood transfusion. Conclusion Postoperative SpHb monitoring decreased the incidence of transient, unnoticed anemia during the period up to POD1 and inappropriate blood transfusion.

The presence of an earlobe crease (ELC) may be a simple sign to predict atherosclerosis. We evaluated the relation between ELC and vascular function. We measured flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID) and observed bilateral earlobes in 400 consecutive subjects. At first, the subjects were divided into 3 groups: non-ELC group, unilateral ELC group, and bilateral ELC group. FMD and NID were significantly lower in the unilateral and bilateral ELC groups than those in the non-ELC group. After adjustment of cardiovascular risk factors, bilateral ELC, but not unilateral ELC, was associated with lower FMD and lower NID. We also investigated whether an increase in the number of ELCs worsens endothelial function, whether the difference in ELC structure (cross stripes and/or ramification) affects endothelial function, and whether endothelial function is impaired in subjects with superficial wrinkles depending on age. The number of ELCs, shape of the ELC, and superficial wrinkles were not associated with endothelial dysfunction. In conclusion, these findings suggest that the presence of bilateral ELCs is associated with vascular dysfunction.

Airborne personal protective equipment is required for healthcare workers when performing aerosol-generating procedures on patients with infectious diseases. Chest compressions, one of the main components of cardiopulmonary resuscitation, require intense and dynamic movements of the upper body. We aimed to investigate the protective effect of tight-fitting powered air-purifying respirators (PAPRs) during chest compressions. This single-center simulation study was performed from February 2021 to March 2021. The simulated workplace protection factor (SWPF) is the concentration ratio of ambient particles and particles inside the PAPR mask; this value indicates the level of protection provided by a respirator when subjected to a simulated work environment. Participants performed continuous chest compressions three times for 2 min each time, with a 4-min break between each session. We measured the SWPF of the tight-fitting PAPR during chest compression in real-time mode. The primary outcome was the ratio of any failure of protection (SWPF <500) during the chest compression sessions. Fifty-four participants completed the simulation. Overall, 78% (n = 42) of the participants failed (the measured SWPF value was less than 500) at least one of the three sessions of chest compressions. The median value and interquartile range of the SWPF was 4304 (685–16,191). There were no reports of slipping down of the respirator or mechanical failure during chest compressions. Although the median SWPF value was high during chest compressions, the tight-fitting PAPR did not provide adequate protection. •Powered air-purifying respirators (PAPRs) is a type of personal protective equipment.•We measured the protective effect of tight-fitting PAPRs during chest compressions.•Tight-fitting PAPR did not provide adequate protection during chest compression.

Abstract Introduction The aim of this study was to evaluate the changes in cardiac performance and myocardial blood perfusion by single photon emission computed tomography (SPECT) in patients upgrading to cardiac resynchronization therapy (CRT) from right ventricular apical pacing (RVAP). Methods Eleven patients (age, 70±7.7 years; pacing career, 95±48.8 months) with chronic RVAP were studied. Their baseline characteristics included New York Heart Association (NYHA) class ≥2, with left ventricular end-diastolic volume (LVEDV) >55 mm or left ventricular ejection fraction (LVEF) <50%, as shown by echocardiography. Cardiac function and cardiac blood perfusion of 17 segments were evaluated by SPECT. Cardio-GRAF (cardio Gated single photon emission computed tomography Regional Assessment for left ventricular Function), a left ventricular (LV) segmental time–volume analyzing program for SPECT, was used to assess dyssynchrony. Results Upgrading from RVAP to CRT resulted in an increase in LVEF and a decrease in LVEDV. The standard deviation of the time from the onset of QRS to end-systole in the 17 LV segments, which indicates LV dyssynchrony, showed the tendency to shorten from 98 to 70 ms. Furthermore, the %uptake of blood perfusion was increased at the inferoseptal lesion. Conclusion Upgrading to CRT from RVAP improved cardiac function and increased %uptake of blood perfusion at the inferoseptal lesion, as demonstrated by SPECT.

Fractional flow reserve (FFR) is widely used for the assessment of myocardial ischemia. However, it has the disadvantage of cost and invasive complication risks. We investigated the usefulness of quantitative coronary angiography–derived translesional pressure (QCA-TP) for predicting functional myocardial ischemia, using FFR as the gold standard. We retrospectively analyzed 152 coronary narrowings (98 left anterior descending arteries, 28 left circumflex arteries, and 26 right) in 132 patients with mild-severe coronary stenosis who underwent coronary angiography and FFR measurements simultaneously. QCA-TP was calculated using software implemented in the QCA software. Coronary morphology was calculated using both densitometry and lumen edges. Functional myocardial ischemia was defined as an FFR of 0.8 or less. The mean values of diameter stenosis by QCA and FFR were 48.9% ± 14.9 and 0.76 ± 0.14, respectively. QCA-TP was significantly correlated with FFR (r = 0.76, p <0.01). The cut-off values of QCA-TP for predicting functional myocardial ischemia based on FFR were 72.8 mm Hg for the left anterior descending arteries (accuracy, 86.7%; area under the curve [AUC], 0.93), 60.5 mm Hg for the left circumflex arteries (accuracy, 89.3%; AUC, 0.88), and 64.4 mm Hg for the right (accuracy, 88.5%; AUC, 0.94). Therefore, our data suggest that QCA-TP can predict myocardial ischemia with high diagnostic accuracy.

Appropriateness use criteria (AUC) are widely used to assess quality of care. American professional organizations and Japanese experts have both developed original AUC for percutaneous coronary intervention (PCI). However, rating discrepancies have not been investigated. Patients registered in the Japanese multicenter PCI registry were analyzed. We assessed the appropriateness of PCI based on both the US and Japanese criteria and compared the ratings. A logistic regression analysis was performed to identify clinical predictors of inappropriate ratings under both standards. From a total of 4,950 nonacute, consecutive PCIs, 1,982 and 2,077 procedures could be successfully rated using the US and Japanese criteria, respectively. The major difference between the 2 criteria was the rating of “asymptomatic, low- or intermediate-risk patients, no lesion in the proximal left anterior descending coronary artery (PLAD)”; this scenario was deemed appropriate in the Japanese but not in the US criteria. As a consequence, the rate of inappropriate PCI using the Japanese criteria (5.2%) was substantially lower when compared with the rating using the US criteria (15%). Common clinical variables associated with “inappropriate” PCI were male, multivessel diseases, and lesions in the non-PLAD. Suboptimal antianginal medication was also a significant predictor of inappropriate PCI under the US but not under the Japanese criteria. Significant and clinically relevant rating discrepancies were observed between the US and Japanese criteria-based assessments, owing largely to the ratings of asymptomatic, non–PLAD-related, low- or intermediate-risk cases.

Intraprocedural stent thrombosis (IPST) is a rare complication of percutaneous coronary intervention that leads to poor outcomes; however, the factors contributing to IPST remain largely unknown. Accordingly, we used intravascular ultrasound (IVUS) to examine the lesion characteristics in patients with IPST. We retrospectively analyzed 1,504 consecutive stent-implanted lesions in 1,324 patients (326 with ST-segment elevation myocardial infarction [STEMI], 403 patients with non–ST-segment elevation acute coronary syndrome [NSTE-ACS], and 595 patients with stable angina). Of these, IPST occurred in 5 patients during percutaneous coronary intervention (0.4% per patient; 3 with STEMI, 2 with NSTE-ACS). The IVUS characteristics of plaques that developed IPST were compared with those of controls without the evidence of IPST (non-IPST; n = 15) who were matched by age, gender, lesion location, and clinical presentation (STEMI, NSTE-ACS, or stable angina). All 5 lesions that led to IPST had ruptured plaques with positive remodeling and attenuation. Plaque rupture was also observed in 40% of the non-IPST group. Multiple plaque ruptures in the culprit lesion were more common in the IPST group (80% vs 7%; p <0.01). The maximum cavity area was larger in the IPST group than in the non-IPST group having plaque rupture (4.6 mm2 [interquartile range, 4.3 to 6.5] vs 2.4 mm2 [1.8 to 2.9]; p <0.01). In conclusion, we found using IVUS that multiple plaque ruptures with larger cavities more often evolved into IPST.