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关键词： Meta-analysis   Aortic Stenosis   Percutaneous Coronary Intervention   Transcatheter Aortic Valve Replacement   Surgical Aortic Valve Replacement   AS   Aortic Stenosis   CAD   Coronary Artery Disease   TAVR   Transcatheter Aortic Valve Replacement   SAVR   Surgical Aortic Valve Replacement   RCTs   Randomized Controlled Trials   CABG   Coronary Artery Bypass Grafting   PCI   Percutaneous Coronary Intervention   AF   Atrial Fibrillation   STS-PROM   Society of Thoracic Surgeons Predicted Risk of Mortality   AKI   acute kidney injury   PPI   permanent pacemaker implantation   NYHA   New York Heart association   Euro-SCORE   European System for Cardiac Operative Risk Evaluation   LVEF   left ventricular ejection fraction   MACE   major adverse cardiac events. LOH, length of hospital   ICU   intensive care unit   RR   risk ratio   MD   mean difference   CI   confidence interval. HR, hazard ratio  

摘要： Severe aortic stenosis (AS) often coexists with coronary artery disease (CAD), present in about 50 % of patients undergoing valve intervention. Surgical aortic valve replacement (SAVR) with coronary artery bypass graft (CABG) has been the traditional standard, providing revascularization and durability, whereas transcatheter aortic valve replacement (TAVR) with percutaneous coronary intervention (PCI) offers a less invasive option. PCI + TAVR may lower perioperative risk, but SAVR + CABG may confer superior survival, with conflicting evidence.

关键词： Pulmonary embolism   Catheter-based thrombectomy   Sex differences   In-hospital outcomes   Acute kidney injury   Peri-procedural bleeding   PE   pulmonary embolism   AKI   acute kidney injury   NIS   national inpatient sample   OR   odds ratio   CI   confidence interval   CAD   coronary artery disease   CKD   chronic kidney disease   COPD   chronic obstructive pulmonary disease   RV   right ventricular   IRB   institutional review board   ICD-10   international classification of diseases, 10th revision   HCUP   healthcare cost and utilization project  

摘要： Pulmonary embolism (PE) remains a significant cause of cardiovascular morbidity and mortality. Catheter-based PE thrombectomy has emerged as an important therapeutic option for high-risk PE patients. Still, sex-based disparities in the outcomes of this procedure are not well understood.

关键词： Carbon emissions   Grad-CAM   Interpretable machine learning   SHAP   Structural deviation   Urban morphology  

摘要： Urban morphology profoundly shapes the spatial distribution of carbon emissions by regulating spatial structure, energy use, and human activity. To systematically uncover its mechanisms, this study develops a structure-sensitive analytical framework that integrates deep learning attention mechanisms with interpretable machine learning, focusing on three core tasks in the morphology–emission relationship: key factor identification, mechanism analysis, and spatial diagnosis. In an empirical case study of Nanjing, China, the framework first trains sector-specific carbon emission prediction models based on remote sensing imagery, and applies Grad-CAM to extract model attention heatmaps. These maps are used to identify morphological features most influential in emission prediction and to construct an attention-weighted morphology indicator system that reflects model-perceived spatial structures. Second, a mediation–moderation model is introduced to clarify the role of demographic and behavioral variables nested within structural pathways, and XGBoost combined with SHAP is employed to characterize the nonlinear responses and threshold behaviors of key morphological factors, revealing multi-path and sector-specific regulation mechanisms. Finally, a structural deviation index is constructed to identify high-emission zones with significant mismatches between observed morphology and model cognition. These zones exhibit threshold shifts and marginal reversals, providing critical guidance for spatial risk detection and structure-sensitive governance strategies. The findings offer new methodological support and theoretical insight for identifying morphological mechanisms of urban carbon emissions and for advancing precision-oriented mitigation.

关键词： Coronary physiology   chronic total occlusion   quantitative flow ratio   ACS   acute coronary syndrome   CABG   coronary artery bypass graft   CAD   coronary artery disease   CTO   chronic total occlusion   iFR   instantaneous wave-free ratio   FFR   fractional flow reserve   PCI   percutaneous coronary intervention   QFR   quantitative flow ratio   TVF   target vessel failure   TVR   target vessel revascularization  

摘要： Physiological assessment is useful in detecting suboptimal results after percutaneous coronary intervention (PCI). However, after angiographically successful PCI of a chronic total occlusion (CTO), coronary perfusion changes over time, which may impact physiological assessment.

关键词： Coronary artery desease   Interleukin-1   Inflammation   AUC-CRP   The area under the curve for C-reactive protein   CAD   Coronary artery disease   HF   Heart failure   IL-1   Interleukin-1   LVEF   Left ventricular ejection fraction   STEMI   ST-elevation myocardial infarction   VCUART   Virginia Commonwealth University Anakinra response trial  

摘要： Patients with a history of coronary artery disease (CAD) presenting with ST-elevation myocardial infarction (STEMI) have high risk. We aimed to determine whether patients with CAD history presenting with STEMI had greater systemic inflammation and/or whether they benefitted similarly from IL-1 blockade.

关键词： Coronary computed tomography angiography   Non-obstructive coronary artery disease   Pericoronary adipose tissue attenuation   Lipoprotein (a)   Major adverse cardiovascular events   AUC   Area under the curve   CABG   Coronary artery bypass grafting   CAD   Coronary artery disease   CCTA   Coronary computed tomography angiography   CPV   Calcified plaque volume   LAD   Left anterior descending   LAPV   Low-attenuation plaque volume   LCX   Left circumflex artery   Lp(a)   Lipoprotein(a)   MACEs   Major adverse cardiovascular events   MI   Myocardial infarction   NCPV   Non-calcified plaque volume   OxPLs   Oxidized phospholipids   PAV   Percentage atheroma volume   PCAT   Pericoronary adipose tissue   PCATa   Pericoronary adipose tissue attenuation   PCATv   Pericoronary adipose tissue volume   PCI   Percutaneous coronary intervention   RCA   Right coronary artery   ROC   Receiver operating characteristic curve   TPV   Total plaque volume  

摘要： This study aimed to enhance major adverse cardiovascular events (MACEs) prediction by pericoronary adipose tissue attenuation (PCATa) in non-obstructive coronary artery disease (CAD) patients when combined with lipoprotein (a) (Lp(a)).

关键词： Spring ligament instability   Flatfoot   Progressive collapsing foot deformity   Biomechanics   Reconstruction  

摘要： The calcaneonavicular ligament (spring ligament) plays a fundamental role in calcaneonavicular static stability and medial longitudinal arch, injury which is related to flatfoot.

摘要： Chorioallantoic membrane (CAM) functions as embryonic “lung” in birds/reptiles and forms through fusion of the chorion and allantois, two extraembryonic membranes conserved in amniotic vertebrates. Modified CAM gives rise to the placenta, performing similar roles in mammalian development. Despite its importance, cellular morphogenesis leading to CAM maturation is poorly understood. In particular, it is unclear how mesoderm-derived capillary cells are positioned within the chorionic ectoderm layer in mature CAM. In this work, using a combination of live imaging, histology, immunofluorescence and electron microscopy approaches, we carried out a systematic analysis of chicken CAM morphogenesis from embryonic day 4.5 (D4.5; soon after its initial formation) to D15 (when it reaches its fully mature architecture). We show that CAM chorionic ectoderm establishes physical contact with the acellular soft shell from D7.5. CAM mesoderm-derived capillary vessels shift from a sub-chorionic ectodermal position to an intra-chorionic ectodermal one from D11 onward. This is mediated by the downward movement of a subset of chorionic ectoderm cells (termed chorionic basal cells) from D9 through inter-capillary spaces, eventually enveloping all superficial capillaries basally and leading to a seemingly mesoderm-out/ectoderm-in topology. All CAM superficial capillary vessels are covered by a thin layer (<1 μm) of chorionic ectodermal cell (capillary covering cell) processes. Another type of superficial chorionic ectodermal cell (villous cavity cell) contains numerous apical villi. Detailed immunofluorescence and electron microscopy studies revealed that germ layer organization and epithelial cell polarity were maintained during CAM morphogenesis and maturation. Heterogeneity in CAM ectoderm, mesoderm and endoderm cells was observed. Cell proliferation was seen in all three germ layers during early maturation, but bec

关键词： Audit reports   Critical audit matter   Going-concern  

摘要： We examine going-concern (GC) critical audit matter (CAM) disclosures by auditors of non-accelerated filers in the U.S. GC issues continue to be of significant interest to the public, given the well-documented failures of SEC registrants without prior GC warnings. We examine whether auditors use GC-CAMs as intermediate-level warning signals of GC issues. Our analyses of 196 GC-CAM disclosures find that only 116 (59%) of GC-CAM disclosures also report a GC-modified audit opinion (GCMO). We find significant differences between firms receiving both GC-CAMs and GCMOs and those receiving only GC-CAMs, specifically in client size, audit fees, absence of revenues, leverage, and audit report lag. These findings suggest that the distress threshold for issuing GC-CAM disclosures is likely lower than for GCMOs. Interestingly, GC-CAMs are not “sticky”—unlike GCMOs, which are “sticky” in successive years. The removal of a GC-CAM in the following year aligns with improved financial conditions, supporting the idea that auditors use GC-CAMs as intermediate warnings of financial distress.

摘要： We read with great interest the recent study evaluating the feasibility and validity of the Family Confusion Assessment Method (FAM-CAM) for delirium detection in postoperative patients [ 1]. The work is highly relevant given the pressing need for...