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Ischemic heart disease in Latin American women current perspective and call to action

Cardiovascular diseases (CVDs) constitute the main cause of death in Latin America (LA), with ischemic heart disease (IHD) as the principal cause in most countries. Women are particularly at risk of premature death by CVDs. Nevertheless, in LA, as in other parts of the world, there is a misconception at public level of the importance of CVDs in women; thus, CVDs do not get as much coverage as breast cancer campaigns. Women frequently have atypical symptoms and nonobstructive coronary artery disease as well as inequity in medical and interventional treatments; therefore, care should be built upon these differences. We show the epidemiological situation of IHD in LA women and present a strategy to face the problem, considering the control of risk factors, the optimized utilization of available resources, and the role of research. The role of the International Atomic Energy Agency is highlighted. To adequately face the problem of CVD in LA women, a coordinated approach is necessary, involving medical professionals, governments, scientific societies, and international organizations, as well as the population concerned. In low- and middle-income countries, where the best use of available financial and technological resources is mandatory, a clinical management combining prevention, guidelines, and clinical judgment is required.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2019 Appropriate Use Criteria for Multimodality Imaging in the Assessment of Cardiac Structure and Function in Nonvalvular Heart Disease

This document is the second of 2 companion appropriate use criteria (AUC) documents developed by the American College of Cardiology, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. The first document (J Am Coll Cardiol 2017;70:1647-1672) addresses the evaluation and use of multimodality imaging in the diagnosis and management of valvular heart disease, whereas this document addresses this topic with regard to structural (nonvalvular) heart disease. While dealing with different subjects, the 2 documents do share a common structure and feature some clinical overlap. The goal of the companion AUC documents is to provide a comprehensive resource for multimodality imaging in the context of structural and valvular heart disease, encompassing multiple imaging modalities. Using standardized methodology, the clinical scenarios (indications) were developed by a diverse writing group to represent patient presentations encountered in everyday practice and included common applications and anticipated uses. Where appropriate, the scenarios were developed on the basis of the most current American College of Cardiology/American Heart Association Clinical Practice Guidelines. A separate, independent rating panel scored the 102 clinical scenarios in this document on a scale of 1 to 9. Scores of 7 to 9 indicate that a modality is considered appropriate for the clinical scenario presented. Midrange scores of 4 to 6 indicate that a modality may be appropriate for the clinical scenario, and scores of 1 to 3 indicate that a modality is considered rarely appropriate for the clinical scenario. The primary objective of the AUC is to provide a framework for the assessment of these scenarios by practices that will improve and standardize physician decision making. AUC publications reflect an ongoing effort by the American College of Cardiology to critically and systematically create, review, and categorize clinical situations in which diagnostic tests and procedures are utilized by physicians caring for patients with cardiovascular diseases. The process is based on the current understanding of the technical capabilities of the imaging modalities examined.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Novel Selectivity-Based Forensic Toxicological Validation of a Paper Spray Mass Spectrometry Method for the Quantitative Determination of Eight Amphetamines in Whole Blood

Paper spray tandem mass spectrometry is used to identify and quantify eight individual amphetamines in whole blood in 1.3 min. The method has been optimized and fully validated according to forensic toxicology guidelines, for the quantification of amphetamine, methamphetamine, 3,4-methylenedioxyamphetamine (MDA), 3,4-methylenedioxy-N-methylamphetamine (MDMA), 3,4-methylenedioxy-N-ethylamphetamine (MDEA), para-methoxyamphetamine (PMA), para-methoxymethamphetamine (PMMA), and 4-fluoroamphetamine (4-FA). Additionally, a new concept of intrinsic and application-based selectivity is discussed, featuring increased confidence in the power to discriminate the amphetamines from other chemically similar compounds when applying an ambient mass spectrometric method without chromatographic separation. Accuracy was within ±15% and average precision was better than 15%, and better than 20% at the LLOQ. Detection limits between 15 and 50 ng/mL were obtained using only 12 μL of whole blood. .

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

High-Resolution Mass Spectrometry Quantification: Impact of Differences in Data Processing of Centroid and Continuum Data

High-resolution mass spectrometry (HRMS) in full scan mode acquires all ions present in the sample of interest offering a lot of qualitative information. This, in combination with the improved performance of the new generation HRMS systems, triggers more (bio) analysts to switch from triple quad MS systems to HRMS for quantitative analysis. Quantitative processing of HRMS data is performed based on narrow mass extraction windows rather than on nominal mass product ion chromatograms (SRM or MRM). Optimal processing of HRMS data requires different considerations and software tools and can have an impact on data processing and final results. The selection of centroid versus continuum/profile data for processing, selection of the optimal narrow mass extraction window, using theoretical versus measured accurate mass for the extraction of the ion chromatograms as well as differences in calculations and data handling residing in the different vendor software packages are tackled in the presented manuscript. These differences are illustrated on HRMS data acquired for the same plasma samples on three different platforms, i.e., a Sciex QToF, a Waters QToF, and a Thermo Orbitrap system, and processed in four different software packages, i.e., Sciex Analyst® TF, Waters Masslynx, Waters Unifi, and Thermo Xcalibur. The impact of these differences on quantitative HRMS performance was evaluated on calibration curves of eight small molecule compounds in plasma using four different ways of processing. Simple guidelines are provided for the selection of an optimal mass extraction window for continuum and centroided data. .

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Functional MRI for Treatment Evaluation in Patients with Head and Neck Squamous Cell Carcinoma: A Review of the Literature from a Radiologist Perspective

Purpose of review: To show the role of functional MRI in patients treated for head and neck squamous cell carcinoma. Recent findings: MRI is commonly used for treatment evaluation in patients with head and neck tumors. However, anatomical MRI has its limits in differentiating between post-treatment effects and tumor recurrence. Recent studies showed promising results of functional MRI for response evaluation. Summary: This review analyzes possibilities and limitations of functional MRI sequences separately to obtain insight in the post-therapy setting. Diffusion, perfusion and spectroscopy show promise, especially when utilized complimentary to each other. These functional MRI sequences aid in the early detection which might improve survival by increasing effectiveness of salvage therapy. Future multicenter longitudinal prospective studies are needed to provide standardized guidelines for the use of functional MRI in daily clinical practice.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Periprocedural Management in Transthoracic Needle Biopsy: Review of the Current Evidence

Purpose of Review: Transthoracic needle biopsy (TTNB) is a common diagnostic tool with expanding clinical indications. While most literature on this topic has focused on complications and techniques, this review will examine the evidence for periprocedural care specific to lung biopsy. Recent Findings: Review of the literature reveals great heterogeneity in clinical practice regarding periprocedural management of TTNB, for example, in terms of post-procedural monitoring as well as strategies for dealing with potential complications of TTNB. This is on the basis of a relative paucity of systematic clinical studies to guide management specific to the procedure. Summary: Further studies focused on periprocedural management in TTNB are needed to establish evidence-based guidelines that address the unique clinical aspects and complications of this procedure.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Emerging Trends in Emergent Stroke Neuroimaging

Purpose of Review: Various imaging techniques used in stroke evaluation have complementary, evolving roles. This article reviews recent updates in emergent stroke neuroimaging. Recent Findings: Multiple recent randomized trials showing benefit of endovascular therapy in strokes with confirmed large-vessel occlusion emphasize need for vessel imaging, typically CTA, in addition to unenhanced head CT. In addition, because recent trials published in 2018 showed efficacy of mechanical thrombectomy at up to 24 h from symptom onset in stroke patients with favorable ischemic core and/or penumbra assessments, imaging techniques to define viable and infarcted tissue, such as DWI or CT/MR perfusion imaging, have an increasing role in emergent stroke assessment. Other studies contributing to new AHA/ASA stroke guidelines are also discussed. Summary: Neuroimaging remains crucial to emergent stroke evaluation, with CTA, MRI, and perfusion studies playing an increasing role in identifying patients likely to benefit from treatment.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

MR Imaging of Patients with Cardiac Implantable Electronic Devices (CIEDs): Implementing a Program and Optimizing CMR

Purpose of review: How to implement a program for MRI in patients with conditional and non-conditional (“legacy”) CIED. How to optimize safety and image quality in CMR? What the radiologists need to know: device programming, pre- and post-MRI CIED parameters. Recent findings: New Center for Medicare and Medicaid Services (CMS) guidelines have opened MRI to many patients with nonconditional devices. Newer pulse sequences for cardiac MRI (CMR) in device patients, including modified cine, late gadolinium enhancement and T1 mapping sequences, have resulted in improved image quality in device patients. We present several cases of CMR in device patients, including imaging of leadless pacemakers subcutaneous ICDs. Imaging pitfalls/artifacts in CMR interpretation are also presented. Summary: An organized institutional workflow with an established protocol involving proper patient screening, device programming, scan monitoring, and pre- and post-ICD interrogation minimizes risk in patients with conditional and non-conditional CIEDs. Although rare, significant changes in lead performance, power-on/reset, inappropriate pacing or ICD discharges and battery voltage depletion should be documented. High-quality scans with accurate scar characterization in CIED patients require the use of wideband sequences. CMS has recently acknowledged MRI as a reasonable test necessary for the diagnosis and treatment of beneficiaries with implanted CIEDs, improving the financial prospects and encouraging future developments.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Tariff Structures to Encourage Micro-Grid Deployment in Sub-Saharan Africa: Review and Recent Trends

This article reviews trends for micro-grid tariffs in Sub-Saharan Africa from two perspectives: guidelines for setting tariffs and methods for structuring tariffs. Different approaches are briefly described, and general benefits and drawbacks presented based on recent experiences and available literature. The pace of micro-grid deployment has suffered from a lack of private sector investment, which is often inhibited by unfavorable policies and uncertainty around tariffs. Traditional utility tariffs are too low to allow micro-grid investors to recover their full costs, but a variety of new approaches can be applied to address these challenges. Broad consensus suggests that cost-reflective tariffs are a critical enabler for micro-grid scale-up. Such tariffs can be coupled with subsidies or with hybridized approaches as well as unique new methods of tapping alternative revenue streams to maintain affordability for low-income customers and financial sustainability for micro-grids. There is no one-size-fits-all approach so long as lifetime costs can be recouped.

24 POWER TRANSMISSION AND DISTRIBUTION↗

Natural gas odorants: A scoping review of health effects

Organosulfur compounds are intentionally added to natural gas as malodorants with the intent of short-term nasal inhalation to aid in leak detection. Regulatory exposure limits have not been established for all commonly used natural gas odorants, and recent community-level exposure events and growing evidence of indoor natural gas leakage have raised concerns associated with natural gas odorant exposures. We conducted a scoping review of peer-reviewed scientific publications on human exposures and animal toxicological studies of natural gas odorants to assess toxicological profiles, exposure potential, health effects and regulatory guidelines associated with commonly used natural gas odorants. We identified only 22 studies which met inclusion criteria for full review. Overall, there is limited evidence of both transient nonspecific health symptoms and clinically diagnosed causative neurotoxic effects associated with prolonged odorant exposures. Across seven community-level exposure events and two occupational case reports, consistent symptom patterns included: headache, ocular irritation, nose and throat irritation, respiratory complaints such as shortness of breath and asthma attacks, and skin irritation and rash. Of these, respiratory inflammation and asthma exacerbations are the most debilitating, whereas the high prevalence of ocular and dermatologic symptoms suggest a non-inhalation route of exposure. The limited evidence available raises the possibility that organosulfur odorants may pose health risks at exposures much lower than presently understood, though additional dose-response studies are needed to disentangle specific toxicologic effects from nonspecific responses to noxious organosulfur odors. Numerous recommendations are provided including more transparent and prescriptive natural gas odorant use practices.

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTAN↗

Challenges and Development of Tin-Based Anode with High Volumetric Capacity for Li-Ion Batteries

Abstract The ever-increasing energy density needs for the mass deployment of electric vehicles bring challenges to batteries. Graphitic carbon must be replaced with a higher-capacity material for any significant advancement in the energy storage capability. Sn-based materials are strong candidates as the anode for the next-generation lithium-ion batteries due to their higher volumetric capacity and relatively low working potential. However, the volume change of Sn upon the Li insertion and extraction process results in a rapid deterioration in the capacity on cycling. Substantial effort has been made in the development of Sn-based materials. A SnCo alloy has been used, but is not economically viable. To minimize the use of Co, a series of Sn–Fe–C, Sn y Fe, Sn–C composites with excellent capacity retention and rate capability has been investigated. They show the proof of principle that alloys can achieve Coulombic efficiency of over 99.95% after the first few cycles. However, the initial Coulombic efficiency needs improvement. The development and application of tin-based materials in LIBs also provide useful guidelines for sodium-ion batteries, potassium-ion batteries, magnesium-ion batteries and calcium-ion batteries. Graphic Abstract

25 ENERGY STORAGE↗

Development of gas chromatographic pattern recognition and classification tools for compliance and forensic analyses of fuels: A review

Gas chromatography (GC) is undoubtedly the analytical technique of choice for analyzing the composition of petroleum-based fuels. Over the past twenty years, as comprehensive two-dimensional gas chromatography (GC×GC) has evolved, fuel analysis has often been highlighted in scientific reports, as their complexity allows for illustration of the impressive peak capacity gains afforded by GC×GC. Indeed, several research groups in recent years have applied GC×GC and chemometrics to demonstrate the potential of these analytical tools to address important compliance (tax evasion, tax credits, physical quality standards) and forensic (arson investigations, oil spills) applications involving fuels. None the less, routine use of GC×GC in forensic laboratories has been limited largely by (1) legal and regulatory guidelines, (2) lack of chemometrics training, and (3) concerns about the reproducibility of GC×GC. The goal of this review is to highlight recent advances in one-dimensional GC (1D-GC) and GC×GC analyses of fuels for compliance and forensic applications, in an effort to assist scientists in overcoming the aforementioned hindrances. An introduction to 1D-GC principles, GC×GC technology (column stationary phases and modulators) and several chemometric techniques will be provided. More specifically, chemometric techniques will be broken down into (1) signal pre-processing, (2) peak decomposition, identification and quantification, and (3) classification and pattern recognition. Examples of compliance and forensic applications will be discussed, with particular emphasis on the demonstrated success of the employed chemometric techniques. Overall, this review will hopefully make 1D-GC and GC×GC coupled with chemometric data analysis tools more accessible to the larger scientific community, and aid in eventual widespread standardization.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Linguistic variation in functional types of statutory law

When the meaning of an ambiguous word, phrase or grammatical structure in a statutory provision is disputed, courts are tasked with identifying the best meaning of the contested language. A common method of resolving linguistic ambiguities is to investigate the meaning of the contested word or structure in statutory provisions with similar subject matter. While the subject matter of a text has a demonstrated effect on language use, register variation research shows that the function of a text is also highly influential in predicting linguistic variation. Thus far, the function of a statutory provision (e.g., obligation to act, authorization to act) has not been considered in legal interpretative research. In the present study, I investigate the extent to which function influences the lexico-grammatical characteristics of statutory texts. 2,573 statutory provisions from the Arizona State Code are individually assigned to one of seven categories representing their function: Duties, Permissions, Impersonal Rules, Operational Definitions, Prohibitions, Procedural Guidelines, and Criminal Offenses. Key feature analysis is used to identify and describe patterns of lexico-grammatical variation between the seven functional types. Results reveal a great deal of lexico-grammatical variation associated with function in the register of statutory law. Furthermore, some functional types of statutory provisions are more linguistically distinct than others. In conclusion, these findings suggest that it may be beneficial to consider communicative function when investigating legal interpretative questions.

99 GENERAL AND MISCELLANEOUS↗

In-situ studies on martensitic transformation and high-temperature shape memory in small volume zirconia

Recently, the shape memory effect with significant recoverable shape deformation has been discovered in small volume single-crystal zirconia. The application potential for such shape memory ceramics has spurred in-depth exploration of the martensitic transformation crystallography and high temperature shape memory effect. In this paper, the martensitic transformation of micron-sized zirconia has been studied in both a pristine as-produced condition and after micromechanical compression, using synchrotron scanning micro X-ray diffraction (μXRD). The pristine zirconia was found to transform into the monoclinic phase via a different crystallographic path than the compressed zirconia, resulting in distinct monoclinic variant preferences. The characteristic martensitic transformation temperatures were also found to be higher after uniaxial compression than in the pristine condition. Such observations provide insight on the differences between stress-induced and thermally-induced martensitic transformation. Moreover, we have observed a full cycle of the shape memory effect with large recoverable strain (7%) in micron-sized zirconia at a temperature of 400 °C. Finally, our findings provide an important guideline to tailor the high-temperature shape memory properties of zirconia for further scientific research and engineering applications.

36 MATERIALS SCIENCE↗

Mechanism of the α-Zr to hexagonal-ZrO transformation and its impact on the corrosion performance of nuclear Zr alloys

Displacive transformations have been widely reported in metals, alloys and ceramics, but rarely reported to be important in the aqueous corrosion of alloys. We report here our analysis of the formation of the hexagonal-ZrO suboxide during the aqueous corrosion of α-Zr alloys and propose this to be a paraequilibrium displacive transformation with the rate controlled by oxygen diffusion. Two orientation relationships were identified between α-Zr and hexagonal-ZrO, ( 0002 ) α − Z r ∥ ( 1 ¯ 011 ) h − Z r O and [ 2 ¯ 110 ] α - Z r ∥ [ 10 1 ¯ 2 ] h - Z r O or ( 0002 ) α − Z r ∥ ( 22 4 ¯ 1 ¯ ) h − Z r O and [ 2 ¯ 110 ] α − Z r ∥ [ 1 1 ¯ 01 ] h − Z r O , with the first one more commonly observed. No specific orientation relationships between either hexagonal-ZrO and monoclinic-ZrO 2 or α-Zr and monoclinic-ZrO 2 were identified, which suggests that the formation of often-reported bulk oxide texture during aqueous corrosion is not related directly to the texture of the metallic substrate. In conclusion, these results provide a guideline for understanding the mechanisms of crystallographic evolution during oxide growth on commercial zirconium alloys, and also demonstrate the capability of transmission Kikuchi diffraction to investigate orientation relationships in nano-scale materials.

36 MATERIALS SCIENCE↗

First-principles and cluster expansion study of the effect of magnetism on short-range order in Fe–Ni–Cr austenitic stainless steels

Short-range order (SRO), the regular and predictable arrangement of atoms over short distances, alters the mechanical properties of technologically relevant structural materials such as medium/high entropy alloys and austenitic stainless steels. In this study, we present a generalized spin cluster expansion (CE) model and show that magnetism is a primary factor influencing the level of SRO present in austenitic Fe-Ni-Cr alloys. The spin CE consists of a chemical cluster expansion combined with an Ising model for Fe-Ni-Cr austenitic alloys. It explicitly accounts for local magnetic exchange interactions, thereby capturing the effects of finite temperature magnetism on SRO. Model parameters are obtained by fitting to a first-principles data set comprising both chemically and magnetically diverse FCC configurations. The magnitude of the magnetic exchange interactions are found to be comparable to the chemical interactions. Compared to a conventional implicit magnetism CE built from only magnetic ground state configurations, the spin CE shows improved performance on several experimental benchmarks over a broad spectrum of compositions, particularly at higher temperatures due to the explicit treatment of magnetic disorder. We find that SRO is strongly influenced by alloy Cr content, since Cr atoms prefer to align antiferromagnetically with nearest neighbors but become magnetically frustrated with increasing Cr concentration. Using the spin CE, we predict that increasing the Cr concentration in typical austenitic stainless steels promotes the formation of SRO and increases order-disorder transition temperatures. Furthermore, this study underscores the significance of considering magnetic interactions explicitly when exploring the thermodynamic properties of complex transition metal alloys. It also highlights guidelines for customizing SRO through adjustments of alloy composition.

36 MATERIALS SCIENCE↗

Chemical trends favoring interstitial cluster formation in bcc high-entropy alloys from first-principles calculations

Achieving high strength and ductility is a common goal in structural alloy design. Body-centered cubic high-entropy alloys (HEAs) commonly highlight the conflict between these properties, with stronger alloys being brittle and vice versa. Recent reports suggest interstitial solutes can be used to overcome this trade-off, in some cases providing both strength and ductility enhancements. This effect has been correlated with interstitial cluster formation, although the conditions favoring their formation remain incompletely understood. Using first-principles calculations of solution energies and diffusivities, we provide insights into thermodynamic and kinetic factors favoring interstitial solute clusters. Among C, N and O solutes, O interstitials display most desirable diffusion kinetics. Further, the results highlight the importance of local composition fluctuations in the HEAs to enable the formation of clusters of appreciable size. The results are explained in terms of bonding and distortion trends across solutes and HEA compositions to provide guidelines for alloy design.

Borges, Pedro P P O↗

Ultra-grain refinement creates FCC pure cobalt with high strength and high ductility

Although pure cobalt is generally known to have a hexagonal close-packed (HCP) structure at room temperature, we show that its high-temperature face-centered cubic (FCC) phase can be strongly stabilized through grain refinement, resulting in FCC pure cobalt at room temperature. Ultrafine-grained (UFG) FCC cobalt exhibits a hierarchical microstructure consisting of dense stacking fault (SF) networks in the dominant FCC grains and numerous SFs and thin FCC layers within a few HCP plates. This unique microstructure leads to a high tensile strength exceeding 1 GPa, together with a tensile elongation of over 35%, thereby surpassing the well-known strength–ductility trade-off of pure metals. In-situ synchrotron X-ray diffraction revealed that the UFG FCC cobalt exhibited a markedly enhanced deformation-induced FCC→HCP martensitic transformation, which provided sustained strain hardening through the transformation-induced plasticity (TRIP) effect. Furthermore, ultra-grain refinement dramatically suppressed premature void and crack formation, causing a transition in the fracture mode from brittle to ductile. These findings advance the fundamental understanding of the phase stability and TRIP-assisted deformation in elemental cobalt and offer new guidelines for the microstructure-driven design of high-performance cobalt-based structural alloys.

Metastability↗