Purpose: The benefit of using the Zilver PTX drug-eluting stent (DES) in superficial femoral artery (SFA) lesions has been demonstrated in multiple clinical studies. This prospective, multicenter study evaluated the 1-year safety and effectiveness of the DES for the treatment of femoropopliteal lesions in a Chinese patient population. Methods: Patients with a single de novo or restenotic SFA lesion ≤140 mm and a Rutherford classification of 2 to 4 were treated with the DES. The primary endpoint was primary patency assessed by duplex ultrasound at 1-year. Secondary endpoints included adverse events, event-free survival (EFS), and freedom from target lesion revascularization (TLR). Clinical outcomes included Rutherford classification, ankle-brachial index (ABI), and the walking impairment questionnaire (WIQ). Results: In this study, 178 patients with symptomatic peripheral artery disease were enrolled at nine institutions in China. The average lesion length was 79.0 ± 48.6 mm (range 14.8–245.4 mm) and 50.0% of lesions were total occlusions. The 1-year primary patency rate was 81.9%. Covariate analysis revealed that lesion length (p < 0.01) was the only significant factor for patency. No paclitaxel-related adverse events or amputations were reported. The 1-year rate for EFS was 94.9% and freedom from TLR was 95.5%. Through 1-year, treatment with the DES resulted in statistically significant improvement in ABI and WIQ scores compared with pre-procedure (p < 0.001). Clinical improvement of at least 1 Rutherford class was achieved in 142 of 174 patients (81.6%). Conclusion: This study showed promising short-term results for the treatment of SFA lesions with Zilver PTX DES in Chinese patients. Unique identifier: ClinicalTrials.gov, identifier: NCT02171962. Copyright © 2022 Ye, Böhme, Fu, Liu, Zhang, Liu, Zhang, Zou, Lu, Lottes, O'Leary, Zeller and Dake.

Paleohydrological investigations were carried out in the Yellow River source area on the northeast (NE) Tibetan Plateau. During our fieldwork investigations, two units of overbank flood deposits (OFD) were found in the Maqu-Kesheng reach. These OFD units were studied using a multi-index approach, including magnetic susceptibility, hygroscopic water, grain size distribution and micro-morphological features. It can be inferred that they have recorded two episodes of overbank flooding of the Yellow River. Using the optically stimulated luminescence (OSL) and AMS 14C dating techniques, the first episode was dated to 34,680 ± 1880-29000 ± 1790 a and correlated with the late Marine Isotope Stage 3a (MIS 3a) with a warm and wet climate. The second episode occurred at 16,500 ± 1,250-14000 ± 1,280 a, which is coincided with the Bølling-Allerød warm stage during the last deglaciation, a period of coexisting global warming and rapidly shrinking ice sheets. At these two periods, the water was mainly derived from the accelerated melting of mountain glaciers surrounding the basin and/or the large-scale precipitation, which led to the overbank flooding events. At the same time, the related overbank flood deposits were interbedded within glacial outwash/flashflood deposits in the valley bottom of the Yellow River, which intensified the valley aggradation. These results are of great significance in enriching the paleoflood records in the Yellow River source area, recognizing the effect of river system on the development of valley landform, as well as understanding the hydro-climatic response of the Tibetan Plateau to global climate warming occurring presently. Copyright © 2022 Zhu, Wang, Zhang, Huang, Zha, Qiu, Jia, Xiao, Chen, Lin and Liu.

The genome of Mycobacterium tuberculosis (Mtb) harbors the genetic machinery for assembly of the Fimbrial low-molecular-weight protein (Flp) type IV pilus. Presumably, the Flp pilus is essential for pathogenesis. However, it remains unclear whether the pili genes are transcribed in culture or during infection of host cells. This study aimed to shed light on the expression of the Flp pili-assembly genes (tadZ, tadA, tadB, tadC, flp, tadE, and tadF) in Mtb growing under different growth conditions (exponential phase, stationary phase, and dormancy NRP1 and NRP2 phases induced by hypoxia), during biofilm formation, and in contact with macrophages and alveolar epithelial cells. We found that expression of tad/flp genes was significantly higher in the stationary phase than in exponential or NRP1 or NRP2 phases suggesting that the bacteria do not require type IV pili during dormancy. Elevated gene expression levels were recorded when the bacilli were in contact for 4 h with macrophages or epithelial cells, compared to mycobacteria propagated alone in the cultured medium. An antibody raised against a 12-mer peptide derived from the Flp pilin subunit detected the presence of Flp pili on intra- and extracellular bacteria infecting eukaryotic cells. Altogether, these are compelling data showing that the Flp pili genes are expressed during the interaction of Mtb with host cells and highlight a role for Flp pili in colonization and invasion of the host, subsequently promoting bacterial survival during dormancy. Copyright © 2022 Alteri, Rios-Sarabia, De la Cruz, González-y-Merchand, Soria-Bustos, Maldonado-Bernal, Cedillo, Yáñez-Santos, Martínez-Laguna, Torres, Friedman, Girón and Ares.

Endoscopic high-speed video (HSV) systems for visualization and assessment of vocal fold dynamics in the larynx are diverse and technically advancing. To consider resulting “concepts shifts” for neural network (NN)-based image processing, re-training of already trained and used NNs is necessary to allow for sufficiently accurate image processing for new recording modalities. We propose and discuss several re-training approaches for convolutional neural networks (CNN) being used for HSV image segmentation. Our baseline CNN was trained on the BAGLS data set (58,750 images). The new BAGLS-RT data set consists of additional 21,050 images from previously unused HSV systems, light sources, and different spatial resolutions. Results showed that increasing data diversity by means of preprocessing already improves the segmentation accuracy (mIoU + 6.35%). Subsequent re-training further increases segmentation performance (mIoU + 2.81%). For re-training, finetuning with dynamic knowledge distillation showed the most promising results. Data variety for training and additional re-training is a helpful tool to boost HSV image segmentation quality. However, when performing re-training, the phenomenon of catastrophic forgetting should be kept in mind, i.e., adaption to new data while forgetting already learned knowledge. © 2022 by the authors.

Stormwater management is of great importance in large shrinking cities with aging and outdated infrastructure. Maintenance of vegetated areas, particularly referred to as green infrastructure, is often aimed at mitigating flooding and the urban heat island effect by stormwater storage and evaporative cooling, respectively. This approach has been applied in large cities as a cost-effective and eco-friendly solution. However, the ecohydrological processes and how the ecohydrology influences the function of green infrastructure and its potential to provide those ecosystem services are not well understood. In this study, continuous field measurements including air temperature, stomatal conductance, and phenocam images were taken in a 308 m2 bioswale retrofitted into a 4063 m2 parking lot on the Wayne State University campus in Detroit, Michigan over a two-year period. Our results suggest that plant characteristics such as water use efficiency impact the ecohydrological processes within bioswales and that retrofitted bioswales will need to be adapted over time to meet environmental demands to allow for full and sustained success. Therefore, projected shifts in precipitation regime change are expected to affect the performance of green infrastructure, and each bioswale needs to be developed and engineered to be able to adapt to changing rainfall patterns. © 2022 by the authors.

The design storm derived from intensity–duration–frequency (IDF) curves is the main input for hydrologic analysis or hydraulic design for flood control. The regions with higher flood risks due to extreme precipitation are often deficient in precipitation gauges. This study presents a detailed evaluation of IDF curves derived using IMERG Final half-hourly precipitation (V06), fitted with the widely used CDFs: Gumbel and MLE, Gumbel and MM, Pearson 3, and GEV. As benchmarks and following the same method, we also derived IDF curves using areal average gridded precipitation constructed from two dense gauges networks over (1) the WegenerNET Feldbach region in the Alpine forelands of Austria and (2) the gauge network of the Walnut Gulch Experimental Watershed, in a semiarid region of the United States. In both regions, the frequency analysis for return periods between 2 and 100 years was based on half-hourly rainfall and compared at a grid-scale with a spatial resolution of IMERG, 0.1° × 0.1° lat/lon. The impact of order in which the gridded gauge-based precipitation average is performed within an IMERG grid was evaluated by computing two different Annual Maximum Series (AMS). In one, the average was computed before obtaining the AMS (AB-AMS), and in the other, the average was computed after obtaining the AMS for each gauge grid (AA-AMS) within the IMERG grid. The evaluation revealed that IMERG AMS agrees better with AB-AMS than AA-AMS for the two study regions. Lastly, it was found that the use of Gumbel distribution in calculating IMERG IDF curves results in better agreement with the ground truth than the use of the other three distributions studied here. The outcomes should provide valuable knowledge for the application of IMERG precipitation over regions with sparse gauges. © 2022 by the authors.

INTRODUCTION: Studies have reported that antidiabetic medications (ADMs) were associated with lower risk of dementia, but current findings are inconsistent. This study compared the risk of dementia onset in patients with type 2 diabetes (T2D) treated with sulfonylurea (SU) or thiazolidinedione (TZD) to patients with T2D treated with metformin (MET). RESEARCH DESIGN AND METHODS: This is a prospective observational study within a T2D population using electronic medical records from all sites of the Veterans Affairs Healthcare System. Patients with T2D who initiated ADM from January 1, 2001, to December 31, 2017, were aged ≥60 years at the initiation, and were dementia-free were identified. A SU monotherapy group, a TZD monotherapy group, and a control group (MET monotherapy) were assembled based on prescription records. Participants were required to take the assigned treatment for at least 1 year. The primary outcome was all-cause dementia, and the two secondary outcomes were Alzheimer's disease and vascular dementia, defined by International Classification of Diseases (ICD), 9th Revision, or ICD, 10th Revision, codes. The risks of developing outcomes were compared using propensity score weighted Cox proportional hazard models. RESULTS: Among 559 106 eligible veterans (mean age 65.7 (SD 8.7) years), the all-cause dementia rate was 8.2 cases per 1000 person-years (95% CI 6.0 to 13.7). After at least 1 year of treatment, TZD monotherapy was associated with a 22% lower risk of all-cause dementia onset (HR 0.78, 95% CI 0.75 to 0.81), compared with MET monotherapy, and 11% lower for MET and TZD dual therapy (HR 0.89, 95% CI 0.86 to 0.93), whereas the risk was 12% higher for SU monotherapy (HR 1.12 95% CI 1.09 to 1.15). CONCLUSIONS: Among patients with T2D, TZD use was associated with a lower risk of dementia, and SU use was associated with a higher risk compared with MET use. Supplementing SU with either MET or TZD may partially offset its prodementia effects. These findings may help inform medication selection for elderly patients with T2D at high risk of dementia. © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Evolution of pest resistance reduces the benefits of widely cultivated genetically engineered crops that produce insecticidal proteins derived from Bacillus thuringiensis (Bt). Better understanding of the genetic basis of pest resistance to Bt crops is needed to monitor, manage, and counter resistance. Previous work shows that in several lepidopterans, resistance to Bt toxin Cry2Ab is associated with mutations in the gene encoding the ATP-binding cassette protein ABCA2. The results here show that mutations introduced by CRISPR/Cas9 gene editing in the Helicoverpa zea (corn earworm or bollworm) gene encoding ABCA2 (HzABCA2) can cause resistance to Cry2Ab. Disruptive mutations in HzABCA2 facilitated the creation of two Cry2Ab-resistant strains. A multiple concentration bioassay with one of these strains revealed it had > 200-fold resistance to Cry2Ab relative to its parental susceptible strain. All Cry2Ab-resistant individuals tested had disruptive mutations in HzABCA2. We identified five disruptive mutations in HzABCA2 gDNA. The most common mutation was a 4-bp deletion in the expected Cas9 guide RNA target site. The results here indicate that HzABCA2 is a leading candidate for monitoring Cry2Ab resistance in field populations of H. zea. © 2022, This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.

In island systems, nitrogen-rich seabird guano is a marine subsidy that can shape terrestrial plant communities. In zones of nutrient upwelling such as the Gulf of California, copious seabird guano is commonplace on bird islands. Several bird islands host regionally unique cactus forests, especially of the large columnar cactus, cardón (Pachycereus pringlei). We show that a chain of interactions across the land-sea interface yields an allochthonous input of nitrogen in the form of seabird guano, fueling the production of some of the densest cactus populations in the world. Fish, seabird, guano, soil, and cactus samples were taken from the representative seabird island of San Pedro Mártir for nitrogen stable isotope ratio measurements, which were compared to soil and cactus samples from other seabird and non-seabird Gulf islands and terrestrial ecosystems throughout the range of the cardón. Isla San Pedro Mártir δ15N values are distinctively high, ranging from fish + 17.7, seabird + 19.7, guano + 14.8, soil + 34.3 and cactus + 30.3 compared to average values across non-bird sites of + 13.0 (N = 213, S.D. = 3.7) for soil and + 9.8 (N = 212, S.D. = 3.4) for cactus. These δ15N values are among the highest ever reported for plants. Seabird island soil and cactus δ15N values were consistently significantly enriched relative to mainland and non-bird islands, a relationship expected due to the progressive volatilization of 14N rich ammonia from decomposing guano deposits. Our findings demonstrate that seabird-mediated marine nutrient deposits provide the source for solubilized nitrogen on desert islands, which stimulate terrestrial plant production in the cardón cactus beyond that seen in either mainland ecosystems or non-seabird islands. © 2022, The Author(s).

Blood pressure variability is an emerging risk factor for Alzheimer’s disease in older adults, independent of average blood pressure levels. Growing evidence suggests increased blood pressure variability is linked to Alzheimer’s disease pathophysiology indexed by cerebrospinal fluid and positron emission tomography markers, but relationships with plasma Alzheimer’s disease markers have not been investigated. In this cross-sectional study of 54 community-dwelling older adults (aged 55–88, mean age 69.9 [8.2 SD]), elevated blood pressure variability over 5 min was associated with lower levels of plasma Aβ1–42 (standardized ß = − 0.36 [95% CI − 0.61, − 0.12]; p = 0.005; adjusted R2 = 0.28) and Aβ1–42: Aβ1–40 ratio (ß = − 0.49 [95% CI − 0.71, − 0.22]; p &lt; 0.001; adjusted R2 = 0.28), and higher levels of total tau (ß = 0.27 [95% CI 0.01, 0.54]; p = 0.04; adjusted R2 = 0.19) and Ptau181:Aβ1–42 ratio (ß = 0.26 [95% CI 0.02, 0.51]; p = 0.04; adjusted R2 = 0.22). Findings suggest higher blood pressure variability is linked to plasma biomarkers of increased Alzheimer’s disease pathophysiology. © 2022, The Author(s).