Dilatation and percutaneous coronary intervention in the presence of calcified lesions is particularly demanding and presents a challenge in the daily work of an interventional cardiologist. Coronary calcification is a marker of the progress of the atherosclerotic process. The existence of calcifying lesions predicts a poorer clinical outcome and is associated with increased mortality and the occurrence of postprocedural major adverse cardiovascular events (MACEs). A male patient who was 61 years old was admitted as a result of ST-elevation myocardial infarction (STEMI) complicated by cardiac arrest caused by in-stent thrombosis of a previously suboptimally expanded stent. The lesion did not respond to a dilation attempt with a noncompliant (NC) balloon; however, an optimal result was obtained with inflation from a super-high-pressure NC balloon (OPN NC) for ultra-high-pressure inflations. Resistant, calcified lesions require a careful and comprehensive approach. The OPN NC balloon has a place in the treatment of this type of lesion. An optimized therapeutic modality after the procedure is imperative to prevent a MACE.

Controversies exist how to predict medium term mortality (Mt) in diabetics (DM) with 3 vessel (3VD) and/or left main (LM) disease undergoing myocardial revascularization ranging from Syntax Score II (SSII) where DM was not predicative variable up to FREEDOM formula which was derived, just from population with DM (without LM), having DM patients (Pts) requirement of insulin as one of predicative variable. To compare predicative power of SSII, FREEDOM and formula developed in our institution in Pts post first isolated CABG with 3VD and/or LM with DM. From our prospective data base of 2455 consecutive pts who had the first isolated CABG in the period 01/2012–12/2014 with complex Ischemic Heart Disease with 100% follow up of 4 years all-cause Mt we created by random sampling Training (1321; Mt:10.4%; DM 511; Mt:13.3%) and Validation (1134; Mt:10.0%; DM 414; Mt: 11.8%) sets. After deriving predicative formula (Cox regression) from training population we validated FREEDOM, SSII and Our Formula in 414 pts with DM from the Validation set. Characteristics of pts, our formula, predicating power by C Statistics, Calibration plots and Brier scores are presented in Picture 1. FREEDOM formula designed just for DM pts with complex Ischemic Heart Disease without LM had the smallest standard error in the estimate, but moderate C statistics as Syntax Score II and our formula which may be used for pts with and without DM and 3VD and/or LM. Picture 1 Type of funding source: Public grant(s) – National budget only. Main funding source(s): Ministry of education, science and technology development, Republic of Serbia

Freedom formula (FF) was derived very recently to assist in decision making by Heart Team in patients (Pts) with diabetes (DM) who are in need for myocardial revascularization (Percutaneous Coronary Intervention or Coronary artery bypass grafting (CABG)) due to complex ischemic Heart disease (but without left main steam disease (LM)). In external validation moderate C statistics values were obtained. To validate FF predictive value in Pts with DM and more complex patients (three vessel (3VD) and/or LM as well lower left ventricular ejection fraction (LVEF)) than in FREEDOM population. From our prospective data base of 2455 consecutive pts who had the first isolated CABG in the period 01/2012–12/2014 with 3VD and/or LM with 100% follow up of 4 years All-cause Mortality (Mt) we retrieved 925 pts with DM. DM was present in 925 Pts (Mt: 12.6%). On insulin were 318 (34.3%; Mt 14.5%). We analysed the predicative value of FF in the whole group (925) of pts with DM as well as in subgroups with LM (294) and without LM (631; most similar to original Freedom population), separately. Characteristics of pts, Freedom formula, predicating power by C Statistics, Calibration plots and Brier scores are presented in Picture 1. Our external validation of FF was almost identical as previous published one. Furthermore, the FF may be of value even in pts with LM disease and other vessels involved. Of note our pts as seen by combined LVEF, ClCr and LM were sicker than pts in FREEDOM. Picture 1 Type of funding source: Public grant(s) – National budget only. Main funding source(s): Ministry of education, science and technological development, Republic of Serbia

Two-dimensional (2-D) volumetric exercise stress echocardiography (ESE) provides an integrated view of preload reserve through end-diastolic volume (EDV) and left ventricular contractile reserve (LVCR) through end-systolic volume (ESV) changes. To assess the dependence of stroke volume (SV) and cardiac output (CO) upon LVCR EDV changes and heart rate (HR) during ESE. We prospectively performed semi-supine bicycle or treadmill ESE in 1,344 patients (age 59.8±11.4 years; 550 female; ejection fraction = 62.5±8%) referred for known or suspected coronary artery disease in 20 quality controlled laboratories of 16 countries from 2016 to 2019. SV was calculated at rest and peak stress from raw measurement of LV EDV and ESV by biplane Simpson rule, 2-D echo. LVCR was the stress-rest ratio of force (systolic blood pressure by cuff sphygmomanometer/ESV, abnormal values <2.0 identify a “weak” heart). Preload reserve was defined by an increase in LV EDV. Abnormal values (lack of EDV increase, peak EDV ≤ rest EDV) identify a “stiff” heart. Cardiac output was calculated as SV * HR (measured with standard EKG). HR reserve (stress/rest ratio) <1.85 identifies a “slow” heart with chronotropic incompetence. By selection, all patients had negative SE by wall motion criteria. Of the 1,344 patients included in the study, 448 belonged to the lowest tertile of CO increase. Of them 326 (73%) achieved HR reserve <1.85; 220 (49%) had a blunted LVCR and 374 (83%) a reduction of preload reserve, with 348 patients (78%) showing ≥2 abnormalities. The more the abnormal criteria, the worse the CO response, which was lowest in slow, stiff and weak hearts: see figure. Patients with normal CO reserve during exercise usually have a fast, compliant and strong heart. Abnormal CO reserve is associated with heterogeneous hemodynamic responses, with slow, stiff and/or weak hearts. The clarification of underlying hemodynamic heterogeneity is the prerequisite for a personalized treatment, and can be easily extracted from a standard 2-D volumetric SE. Hearts with normal CO are all alike; every heart with abnormal CO is abnormal in its own way. CO % changes in subsets (*p<0.001) Type of funding source: None

746 EJD, vol. 30, n◦ 6, November-December 2020 7. Hayami M, Fuzitani T. A case of benigh lymphocytoma found in the stroma of Bowen’s disease. Rinsho hihuka 1998; 52: 1130-3. 8. Vandaele R. Benign lymphocytoma (lymphadenoma) of the skin associated with Bowen’s disease. Arch Belg Dermatol Syphiligr 1957; 13: 494-9. 9. Maubec E, Pinquier L, Viguier M, et al. Vaccination-induced cutaneous pseudolymphoma. J Am Acad Dermatol 2005; 52: 623-9.

Coronary chronic total occlusion (CTO) is characterized by the presence of collateral blood vessels which can provide additional blood supply to CTO-artery dependent myocardium. Successful CTO recanalization is followed by significant decrease in collateral donor artery blood flow and collateral derecruitment. Study aim was to assess time-dependent changes in coronary flow reserve (CFR) in collateral donor artery after CTO recanalization and identify factors that influence these changes. Our study enrolled 31 patients with CTO scheduled for percutaneous coronary intervention (PCI). Non-invasive CFR was measured before PCI in collateral donor artery, and 24h and 6 months post-PCI in CTO and collateral donor artery. Gated SPECT MIBI was performed before PCI, while quality of life was assessed by Seattle angina questionnaire (SAQ) pre-PCI, and 6 months after PCI. Collateral donor artery showed significant increase in CFR 24h after CTO recanalization compared to pre-PCI values (2.30±0.49 vs. 2.71±0.45, p=0.005), which remained unchanged after 6 months (2.68±0.24). Maximum baseline blood flow velocity of the collateral donor artery showed significant decrease measured 24h post-PCI compared to pre-PCI values (0.28±0.06 vs. 0.24±0.04m/s), and remained similar after 6-months. There was no significant difference in maximum hyperemic blood flow velocity pre-PCI, 24h and 6 months post-PCI. CFR change of the collateral donor artery 24h post-PCI compared to pre-PCI values showed inverse correlation with left ventricle ejection fraction (LVEF) measured on SPECT. CFR changes showed no correlation with the changes in quality of life assessed by SAQ post-PCI compared to pre-PCI. Significant increase in CFR of the collateral donor artery was observed within 24h after successful recanalization of CTO artery, which maintained constant after the 6 months follow-up. This increase was largely driven by the significant reduction in the maximum baseline blood flow velocity within 24h after CTO recanalization compared to pre-PCI values. Our results suggest that possible benefit of CTO recanalization could be the improvement in physiology of the collateral donor artery. Type of funding source: None

The low environmental impact and high long-term performance of products are becoming imperative for the sustainable development of the construction industry. Alkali-activated materials (AAMs) are one of the available low-embodied-carbon alternatives to Portland cement (OPC). For their application in the marine environment or where de-icing salts are used, it is of utmost importance to demonstrate their equal or better performance compared to OPC. The aim of this study was to compare the corrosion behaviour of the steel in AAMs based on different regionally available by-products with the behaviour of the steel in OPC. The by-products used were fly ash, slag, silica fume, and iron-silica fines. The corrosion process of each system was monitored by the corrosion potential and polarisation resistance during exposure to tap water and chloride solution over a period of almost one year. Certain AAMs showed a higher resistance to chloride penetration compared to OPC, which was attributed to the smaller number of capillary pores and higher gel phase precipitation. The same corrosion resistance compared to OPC was achieved with alkali-activated fly ash and alkali-activated slag mortars. The stability of the systems in tap water and chloride solution was confirmed by the visual assessment of the steel surface at the end of the test period.

A new modified ion-selective electrode with membranes of LaF3 single crystals with different internal contacts (solid steel or electrolyte) and with FexOy nanoparticles as loading was developed. The best response characteristic with linear potential change was found in the fluoride concentration range from 10−1 to 3.98 × 10−7 M. The detection limit for the electrolyte contact was determined at 7.41 × 10−8 M with a regression coefficient of 0.9932, while the regression coefficient for the solid contact was 0.9969. The potential change per concentration decade ranged from 50.3 to 62.4 mV, depending on whether the contact was solid or electrolytic. The prepared modified electrode has a long lifetime, as well as the possibility of application in different positions (solid contact), and it can also be used for the determination of iron ions. The electrode characterization was performed with scanning electron microscopy and elemental analysis with the technique of electron-dispersive X-ray spectroscopy.

A reliable and precise model of the environment is of the highest importance for autonomous vehicles. Occupancy grids are a well-known approach for environment modeling and are a crucial part of multiple autonomous driving functionalities. The standard method is to use a single 2D occupancy grid to model the environment using nonground points. In this paper, we propose a decentralized occupancy grid filtering chain (pipeline) where a high-density 64-layer LiDAR provided the input to our pipeline. Our approach enables us to obtain detailed 2D and 3D models of the environment simultaneously. The pipeline was validated on different scenarios in both simulation and real world. The performance of the designed occupancy grid pipeline was evaluated by the proposed key performance indicators (KPIs) based on accuracy. The results have shown that the approach was able to extract free space information with a high degree of accuracy, while reducing the size of the unobserved area in the grid compared to the standard methods and achieving real-time performance.

The long‐wavelength geoid is sensitive to Earth's mantle density structure as well as radial variations in mantle viscosity. We present a suite of inversions for the radial viscosity profile using whole‐mantle models that jointly constrain the variations in density, shear‐ and compressional‐wavespeeds using full‐spectrum tomography. We use a Bayesian approach to identify a collection of viscosity profiles compatible with the geoid, while enabling uncertainties to be quantified. Depending on tomographic model parameterization and data weighting, it is possible to obtain models with either positive‐ or negative‐buoyancy in the large low shear velocity provinces. We demonstrate that whole‐mantle density models in which density and VS variations are correlated imply an increase in viscosity below the transition zone, often near 1,000 km. Many solutions also contain a low‐viscosity channel below 650 km. Alternatively, models in which density is less‐correlated with VS—which better fit normal mode data—require a reduced viscosity region in the lower mantle. This feature appears in solutions because it reduces the sensitivity of the geoid to buoyancy variations in the lowermost mantle. The variability among the viscosity profiles obtained using different density models is indicative of the strong nonlinearities in modeling the geoid and the limited resolving power of the geoid kernels. We demonstrate that linearized analyses of model resolution do not adequately capture the posterior uncertainty on viscosity. Joint and iterative inversions of viscosity, wavespeeds, and density using seismic and geodynamic observations are required to reduce bias from prior assumptions on viscosity variation and scalings between material properties.

In this paper, we propose a convolutional neural network (CNN) aided automatic modulation recognition (AMR) method for a multiple antenna system. We also present two specific combination strategies, such as the relative majority voting method and arithmetic mean method to improve the classification performance in comparison with the state of the art. Our results are given to verify that the proposed method dominant exploits features and classify the modulation types with higher accuracy in comparison with the AMR employing high order cumulants (HOC) and artificial neural networks (ANN).