Optimal antiplatelet monotherapy during the chronic maintenance period in patients who undergo coronary stenting is unknown. We aimed to compare head to head the efficacy and safety of aspirin and ...clopidogrel monotherapy in this population.
We did an investigator-initiated, prospective, randomised, open-label, multicentre trial at 37 study sites in South Korea. We enrolled patients aged at least 20 years who maintained dual antiplatelet therapy without clinical events for 6–18 months after percutaneous coronary intervention with drug-eluting stents (DES). We excluded patients with any ischaemic and major bleeding complications. Patients were randomly assigned (1:1) to receive a monotherapy agent of clopidogrel 75 mg once daily or aspirin 100 mg once daily for 24 months. The primary endpoint was a composite of all-cause death, non-fatal myocardial infarction, stroke, readmission due to acute coronary syndrome, and Bleeding Academic Research Consortium (BARC) bleeding type 3 or greater, in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT02044250.
Between March 26, 2014, and May 29, 2018, we enrolled 5530 patients. 5438 (98·3%) patients were randomly assigned to either the clopidogrel group (2710 49·8%) or to the aspirin group (2728 50·2%). Ascertainment of the primary endpoint was completed in 5338 (98·2%) patients. During 24-month follow-up, the primary outcome occurred in 152 (5·7%) patients in the clopidogrel group and 207 (7·7%) in the aspirin group (hazard ratio 0·73 95% CI 0·59–0·90; p=0·0035).
Clopidogrel monotherapy, compared with aspirin monotherapy during the chronic maintenance period after percutaneous coronary intervention with DES significantly reduced the risk of the composite of all-cause death, non-fatal myocardial infarction, stroke, readmission due to acute coronary syndrome, and BARC bleeding type 3 or greater. In patients requiring indefinite antiplatelet monotherapy after percutaneous coronary intervention, clopidogrel monotherapy was superior to aspirin monotherapy in preventing future adverse clinical events.
ChongKunDang, SamJin, HanMi, DaeWoong, and the South Korea Ministry of Health and Welfare.
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•Removal behaviors of different constituents within landfill leachate were tracked.•Firstly using 2D-COS to explore sequential changes upon Fenton oxidation.•Preferential removal ...occurred in the order of C3 > C2 > C1 with higher H2O2.•Changes occurred in the order of aromatic > carboxylic > aldehyde functional groups.•Hetero 2D-COS revealed association of aromatic and carboxylic groups with C1 and C3.
In this work, the changes of different organic constituents in landfill leachate were tracked in Fenton oxidation processes with different operation parameters including H2O2 doses, pH, and the ratios of H2O2/Fe via fluorescence excitation emission matrix – parallel factor analysis (EEM-PARAFAC) and two-dimensional correlation spectroscopy (2D-COS). One tryptophan-like (C1), one fulvic-like (C2), and one humic-like (C3) components were identified in the leachates. The removal behaviors of the individual fluorescent components were dependent upon the operation conditions, suggesting the existence of unique characteristics with respect to the responses to the oxidation mechanisms, which were likely altered by different operation conditions. For all tested conditions, a greater extent of removal was consistently found for C3 versus C1 and C2 except for the relatively high pH ranges (>6.0), in which C2 presented the highest removal rates. 2D-COS combined with synchronous fluorescence spectra exhibited the preferential oxidation sequence in the order of C3 > C1 > C2 with higher H2O2 doses. 2D-COS coupled with Fourier transform infrared (2D-COS-FTIR) showed that aromatic functional groups were initially oxidized, followed by the removal of carboxylic groups and the formation of inorganic functional groups and aldehyde or ketonic groups. Hetero 2D-COS maps further revealed the close association between the aromatic groups and C3, and between the carboxylic groups and C1. This study utilizing 2D-COS provided new insights into the dynamic behavior of heterogeneous landfill leachate in Fenton oxidation processes under varying operation conditions.
Various biochars (BCs) have been developed to remove heavy metals contained in road runoff; however, there is insufficient information regarding the competitive adsorption efficiency of modified BC ...with regard to heavy metals due to a lack of comparative evaluation based on BC properties and modification methods. In this study, three different types of BC (RBC: rice husk, WBC: wood chip, MBC: mixture) were modified following five different methods: acidic, alkaline, oxidic, and manganese oxide (MnOx) and iron oxide (FeOx) impregnation. The changes in the physicochemical and morphological properties of the modified BC were investigated, and the adsorption characteristics of three heavy metals (Cd, Pb, and Zn) under single and mixed conditions were compared and evaluated. The improvements in the BC properties varied for different BC types and modification methods; in particular, alkaline and manganese modification caused substantial the changes in the surface area and functional groups (such as aromatic ring, –OH, and Mn–O groups). The BC prepared by manganese oxide impregnation absorbed a high amount of heavy metals (>9.15 mg/g) even under mixed conditions through cation exchange and surface complexation. The distribution coefficient (Kd) of heavy metals was high in the order of Pb > Cd > Zn; thus, the adsorption of Pb replaced that of Zn in competitive adsorption due to the difference in their affinity to BC. Therefore, the results suggest that BC prepared by manganese oxide impregnation is suitable for removing heavy metals from road runoff, as it maintained high heavy metals adsorption regardless of the BC material, even under competitive conditions.
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•Biochar (BC) types were modified by different methods for heavy metal removal.•Physicochemical and morphological properties of the modified BC were examined.•Physical properties of RBC and chemical properties of BCs showed major changes.•Irrespective of BC type, manganese oxide-impregnated BC had the highest adsorption.•Competitive adsorption depended on the intrinsic properties of the heavy metals.
Biochar (BC) application has the potential to be integrated into a carbon-trading framework owing to its multiple environmental and economic benefits. Despite the increasing research attention over ...the past ten years, the mechanisms of BC-induced priming effects on soil organic carbon mineralization and their influencing factors have not been systematically considered. This review aims to document the recent progress in BC research by focusing on (1) how BC-induced priming effects change the soil environment, (2) the factors governing the mechanisms underlying BC amendment effects on soils, and (3) how BC amendments alter soil microbial communities and nutrient dynamics. Here, we carried out a detailed examination of the origins of different biochar, its pyrolysis conditions, and potential interactions with various factors that affect BC characteristics and mechanisms of C mineralization in primed soil. These findings clearly addressed the strong linkage between BC properties and abiotic factors that leads to change the soil microclimate, priming effects, and carbon stabilization. This review offers an overview of a fragmented body of evidence and the current state of understanding to support the application of BC in different soil environments with the aim of sustaining or improving the agricultural crop production.
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•A mechanistic overview of BC-induced priming effect (PE) is presented in the review.•Interactive effects of biochar, SOM, and soil microflora are clearly explained.•Influencing factors from BC and soil on PE are critically evaluated from various perspectives.•BC effects on nutrients recycling are clarified and summarized
Using surface functionalization and related applications to 2D materials as innovative solutions to environmental pollution has gained considerable attention among researchers. Fluorinated graphene ...has derivative-based synergistic components with high thermal and chemical stability because of its structure and bonding. Fluorine-functionalized reduced graphene oxide (rFGO-TiO2) demonstrated enhanced hydrophilicity and wettability, highly efficient photocatalytic disinfection, and an algicidal effect. This study presents the hydrothermal synthesis of rFGO-TiO2 to realize antibacterial properties with high stability, which was conducted against the gram-negative bacteria Escherichia coli. To optimize antibacterial performance, the effects of multiple synthetic conditions were investigated. The antibacterial performance was optimized at an rFGO content of 1 wt%, hydrothermal temperature of 200 °C, and hydrothermal time of 1 h. The rFGO–TiO2 composite demonstrated an antibacterial efficiency of 5.76 log under ultraviolet A irradiation for 10 min and around 2 log under visible light. In the absence of light, rFGO–TiO2 took 6 h to reach an antibacterial efficiency of 6 log. Increasing the rFGO content and hydrothermal temperature beyond the optimal conditions reduced the antibacterial efficiency because of the excess rFGO and disruption of rFGO–TiO2 binding. Measurements with electron spin resonance spectroscopy confirmed that hydroxyl radicals and superoxide ions caused stress and damaged the membrane of a cell, which led to cell death.
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•RFGO-TiO2 was synthesized by applying an ecofriendly hydrothermal method.•The disinfection properties of rFGO-TiO2 against E. coli were investigated.•The algicidal properties of rFGO-TiO2 against M. aeruginosa were investigated.•RFGO-TiO2 showed high efficiency throughout over 10-cycles of repetition test.
In patients with acute myocardial infarction receiving potent antiplatelet therapy, the bleeding risk remains high during the maintenance phase. We sought data on a uniform unguided de-escalation ...strategy of dual antiplatelet therapy (DAPT) from ticagrelor to clopidogrel after acute myocardial infarction.
In this open-label, assessor-masked, multicentre, non-inferiority, randomised trial (TALOS-AMI), patients at 32 institutes in South Korea with acute myocardial infarction receiving aspirin and ticagrelor without major ischaemic or bleeding events during the first month after index percutaneous coronary intervention (PCI) were randomly assigned in a 1:1 ratio to a de-escalation (clopidogrel plus aspirin) or active control (ticagrelor plus aspirin) group. Unguided de-escalation without a loading dose of clopidogrel was adopted when switching from ticagrelor to clopidogrel. The primary endpoint was a composite of cardiovascular death, myocardial infarction, stroke, or bleeding type 2, 3, or 5 according to Bleeding Academic Research Consortium (BARC) criteria from 1 to 12 months. A non-inferiority test was done to assess the safety and efficacy of de-escalation DAPT compared with standard treatment. The hazard ratio (HR) for de-escalation versus active control group in a stratified Cox proportional hazards model was assessed for non-inferiority by means of an HR margin of 1·34, which equates to an absolute difference of 3·0% in the intention-to-treat population and, if significant, a superiority test was done subsequently. To ensure statistical robustness, additional analyses were also done in the per-protocol population. This trial is registered at ClinicalTrials.gov, NCT02018055.
From Feb 26, 2014, to Dec 31, 2018, from 2901 patients screened, 2697 patients were randomly assigned: 1349 patients to de-escalation and 1348 to active control groups. At 12 months, the primary endpoints occurred in 59 (4·6%) in the de-escalation group and 104 (8·2%) patients in the active control group (pnon-inferiority<0·001; HR 0·55 95% CI 0·40–0·76, psuperiority=0·0001). There was no significant difference in composite of cardiovascular death, myocardial infarction, or stroke between de-escalation (2·1%) and the active control group (3·1%; HR 0·69; 95% CI 0·42–1·14, p=0·15). Composite of BARC 2, 3, or 5 bleeding occurred less frequently in the de-escalation group (3·0% vs 5·6%, HR 0·52; 95% CI 0·35–0·77, p=0·0012).
In stabilised patients with acute myocardial infarction after index PCI, a uniform unguided de-escalation strategy significantly reduced the risk of net clinical events up to 12 months, mainly by reducing the bleeding events.
ChongKunDang Pharm, Medtronic, Abbott, and Boston Scientific.
Rapid antigen (Ag) tests for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) provide quick results, do not require specialized technical skills or infrastructure, and ...can be used as a point-of-care method to prevent the spread of coronavirus disease (COVID-19). The performance of a magnetic force-assisted electrochemical immunoassay-based test, namely the MARK-B COVID-19 Ag test (BBB, Sungnam, Republic of Korea), was evaluated using 170 nasopharyngeal swab specimens and compared to that of RT-PCR and commercial rapid Ag test (STANDARD Q COVID-19 Ag Test, SD Biosensor, Suwon-si, Republic of Korea). The overall sensitivity and specificity of the MARK-B test were 90.0% (95% CI 79.4%-96.2%) and 99.0% (95% CI 95.0%-99.9%), respectively, with a kappa coefficient of 0.908. The correlations between the electrical current values of MARK-B and the Ct values of RT-PCR were -0.898 (E gene, 95% CI -0.938 to -0.834) and -0.914 (RdRp gene, 95% CI -0.948 to -0.860), respectively. The limit of detection of the MARK-B was measured using the viral culture reference samples and found to be 1 x 10.sup.2 pfu/mL. The magnetic force-assisted electrochemical immunoassay-based Ag test can be used to rapidly detect SARS-CoV-2 infections, and the corresponding fully automated portable device can provide easy readability and semi-quantitative results.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Muscle development and lipid accumulation in muscle critically affect meat quality of livestock. However, the genetic factors underlying myofiber-type specification and intramuscular fat (IMF) ...accumulation remain to be elucidated. Using two independent intercrosses between Western commercial breeds and Korean native pigs (KNPs) and a joint linkage-linkage disequilibrium analysis, we identified a 488.1-kb region on porcine chromosome 12 that affects both reddish meat color (a*) and IMF. In this critical region, only the MYH3 gene, encoding myosin heavy chain 3, was found to be preferentially overexpressed in the skeletal muscle of KNPs. Subsequently, MYH3-transgenic mice demonstrated that this gene controls both myofiber-type specification and adipogenesis in skeletal muscle. We discovered a structural variant in the promotor/regulatory region of MYH3 for which Q allele carriers exhibited significantly higher values of a* and IMF than q allele carriers. Furthermore, chromatin immunoprecipitation and cotransfection assays showed that the structural variant in the 5'-flanking region of MYH3 abrogated the binding of the myogenic regulatory factors (MYF5, MYOD, MYOG, and MRF4). The allele distribution of MYH3 among pig populations worldwide indicated that the MYH3 Q allele is of Asian origin and likely predates domestication. In conclusion, we identified a functional regulatory sequence variant in porcine MYH3 that provides novel insights into the genetic basis of the regulation of myofiber type ratios and associated changes in IMF in pigs. The MYH3 variant can play an important role in improving pork quality in current breeding programs.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Home blood pressure (HBP) is useful to decide whether blood pressure (BP) is controlled. However, applying HBP to daily clinical practices is still challenging without easy access to the average HBP. ...Therefore, we developed a simple method to make a quick decision regarding the controlledness of HBP through high BP counts. We simulated 100 cases of HBP series for each combination of 3 numbers of BP readings (K = 16, 20, 24) and 4 levels of the standard deviations (SDs = 5, 10, 15, 20). A high BP was defined as an individual BP ≥ 135/85 mmHg, and an uncontrolled HBP was defined as a mean HBP ≥ 135/85 mmHg. Validation for the decision method was conducted using actual HBP data. The C-statistics and the accuracy of the high BP counts for the uncontrolled HBP were generally high (> 0.85) for all combinations of Ks and SDs and decreased as SDs increased but remained steady as Ks increased. In validation, the C-statistic of the high BP count-to-total BP reading (C/T) ratio was 0.985, and the C/T ratio ≥ 0.5 showed a sensitivity of 0.957, a specificity of 0.907, and an accuracy of 0.927. The count-based decision method can provide an accurate quick assessment of the controlledness of HBP.
To gain insight into factors that lead to dissociation of Bax from a complex with Hsp70 during apoptosis, we recently constructed a fluorescence resonance energy transfer (FRET) system composed of ...the Hsp70‐YFP (YFP=yellow fluorescent protein) fusion protein and fluorescent amino acid (ANAP=6‐acetyl(naphthalen‐2‐ylamino)‐2‐aminopropanoic acid)‐containing Bax (Bax‐ANAP), which was produced by using the genetic code expansion technique. In the current study, the FRET system was employed to elucidate how brefeldin A (an endoplasmic reticulum stress inducer), chlorpromazine and apoptozole (lysosomal membrane destabilizers), bafilomycin A1 (an inhibitor of lysosomal acidification) as well as raptinal and Az‐TPP‐O3 (mitochondria‐targeted apoptosis inducers) affect the interaction between Bax and Hsp70. Analyses of single live cell images together with results of co‐immunoprecipitation assays reveal that brefeldin A, chlorpromazine, and apoptozole promote dissociation of the Bax/Hsp70 complex through activation of the activator BH3‐only protein. However, the results show that bafilomycin A1, raptinal, and Az‐TPP‐O3 have no influence on the interaction of Bax with Hsp70. The combined observations made in the current and previous studies demonstrate that the FRET system consisting of Bax‐ANAP and Hsp70‐YFP is highly useful to understand apoptotic processes associated with the Bax–Hsp70 interaction.
Understanding interactions: To elucidate how organelle‐targeting substances affect the Bax–Hsp70 interaction, a FRET system of Hsp70‐YFP and ANAP‐Bax was employed. Our results reveal that brefeldin A, chlorpromazine and apoptozole promote dissociation of the Bax/Hsp70 complex but bafilomycin A1, raptinal and Az‐TPP‐O3 have no influence on the interaction of Bax with Hsp70.
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