This study aims to estimate the risk factors of gastrointestinal (GI) bleeding in patients with acute coronary syndrome (ACS) and to evaluate the optimal duration of dual antiplatelet therapy (DAPT).
...We enrolled 1266 patients with ACS in a telephone follow-up program to determine whether any of the patients were hospitalized for GI bleeding. We collected baseline data, laboratory tests, electrocardiograms, and echocardiography covering all ACS patients. Multivariable regression was performed to adjust for confounders and predictors of GI bleeding. At the same time, the optimal duration of DAPT for ACS patients was evaluated.
A total of 1061 ACS patients were included in the study. After 13-68 months, 48 patients (4.5%) were hospitalized for GI bleeding. The risk of GI bleeding was significantly increased in patients treated with DAPT for more than 18 months (hazard ratio 12.792, 5.607-29.185,
< 0.01). Receiver Operating Characteristic curve showed that the duration of DAPT using a cutoff of 14.5 months resulted in a sensitivity of 66.7% and a specificity of 77%.
In patients with ACS, DAPT time are the main risk factors of GI bleeding. The optimal duration of DAPT is 14.5 months.
The incorporation of ceramic particulate reinforcements into titanium alloys can improve the specific strength and specific stiffness, while inevitably reduce the plasticity and ductility. In this ...study, in situ synthesized multilayer Ti-(TiB+La2O3)/Ti composite was designed by learning from the microstructure of nature biological materials with excellent mechanical properties. The Ti-(TiB+La2O3)/Ti composite with unique characteristic of laminated structure was prepared by combined powder metallurgy and hot rolling. The method has the synthesize advantages with in-situ reaction of Ti and LaB6 at high temperature and controllability of reinforcements size and constituent phases in composites. The result shows that the pores in the as sintered laminated structure composite completely disappeared after hot rolling at 1050°C. The agglomerated reinforcement particles were well dispersed and distributed uniformly along the rolling direction. The thickness of pure Ti layer and (TiB+La2O3)/Ti composite layer decreased from 1mm to about 200μm. Meanwhile, the grains size was refined obviously after rolling deformation. The room temperature tensile test indicates that the elongation of the laminated Ti-(TiB+La2O3)/Ti composite improved from 13% to 17% in comparison with the uniform (TiB+La2O3)/Ti composite, while the tensile strength had little change. It provides theoretical and experimental basis for fabricating the novel high performance laminated Ti-(TiB+La2O3)/Ti composites.
In this study, we report a novel approach to enhance strength and stiffness in titanium alloys while maintaining ductility. We prepared a two-scale laminated structured titanium matrix composite ...(TMC) using graphene nanoplatelets (GNPs) introduced into a Ti6Al4V matrix. The intrinsic structure of the GNPs was preserved, and an appropriate interface reaction facilitated strong bonding. Strengthening and toughening effects were achieved through uniform distribution, diverse interface designs, firm interface bonding, and laminated architecture. Our results demonstrate that the laminated GNPs/Ti6Al4V composite exhibits excellent strength-ductility synergy, with an enhanced yield strength (+163.35 MPa compared to pure Ti6Al4V) while maintaining a good ductility of 17.39%. This study presents a practical approach to achieving a balance between strength and ductility in titanium matrix composites.
•A novel two-scale laminated structured titanium matrix composite were designed and fabricated.•Homogeneous layers and reinforcements were obtained in the laminated composites.•The strengthening and toughening mechanism of the two-scale laminated titanium matrix composites were discussed in detail.
The introduction of particulate reinforcements into titanium alloys can improve the strength and stiffness, but it generally results in unsatisfactory plasticity and ductility. In this study, in situ ...synthesized multilayer titanium matrix composites were designed and fabricated by learning from the microstructure of nature biological materials with attractive mechanical properties. Laminated Ti-(TiB+La2O3)/Ti composites with different reinforcement volume fraction were fabricated through powder metallurgy, followed by hot rolling process. The results show that pore defects, TiB whisker and large La2O3 particle agglomerates can be observed in the composites after vacuum sintering at 1573K, further the pores are disappeared and the grains are refined significantly after hot rolling at 1323K. Meanwhile, the reinforcements agglomerates are well dispersed and distributed uniformly along the rolling direction. The tensile testing results indicate that the Ti-10vol.% (TiB+La2O3)/Ti composite shows promising mechanical properties due to the configuration design of laminated structure, which results in an improvement of 30% in elongation with <4% decline in tensile strength compared with 5vol.% (TiB+La2O3)/Ti composites. Moreover, further increase in reinforcement volume fraction leads to slight increase in tensile strength and significant decrease in elongation due to the increasing of large La2O3 agglomerates.
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•Laminated titanium matrix composites were designed and fabricated.•Homogeneous layers and reinforcements were obtained in the laminated composites.•Both the tensile strength and ductility are improved by the laminated structure.•Large flocculent La2O3 particles are harmful to the tensile properties.
The incorporation of ceramic particulate reinforcements into titanium alloys can improve the specific strength and specific stiffness,while inevitably reduce the plasticity and ductility.In this ...study,in situ synthesized multilayer Ti-（TiB +La2O3）/Ti composite was designed by learning from the microstructure of nature biological materials with excellent mechanical properties.The Ti-（TiB + La2O3）/Ti composite with unique characteristic of laminated structure was prepared by combined powder metallurgy and hot rolling.The method has the synthesize advantages with in-situ reaction of Ti and LaB6 at high temperature and controllability of reinforcements size and constituent phases in composites.The result shows that the pores in the as sintered laminated structure composite completely disappeared after hot rolling at 1050℃.The agglomerated reinforcement particles were well dispersed and distributed uniformly along the rolling direction.The thickness of pure Ti layer and（TiB+La2O3）/Ti composite layer decreased from 1 mm to about 200 μm.Meanwhile,the grains size was refined obviously after rolling deformation.The room temperature tensile test indicates that the elongation of the laminated Ti-（TiB + La2O3）/Ti composite improved from 13%to 17%in comparison with the uniform（TiB + La2O3）/Ti composite,while the tensile strength had little change.It provides theoretical and experimental basis for fabricating the novel high performance laminated Ti-（TiB + La2O3）/Ti composites.
Genomic DNA is folded into a higher-order structure that regulates transcription and maintains genomic stability. Although progress has been made on understanding biochemical characteristics of ...epigenetic modifications in cancer, the in-situ higher-order folding of chromatin structure during malignant transformation remains largely unknown. Here, using optimized stochastic optical reconstruction microscopy (STORM) for pathological tissue (PathSTORM), we uncover a gradual decompaction and fragmentation of higher-order chromatin folding throughout all stages of carcinogenesis in multiple tumor types, and prior to tumor formation. Our integrated imaging, genomic, and transcriptomic analyses reveal functional consequences in enhanced transcription activities and impaired genomic stability. We also demonstrate the potential of imaging higher-order chromatin disruption to detect high-risk precursors that cannot be distinguished by conventional pathology. Taken together, our findings reveal gradual decompaction and fragmentation of higher-order chromatin structure as an enabling characteristic in early carcinogenesis to facilitate malignant transformation, which may improve cancer diagnosis, risk stratification, and prevention.
A large volume of wastewater containing low concentrations of uranium is generated owing to the development and utilization of nuclear energy, which poses an environmental hazard. Therefore, an ...efficient strategy to remove uranium from the wastewater is important. In this study, a novel adsorbent, namely aMSP/SA, was prepared by immobilizing amino-functionalized mesoporous silica (aMSP) with sodium alginate (SA) for removing low concentration hexavalent U(VI), which is mobile and soluble. The effects of pH, initial concentration, time, temperature, coexisting ions, and regeneration on the removal efficiency of uranium by aMSP/SA were investigated. Results show that the saturated adsorption capacity of aMSP/SA for uranium was 210 mg/g at pH 4.0 and 313 K, and the concentration of U(VI) could be reduced from 1.0 mg/L to 1.31 μg/L. The aMSP/SA shows a high efficiency uranium removal of 99.41% in mine water and affinity toward uranium in a mixed metal solution. Additionally, the structure and possible adsorption mechanism of aMSP/SA were characterized by Fourier transform infrared spectrometer (FTIR), X-ray photoelectron spectroscopy (XPS), scanning electron microscope (SEM), and energy-dispersive spectrometry (EDS). The main interaction mechanisms may be explained by ion exchange with Ca2+ on carboxyl and coordination with hydroxyl and amino groups. This study highlights that a high removal efficiency (99.87% for 1.0 mg/L) and easy separation of large particle sizes (3–4 mm) makes aMSP/SA a promising material for eliminating low concentration U(VI) in industrial applications.
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•Applying aMSP/SA can reduce the concentration of U(VI) from 1.0 mg/L to 1.3 μg/L.•The removal efficiency of U(VI) from practical mine water by aMSP/SA is 99.41%.•The aMSP/SA shows selectivity toward uranium in a mixed metal solution.•The removal mechanisms are mainly related to ion-exchange and coordination.
•There had a good synergistic effect in hydrated gelling systems containing FA, SS and FGD.•The observed the synergy effect between FA, FGD and SS was attributed to produce more C-S-H gel and promote ...the secondary reaction of C-S-H.
This paper presented the synergistic effects with respect to compressive strength in hydrated gel systems containing fly ash (FA), flue gas desulfurization gypsum (FGD) and steel slag (SS). The compressive strength of ternary, binary and unary gel system blocks were primarily investigated, and then the block of highest compressive strength in each gel system was selected to optimize its ratio of raw materials. The results showed that the compressive strength of the complex gel blocks in different gel systems changed as follows: ternary system > binary system > unary system, in addition, the blocks with highest compressive strength in binary and unary systems were SS-FA gel block and SS gel block. Due to the optimized ratio of raw materials, there was an enhancement of compressive strength for binary (SS-FA) and ternary system blocks. For a ternary mixture containing 20% FA, 70% SS and 10% FGD, the synergistic effect was observed mostly at 28 days and it resulted in the highest compressive strength and lowest water absorption. Studies water durability revealed the gel blocks submerged in distilled water exhibited better strength development than that cured in air-dry. In this study, XRD, SEM and TGA were used to analyze the mineral composition, microstructure and thermal weight loss characteristics of different gel system blocks in order to determine the source of the synergy and quantify its magnitude. The results indicated that the observed the synergy effect between FA, FGD and SS was attributed to produce more hydrated calcium silicate (C-S-H) and new hydration products (eg. ettringite and C-S-H with a low calcium silicon ratio).
Multidrug-resistant plasmid-carrying bacteria are of particular clinical concern as they could transfer antibiotic resistance genes to other bacterial species. However, little is known whether ...evolutionary adaptation of plasmid-carrying bacteria after long-term antibiotic exposure could affect their subsequent colonization of the human gut. Herein, we combined a long-term evolutionary model based on Escherichia coli K-12 MG1655 and the multidrug-resistant plasmid RP4 with in vivo colonization experiments in mice. We found that the evolutionary adaptation of plasmid-carrying bacteria to antibiotic exposure facilitated colonization of the murine gut and subsequent plasmid transfer to gut bacteria. The evolved plasmid-carrying bacteria exhibited phenotypic alterations, including multidrug resistance, enhanced bacterial growth and biofilm formation capability and decreased plasmid fitness cost, which might be jointly caused by chromosomal mutations (SNPs in rpoC, proQ, and hcaT) and transcriptional modifications. The upregulated transcriptional genes, e.g., type 1 fimbrial-protein pilus (fimA and fimH) and the surface adhesin gene (flu) were likely responsible for the enhanced biofilm-forming capacity. The gene tnaA that encodes a tryptophanase-catalyzing indole formation was transcriptionally upregulated, and increased indole products participated in facilitating the maximum population density of the evolved strains. Furthermore, several chromosomal genes encoding efflux pumps (acriflavine resistance proteins A and B (acrA, acrB), outer-membrane protein (tolC), multidrug-resistance protein (mdtM), and macrolide export proteins A and B (macA, macB)) were transcriptionally upregulated, while most plasmid-harboring genes (conjugal transfer protein (traF) and (trbB), replication protein gene (trfA), beta-lactamase TEM precursor (bla
), aminoglycoside 3'-phosphotransferase (aphA) and tetracycline resistance protein A (tetA)) were downregulated. Collectively, these findings demonstrated that evolutionary adaptation of plasmid-carrying bacteria in an antibiotic-influenced environment facilitated colonization of the murine gut by the bacteria and plasmids.
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