Many recent trials have investigated the long-term efficacy and safety of endarterectomy versus stenting in treating patients with carotid artery stenosis. We aimed to determine the long-term ...comparative efficacy and safety of both procedures by pooling this evidence in a meta-analysis.
We searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials for studies published until May 6, 2016. Randomized controlled trials, which reported outcomes of interest with a median follow-up of at least 4-year, were included.
Eight trials involving 7005 patients and 41824 patient-years of follow-up were included. In terms of the periprocedural outcomes, stenting was associated with a lower risk of myocardial infarction (OR: 0.51; 95% CI: 0.33 to 0.80; P = 0.003) but a higher risk of death or stroke (the composite endpoint, OR: 1.76; 95% CI: 1.38 to 2.25; P < 0.0001), a result that was primarily driven by minor stroke (OR: 2.19; 95% CI: 1.59 to 3.01; P < 0.0001), less so by periprocedural death (OR: 1.68; 95% CI: 0.82 to 3.44; P = 0.16) and major stroke (OR: 1.41; 95% CI: 0.95 to 2.09; P = 0.09). In terms of the long-term outcomes, stenting was associated with a higher risk of stroke (OR 1.45; 95% CI: 1.22 to 1.73; P < 0.0001) and the composite outcome of death or stroke (OR 1.25; 95% CI: 1.05 to 1.48; P = 0.01). No difference was found in long-term all-cause mortality between stenting and endarterectomy (OR: 1.09; 95% CI: 0.95 to 1.26; P = 0.21) and restenosis (OR: 1.48 (95% CI: 0.93 to 2.35; P = 0.10). No evidence of significant heterogeneity was found in any of the analyses.
Carotid endarterectomy was found to be superior to stenting for short- and long-term outcomes, although endarterectomy was associated with a higher risk of periprocedural myocardial infarction. Carotid endarterectomy should be offered as the first choice for carotid stenosis at present, however, more evidence is needed because rapid progress in concurrent devices and medical treatments is being made.
The nitrogenous nucleophile electrooxidation reaction (NOR) plays a vital role in the degradation and transformation of available nitrogen. Focusing on the NOR mediated by the β‐Ni(OH)2 electrode, we ...decipher the transformation mechanism of the nitrogenous nucleophile. For the two‐step NOR, proton‐coupled electron transfer (PCET) is the bridge between electrocatalytic dehydrogenation from β‐Ni(OH)2 to β‐Ni(OH)O, and the spontaneous nucleophile dehydrogenative oxidation reaction. This theory can give a good explanation for hydrazine and primary amine oxidation reactions, but is insufficient for the urea oxidation reaction (UOR). Through operando tracing of bond rupture and formation processes during the UOR, as well as theoretical calculations, we propose a possible UOR mechanism whereby intramolecular coupling of the N−N bond, accompanied by PCET, hydration and rearrangement processes, results in high performance and ca. 100 % N2 selectivity. These discoveries clarify the evolution of nitrogenous molecules during the NOR, and they elucidate fundamental aspects of electrocatalysis involving nitrogen‐containing species.
During urea electrooxidation over a Ni(OH)2 electrode the dehydrogenation reaction from β‐Ni(OH)2 to β‐Ni(OH)O can lead to spontaneous urea dehydrogenation. Spontaneous intramolecular coupling of the N−N bond and hydration of urea dehydrogenation intermediates play important roles in the oxidation path from urea to N2 and CO2.
The use of nitrogen fertilizers has been estimated to have supported 27% of the world’s population over the past century. Urea (CO(NH2)2) is conventionally synthesized through two consecutive ...industrial processes, N2 + H2 → NH3 followed by NH3 + CO2 → urea. Both reactions operate under harsh conditions and consume more than 2% of the world’s energy. Urea synthesis consumes approximately 80% of the NH3 produced globally. Here we directly coupled N2 and CO2 in H2O to produce urea under ambient conditions. The process was carried out using an electrocatalyst consisting of PdCu alloy nanoparticles on TiO2 nanosheets. This coupling reaction occurs through the formation of C–N bonds via the thermodynamically spontaneous reaction between *N=N* and CO. Products were identified and quantified using isotope labelling and the mechanism investigated using isotope-labelled operando synchrotron-radiation Fourier transform infrared spectroscopy. A high rate of urea formation of 3.36 mmol g–1 h–1 and corresponding Faradic efficiency of 8.92% were measured at –0.4 V versus reversible hydrogen electrode.Conventionally, urea is synthesized via two consecutive processes, N2 + H2 → NH3 followed by NH3 + CO2. Now, an electrocatalyst consisting of PdCu alloy nanoparticles on TiO2 nanosheets has been shown to directly couple N2 and CO2 in H2O to produce urea under ambient conditions.
Probiotic pretreatment is an effective non-antibiotic strategy for preventing or controlling Salmonella infections. We found that Lactobacillus johnsonii L531, isolated from the colon of a clinically ...healthy weaned piglet, effectively prevented infection with Salmonella enterica serovar Infantis in a pig model. Newly weaned piglets were intragastrically administered Lactobacillus johnsonii L531 at 1.0 × 10
CFU/day for 1 week before S. Infantis challenge. Pretreatment with L. johnsonii L531 lessened the severity of diarrhea and ileal inflammation in S. Infantis-infected piglets. Lactobacilli were more abundant in the ileum than jejunum after L. johnsonii L531 pretreatment. Treatment with L. johnsonii L531 reduced the abundance of total bacteria in the ileal mucosa and the production of lipocalin 2 in the jejunum of piglets challenged with Salmonella. Both intestinal morphology and transmission electron microscopy results indicated that L. johnsonii L531 alleviated intestinal tissue damage following S. Infantis challenge, especially in the villus and endoplasmic reticulum (ER). ER stress induced by S. Infantis was attenuated by L. johnsonii L531 treatment. The number of CD4
CCR6
T cells decreased following S. Infantis challenge, but the percentage of CCR6
IFNγ
T cells in peripheral blood increased. In intestinal mesenteric lymph nodes, S. Infantis increased the proportion of CCR6
IFNγ
T cells, whereas L. johnsonii L531 induced an increase in the proportion of CD4
CCR6
T cells in response to S. Infantis infection. Our data thus suggest that L. johnsonii L531 contributes to the maintenance of intestinal homeostasis by modulating T-cell responses and ER stress.
Lithium is becoming increasingly important due to its essential role in lithium-ion batteries. Over 70% of the global lithium resources are found in salt lake brines, where lithium is always ...accompanied by magnesium. The system of TBP (tributyl phosphate)/FeCl3 has been widely studied for selective lithium extraction from high Mg-containing salt lake brines. However, the system requires a high concentration of HCl for lithium stripping, which causes equipment corrosion, consumes large amounts of reagents, and requires careful neutralization of the organic phase for regeneration. In this study, we develop a novel ternary synergistic solvent extraction system of TBP/FeCl3/P507 (P507 is 2-ethylhexyl phosphonic acid mono 2-ethylhexyl) to significantly enhance the stripping of lithium while largely maintaining lithium extraction capacity. During lithium extraction from Mg-containing solutions, TBP and FeCl3 coordinate with lithium in the form of Li·2TBP·FeCl4, while P507 is not involved in the coordination. When the loaded organic phase is contacted with water, P507 and TBP synergistically coordinate with Fe3+ in the form of FeCl2L·(HL)·2TBP (HL denotes P507), leading to efficient stripping of lithium due to the breaking of the coordination structure of Li·2TBP·FeCl4, and Fe3+ is maintained in the organic phase for the next extraction cycle. The efficient stripping of lithium using only water, instead of high concentration HCl, is a key step forward toward the sustainable extraction of lithium from brines.
Background and Purpose
Atherosclerosis induced by cyclosporine A (CsA), an inhibitor of the calcineurin/nuclear factor of activated T cells (NFAT) pathway, is a major concern after organ ...transplantation. However, the atherosclerotic mechanisms of CsA remain obscure. We previously demonstrated that calcineurin/NFAT signalling inhibition contributes to atherogenesis via suppressing microRNA‐204 (miR‐204) transcription. We therefore hypothesised that miR‐204 is involved in the development of CsA‐induced atherosclerosis.
Experimental Approach
ApoE−/− mice with macrophage‐miR‐204 overexpression were generated to determine the effects of miR‐204 on CsA‐induced atherosclerosis. Luciferase reporter assays and chromatin immunoprecipitation sequencing were performed to explore the targets mediating miR‐204 effects.
Key Results
CsA alone did not significantly affect atherosclerotic lesions or serum lipid levels. However, it exacerbated high‐fat diet‐induced atherosclerosis and hyperlipidemia in C57BL/6J and ApoE−/− mice, respectively. miR‐204 levels decreased in circulating monocytes and plaque lesions during CsA‐induced atherosclerosis. The upregulation of miR‐204 in macrophages inhibited CsA‐induced atherosclerotic plaque formation but did not affect serum lipid levels. miR‐204 limited the CsA‐induced foam cell formation by reducing the expression of the scavenger receptors SR‐BII and CD36. SR‐BII was post‐transcriptionally regulated by mature miR‐204‐5p via 3′‐UTR targeting. Additionally, nuclear‐localised miR‐204‐3p prevented the CsA‐induced binding of Ago2 to the CD36 promoter, suppressing CD36 transcription. SR‐BII or CD36 expression restoration dampened the beneficial effects of miR‐204 on CsA‐induced atherosclerosis.
Conclusion and Implications
Macrophage miR‐204 ameliorates CsA‐induced atherosclerosis, suggesting that miR‐204 may be a potential target for the prevention and treatment of CsA‐related atherosclerotic side effects.
The optimal revascularization technique in patients with left main coronary artery disease (CAD) remains controversial. We aimed to compare the long-term performance of percutaneous coronary ...intervention (PCI) versus coronary artery bypass graft (CABG) surgery in treatment of left main CAD.
PubMed, EMBASE, and the Cochrane Library were searched until November 16, 2016.
Six randomized controlled trials and 22 matched observational studies including 22,487 patients and 90,167 patient-years of follow-up were included. PCI was associated with an overall higher risk for the major adverse cardiac and cerebrovascular events (hazard ratio (HR), 1.42; 95% confidence interval (CI), 1.14-1.77), mainly driven by higher rates of myocardial infarction (HR, 1.69; 95% CI, 1.22-2.34) and revascularization (HR, 2.80; 95% CI, 1.86-4.22). The overall risks for all-cause death (HR, 1.05; 95% CI, 0.93-1.20), cardiac death (HR, 1.05; 95% CI, 0.69-1.59), stroke (HR, 0.64; 95% CI, 0.33-1.24), and the composite safety endpoint of death, myocardial infarction, or stroke (HR, 1.06; 95% CI, 0.97-1.16) were similar between PCI and CABG. Stratified analysis based on stent types showed that the increased risk for myocardial infarction associated with PCI was only evident in patients with bare-metal stents or early-generation drug-eluting stents (DES), but not newer-generation DES. Stratified analyses based on study designs showed largely similar findings with the overall analyses, except for a significantly higher incidence of myocardial infarction in adjusted studies (HR, 2.01; 95% CI, 1.64-2.45) but a trend toward higher incidence in randomized trials (HR, 1.39; 95% CI, 0.85-2.27) associated with PCI.
Compared with CABG, PCI with newer-generation DES might be a safe alternative revascularization strategy for treatment of left main CAD, but is associated with more repeat revascularization.
Abundant tourmaline occurs in the Mopanshan pluton in Inner Mongolia of NE China, and can be classified by its occurrence into four types: nodular tourmalines (ND type), pegmatite-pocket tourmalines ...(PP type), stockwork tourmalines (SW type) and vein tourmalines (VT type). All these tourmalines belong to the alkali group and are dravite-schorl. Petrography and major elements data suggest that the ND- and PP-type tourmalines crystallized during the transition from late-magmatic to early-hydrothermal evolution of granite with all the components derived from the magma. Petrography and trace elements (especially Sr、V、Cr、Ni、Ti) data suggest that the SW- and VT-type tourmalines may form by the mixing of magmatic and country rocks components in the post-magmatic hydrothermal environment. Due to the similar δ11B of the SW-type with the ND- and PP-type tourmalines (variation <2‰, and all averaged at −15.8‰), the boron source of the SW-type tourmalines is likely the same as the ND- and PP-type ones, i.e., from the granitic magma. The VT-type tourmalines have extremely negative δ11B values from −27.0‰ to −29.8‰, indicating a distinct and isotopically lighter boron source. The potential presence of non-marine evaporites (with very light boron isotopes) in the meta-sedimentary strata deep in the region may contribute boron to the VT-type tourmalines. The high Sn contents in the tourmalines, in particular the SW-type (918–2172 ppm) may have prospecting significance to target tin mineralization related to granite in the region.
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•Four types of tourmaline occurrences are associated with the Mopanshan pluton.•The tourmalines formed from late-magmatic or post-magmatic hydrothermal fluids.•The Mopanshan tourmalines have high Sn contents up to 2172 ppm.•The tourmalines source their B from two isotopically distinct sources.
GaN-based light emitting diodes (LEDs) have potential as photodetectors (PDs) for visible light communication (VLC). In current studies on LED-based PDs, devices are operated in a reverse-biased or ...zero-biased state. In this work, the performance of an blue mini-LED as both a PD and light source was studied. An aluminum oxide passivation was deposited on the sidewalls of the active region using atomic-layer deposition. In addition to improving the external quantum efficiency of mini-LEDs and reducing leakage current, sidewall passivation can also increase the responsivity of mini-LED PD. At a bias of 3 V (corresponding to injection current of 11.5 mA), the mini-LED PD had a response of 0.243 A/W. Based on the system above, a VLC link over 1 m with a data rate of 528 Mbps is achieved using 16-ary quadrature amplitude modulation orthogonal frequency division multiplexing. Moreover, the mini-LED PD could simultaneously act as an uplink detector and a downlink transmitter in the same full-duplex VLC system. With transmission distance of 1 m/1 m, a transmission rate of 350 Mbps in the uplink and downlink was achieved. The proposed method allows the same mini-LED to be used simultaneously as a display and VLC transmitter and receiver, which not only simplifies the structure of the full-duplex communication system and reduces system power consumption, but also facilitates the integration of multifunctional small LED devices.
Microbial fuel cell (MFC) is a promising approach that could utilize microorganisms to oxidize biodegradable pollutants in wastewater and generate electrical power simultaneously. Introducing ...advanced anode nanomaterials is generally considered as an effective way to enhance MFC performance by increasing bacterial adhesion and facilitating extracellular electron transfer (EET). This review focuses on the key advances of recent anode modification materials, as well as the current understanding of the microbial EET process occurring at the bacteria‐electrode interface. Based on the difference in combination mode of the exoelectrogens and nanomaterials, anode surface modification, hybrid biofilm construction and single‐bacterial surface modification strategies are elucidated exhaustively. The inherent mechanisms may help to break through the performance output bottleneck of MFCs by rational design of EET‐related nanomaterials, and lead to the widespread application of microbial electrochemical systems.
Profiting from superior electrical properties, porosity, specific surface area and biocompatibility, nanomaterials show tremendous potential in promoting the power supply of microbial fuel cells. This Review provides an outline of recent progress on anode modification nanomaterials in microbial fuel cells from the viewpoint of different binding modes of bacteria and materials.
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