Repeat percutaneous coronary revascularization: Indications and outcomes in a “Real World” cohort

Objectives : To investigate rates of and reasons for second and subsequent stent procedures in an unselected, “real‐world” population. Background : Repeat stenting is the primary difference reported in clinical trials of alternative revascularization strategies. The incidence, indication, and outcome for repeat stenting in contemporary practice outside the more selective populations of trials and registries has not been described. Method : All patients undergoing a first percutaneous coronary intervention (PCI) procedure with stenting from January 2001 to August 2009 (10,509) from a large UK tertiary referral and district general hospital were identified. Mortality and the incidence, timing, and indication for repeat revascularization in this population were investigated from patient records. Results : Of 10,509 patients undergoing a first PCI and stent implant 23.5% underwent repeat angiography of which 11.2% required repeat PCI and 2% coronary artery bypass grafting (median follow‐up of 3.8 years). A total of 1.3% went on to a third PCI. The commonest indication for repeat stenting was disease progression remote from the original stent (46%) and planned staged PCI (23%); 21% had a stent‐related indication. Functional assessment before repeat stenting was used in one‐third of stable patients. Mortality was 2.5% per annum. Conclusions : In contemporary practice, patients undergoing a first stenting procedure have a low subsequent mortality, and the substantial majority (86.4%) requires no further revascularization over a median 3.8 year follow‐up. For those who do require repeat stenting, this is most commonly at a site remote from the first stent. © 2012 Wiley Periodicals, Inc.     

Inter-eye relationship of intraocular pressure change after unilateral trabeculectomy,filtering canaloplasty,or PreserFlo™ microshunt implantation

Graefe's Archive for Clinical and Experimental Ophthalmology - This study assesses short-term intraocular pressure (IOP) change in the fellow eye of glaucoma patients after mitomycin...     

Failures of stereoscopic shape constancy over changes of viewing distance and size for bilaterally symmetric polyhedra

Two shape matching experiments examined the effects of viewing distance and object size on observers’ judgments of 3D metric shape under binocular viewing. Unlike previous studies on this topic, the stimuli were specifically designed to satisfy the minimal conditions for computing veridical shape from symmetry. Concretely, the stimuli were complex, mirror-symmetric polyhedra whose symmetry planes were oriented at an angle of 45^o relative to the line of sight in a shape-matching task. Although it is mathematically possible to accurately compute the 3D shapes of these stimuli using relatively simple algorithms, the results indicated that human observers are unable to do so. Indeed, the apparent shapes of the objects were systematically expanded or compressed in depth as a function of viewing distance, in exactly the same way as has been reported for simpler stimuli that do not satisfy the minimal conditions for an accurate computational analysis. For objects presented at near distances, we also obtained statistically significant effects of object size on observers’ shape judgments.     

Free-standing Li+-conductive films based on PEO–PVDF blends

Solid electrolytes are of high interest for the development of advanced electrochemical energy storage devices with all-solid-state architectures. Here, we report the fabrication of the electrolyte membranes based on LiTFSI (LiN(CF₃SO₂)₂) and PEO–PVDF blends with improved properties. We show that addition of PVDF enables preparation of free-standing films of the compositions within the so called “crystallinity gap” of the LiTFSI–PEO system known to provide high ion conductivity. We show that optimal PVDF content enables preparation of the films with reasonable elastic modulus and high ionic conductivity of about 0.3 mS cm⁻¹ at 60 °C and about 0.1 mS cm⁻¹ at room-temperature. Combining FTIR spectroscopy, XRD and DSC measurements we show that a noticeable fraction of PVDF remains crystalline and enhances the mechanical properties of the material, and at the same time it additionally promotes LiTFSI dissociation and disordering. Density functional theory calculations showed that the Li⁺–PEO–PVDF complexation energy magnitude is almost as high as that of Li–PEO complexes, thus the salt dissociation ability can be retained in spite of the introduction of the substantial amounts of PVDF required for mechanical stability.

Addition of PVDF to LiTFSI–PEO solid electrolytes enables preparation of free-standing films with the compositions within the so called “crystallinity gap” of LiTFSI–PEO system. Such films possess ionic conductivity of about 0.3 mS cm⁻¹ at 60 °C.     

Nanoformulation-by-design: an experimental and molecular dynamics study for polymer coated drug nanoparticles

The formulation of drug compounds into nanoparticles has many potential advantages in enhancing bioavailability and improving therapeutic efficacy. However, few drug molecules will assemble into stable, well-defined nanoparticulate structures. Amphiphilic polymer coatings are able to stabilise nanoparticles, imparting defined surface properties for many possible drug delivery applications. In the present article we explore, both experimentally and in silico, a potential methodology to coat drug nanoparticles with an amphiphilic co-polymer. Monomethoxy polyethylene glycol–polycaprolactone (mPEG-b-PCL) diblock copolymers with different mPEG lengths (M_w 350, 550, 750 and 2000), designed to give different levels of colloidal stability, were used to coat the surface of indomethacin nanoparticles. Polymer coating was achieved by a flow nanoprecipitation method that demonstrated excellent batch-to-batch reproducibility and resulted in nanoparticles with high drug loadings (up to 78%). At the same time, in order to understand this modified nanoprecipitation method at an atomistic level, large-scale all-atom molecular dynamics simulations were performed in parallel using the GROMOS53a6 forcefield parameters. It was observed that the mPEG-b-PCL chains act synergistically with the acetone molecules to dissolve the indomethacin nanoparticle while after the removal of the acetone molecules (mimicking the evaporation of the organic solvent) a polymer–drug nanoparticle was formed (yield 99%). This work could facilitate the development of more efficient methodologies for producing nanoparticles of hydrophobic drugs coated with amphiphilic polymers. The atomistic insight from the MD simulations in tandem with the data from the drug encapsulation experiments thus leads the way to a nanoformulation-by-design approach for therapeutic nanoparticles.

Experimental studies of drug–polymer nanoparticle formation combined with molecular dynamics simulations provide atomistic explanations for the high drug loadings obtained.     

The influence of structural gradients in large pore organosilica materials on the capabilities for hosting cellular communities

Cells exist in the so-called extracellular matrix (ECM) in their native state, and numerous future applications require reliable and potent ECM-mimics. A perspective, which goes beyond ECM emulation, is the design of a host-material with features which are not accessible in the biological portfolio. Such a feature would, for instance, be the creation of a structural or chemical gradient, and to explore how this special property influences the biological processes. First, we wanted to test if macroporous organosilica materials with appropriate surface modification can act as a host for the implementation of human cells like HeLa or LUHMES. It was possible to use a commercially available polymeric foam as a scaffold and coat it with a thiophenol-containing organosilica layer, followed by biofunctionalization with biotin using click chemistry and the subsequent coupling of streptavidin–fibronectin to it. More importantly, deformation of the scaffold allowed the generation of a permanent structural gradient. In this work, we show that the structural gradient has a tremendous influence on the capability of the described material for the accommodation of living cells. The introduction of a bi-directional gradient enabled the establishment of a cellular community comprising different cell types in spatially distinct regions of the material. An interesting perspective is to study communication between cell types or to create cellular communities, which can never exist in a natural environment.

Chemical and structural gradients in biofunctionalized organosilica–polymer nanocomposites control cell adhesion properties and open perspectives for artificial cellular community systems.     

Tantalum(v) 1,3-propanediolate β-diketonate solution as a precursor to sol–gel derived,metal oxide thin films

Tantalum oxide is ubiquitous in everyday life, from capacitors in electronics to ion conductors for electrochromic windows and electrochemical storage devices. Investigations into sol–gel deposition of tantalum oxide, and its sister niobium oxide, has accelerated since the 1980s and continues to this day. The aim of this study is to synthesize a near UV sensitive, air stable, and low toxicity tantalum sol–gel precursor solution for metal oxide thin films – these attributes promise to reduce manufacturing costs and allow for facile mass production. By utilizing 1D and 2D nuclear magnetic resonance, this study shows that by removing ethanol from the precursor solution at a relatively low temperature and pressure, decomposition of the photosensitive complex can be minimized while obtaining a precursor solution with sufficient stability for storage and processing in the atmosphere. The solution described herein is further modified for inkjet printing, where multiple material characterization techniques demonstrate that the solution can be utilized in low temperature, photochemical solution deposition of tantalum oxide, which is likely amorphous. Tested substrates include amorphous silica, crystalline silicon wafer, and gold/titanium/PET foil. The hope is that these results may spark future investigations into electronic, optical, and biomedical device fabrication with tantalum oxide, and potentially niobium oxide, based films using the proposed synthesis method.

Synthesis of tantalum(v) 1,3-propanediolate β-diketonate solution and use in photochemical solution deposition to form tantalum oxide films.