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Smart devices, such as soft robots, artificial organs, and soft actuators, require materials that adapt their morphologies and properties in response to their environment. These materials can be obtained through the composition of different types of materials that exhibit different responses to environmental stimuli, arranged in a rational spatial configuration. We achieved unique responsive materials by forming interfaces and surfaces of appropriate materials using the sol–gel method. In recent decades, we have proposed the use of wrinkles and nano-brushes on sol–gel-derived materials for various sophisticated applications, such as micropattern fabrication, wettability control, and linear actuators for size-selective transportation. This account introduces environment-responsive materials with rational interfaces via the sol–gel method, particularly those characterized by surface morphology. Highlights: Responsive and adaptive interfaces fabricated via the sol–gel method. Microrolls formed by self-scrolling of sol–gel hybrid films. Photofabrication of micropatterns and actuators on sol–gel hybrid films. Manipulation of water droplets on titanate nanotube brushes fabricated by the sol–gel method. [ABSTRACT FROM AUTHOR]

There is no treatment for acute aortic dissection (AAD) targeting inflammatory cells. We aimed to identify the new therapeutic targets associated with inflammatory cells. We characterized the specific distribution of myeloid cells of both human type A AAD samples and a murine AAD model generated using angiotensin II (ANGII) and β-aminopropionitrile (BAPN) by single-cell RNA sequencing (scRNA-seq). We also examined the effect of an anti-interleukin-1β (IL-1β) antibody in the murine AAD model. IL1B+ inflammatory macrophages and classical monocytes were increased in human AAD samples. Trajectory analysis demonstrated that IL1B+ inflammatory macrophages differentiated from S100A8/9/12+ classical monocytes uniquely observed in the aorta of AAD. We found increased infiltration of neutrophils and monocytes with the expression of inflammatory cytokines in the aorta and accumulation of inflammatory macrophages before the onset of macroscopic AAD in the murine AAD model. In blocking experiments using an anti-IL-1β antibody, it improved survival of murine AAD model by preventing elastin degradation. We observed the accumulation of inflammatory macrophages expressing IL-1β in both human AAD samples and in a murine AAD model. Anti-IL-1β antibody could improve the mortality rate in mice, suggesting that it may be a treatment option for AAD. [ABSTRACT FROM AUTHOR]

The use of deicers in urban areas, on runways and aircrafts has raised concerns about their environmental impact. Understanding the ice-melting mechanism is crucial for developing environmentally friendly deicers, yet it remains challenging. This study employs machine learning to investigate the ice penetration capacity (IPC) of 21 salts and 16 organic solvents as deicers. Relationships between their IPC and various physical properties were analysed using extreme gradient boosting (XGBoost) and Shapley additive explanation (SHAP). Three key ice-melting mechanisms were identified: (1) freezing-point depression, (2) interactions between deicers and H2O molecules and (3) infiltration of ions into ice crystals. SHAP analysis revealed different ice-melting factors and mechanisms for salts and organic solvents, suggesting a potential advantage in combining the two. A mixture of propylene glycol (PG) and sodium formate demonstrated superior environmental impact and IPC. The PG and sodium formate mixture exhibited higher IPC when compared to six commercially available deicers, offering promise for sustainable deicing applications. This study provides valuable insights into the ice-melting process and proposes an effective, environmentally friendly deicer that combines the strengths of organic solvents and salts, paving the way for more sustainable practices in deicing. [ABSTRACT FROM AUTHOR]

OBJECTIVES Our goal was to review our surgical experiences in patients with complex pathologies of the aortic arch who have undergone anterolateral thoracotomy with a partial sternotomy (ALPS). METHODS From October 2019 to November 2023, a total of 23 patients underwent one-stage repairs of complex pathologies of the aortic arch through the ALPS approach. The mean age was 61.9 ± 16.7 years old. The aortic pathologies were as follows: aorta-related infection in 11 (aorto-oesophageal fistula: 4, graft infection: 6, native aortic infection: 1); aortic dissection in 9 including shaggy aorta in 2, non-dissecting aneurysm in 1, and coarctation of the aorta (CoA) in 2. RESULTS Eighteen patients underwent aortic replacement from either the sinotubular junction or the ascending aorta to the descending aorta; 1 patient underwent it from the aortic root to the descending aorta (redo Bentall procedure and extensive aortic arch replacement); 3 patients underwent it from the aortic arch between the left carotid artery and left subclavian artery to the descending aorta; and 1 patient underwent a descending aortic replacement. Ten patients underwent omentopexy, latissimus dorsi muscle flap installation or both procedures. The hospital mortality rate was 13.0% (3/23). The overall survival and freedom from aortic events were 73.3%±10.2% and 74.1%±10.2%, respectively, at the 3-year follow-up. There was an absence of aorta-related deaths, and no recurrent infections were identified. CONCLUSIONS The short-term outcomes using the ALPS approach for the treatment of complex pathologies of the aortic arch were acceptable. Further studies will be required to determine the long-term results. [ABSTRACT FROM AUTHOR]

A 59-year-old male underwent Bio-Bentall + total arch replacement with a frozen elephant trunk for acute type A aortic dissection before at another hospital. He was diagnosed as mediastinitis and previous graft infection, followed by wound closure with omental flap installation. However, the recurrent graft infection from the aortic root to the FET in the descending aorta was diagnosed by 18-fluorodeoxyglucose positron emission tomography. Redo modified Bio-Bentall procedure, total arch replacement, and descending aortic replacement for previous graft infection using anterolateral thoracotomy with partial sternotomy was successfully performed. Anterolateral thoracotomy with partial sternotomy provided not only the excellent exposure from the aortic root to the descending aorta but also sure myocardial protection with antegrade and selective delivery of cold crystalloid cardioplegia and stable brain protection with antegrade selective cerebral perfusion. The patient is doing well without recurrent of infection after 2 years of the operation. [ABSTRACT FROM AUTHOR]

Purpose: The present study analyzed the outcomes of our experience with abdominal aortic aneurysm (AAA) repair over 20 years using endovascular aortic repair (EVAR) with commercially available devices or open aortic repair (OAR) and reviewed our surgical strategy for AAA. Methods: From 1999 to 2019, 1077 patients (659 OAR, 418 EVAR) underwent AAA repair. The OAR and EVAR groups were compared retrospectively, and a propensity matching analysis was performed. Results: EVAR was first introduced in 2008. Our strategy was changed to an EVAR-first strategy in 2010. Beginning in 2018, this EVAR-first strategy was changed to an OAR-first strategy. After propensity matching, the overall survival in the OAR group was significantly better than that in the EVAR group at 10 years (p = 0.006). Two late deaths due to AAA rupture were identified in the EVAR group, although there were no significant differences between the OAR and EVAR groups with regard to the freedom from AAA-related death at 10 years. The rate of freedom from aortic events at 10 years was significantly higher in the OAR group than in the EVAR group (p < 0.0001). Conclusion: The rates of freedom from AAA-related death in both the OAR and EVAR groups were favorable, and the rate of freedom from aortic events was significantly lower in the EVAR group than in the OAR group. Close long-term follow-up after EVAR is mandatory. [ABSTRACT FROM AUTHOR]

Aluminum foam is expected to be one of the candidates for lightweight materials for structural components as it is lightweight and has excellent shock absorption and sound absorption properties. However, aluminum foam has low tensile and flexural strength due to its thin cell walls. Therefore, aluminum foam is used by combining with dense materials. In particular, with the recent trend toward multi-materials, research on the combination with lightweight resins is expected. In this study, we attempted to join aluminum foam fabricated by the precursor method to a thermoplastic resin polycarbonate (PCTA) plate by friction welding. It was found that the aluminum foam and PCTA plate can be joined in about 1 min by friction welding, by rotating the aluminum foam at 2000 rpm and pressing 1 mm into the PCTA plate. In addition, in the friction welding of aluminum foam and PCTA plate, it was found that the pores of the aluminum foam were maintained without being collapsed. The anchoring effect is presumably caused by the penetration of PCTA softened by the frictional heat generated by the friction welding into the pores. Furthermore, tensile tests of the joined samples showed that fracture occurred either at the joining interface or at the base material of the aluminum foam, and that the joining strength was equivalent to the tensile strength of the aluminum foam itself. [ABSTRACT FROM AUTHOR]

Aims Post-extubation dysphagia (PED), an often overlooked problem, is a common and serious complication associated with mortality and major morbidity after cardiovascular surgery. Dysphagia is considered an age-related disease, and evaluating its long-term effects is a pressing issue with rapidly progressing ageing worldwide. Therefore, we examined the effect of PED on functional status and long-term cardiovascular events in patients undergoing cardiovascular surgery. Methods and results This single-centre, retrospective cohort study included 712 patients who underwent elective cardiovascular surgery and met the inclusion criteria. Patients were divided into PED and non-PED groups based on their post-operative swallowing status. The swallowing status was assessed using the Food Intake Level Scale. Functional status was evaluated as hospital-associated disability (HAD), defined as a decrease in activities of daily living after hospital discharge compared with preoperative values. The patients were subsequently followed up to detect major adverse cardiac and cerebrovascular events (MACCEs). Post-extubation dysphagia was present in 23% of the 712 patients and was independently associated with HAD (adjusted odds ratio, 2.70). Over a 3.5-year median follow-up period, MACCE occurred in 14.1% of patients. Multivariate Cox proportional hazard analysis revealed HAD to be independently associated with an increased risk of MACCE (adjusted hazard ratio, 1.85), although PED was not significantly associated with MACCE. Conclusion Post-extubation dysphagia was an independent HAD predictor, with the odds of HAD occurrence being increased by 2.7-fold due to PED. Hospital-associated disability accompanied by PED is a powerful predictor of poor prognosis. Perioperative evaluation and management of the swallowing status, and appropriate therapeutic interventions, are warranted. [ABSTRACT FROM AUTHOR]

This work implements artificial neural networks (ANNs) to monitor tool wear during turning of AISI D6 steel. The goal is to detect wear, prevent tool breakage, and enhance productivity. Experimental tests involve using polycrystalline cubic boron nitride tools to turn AISI D6 steel, measuring wear and surface roughness. ANNs are trained with machining forces, electric current, and acoustic emission data. Findings showed that cutting and machining forces, along with motor current, increased as the wear progresses. The dominant frequencies of the acoustic emission signal range from 30 to 40 kHz, with decreasing RMS as wear increases. The ANN achieved satisfactory results, with wear estimation deviations below 0.09 mm. However, its predictive capability beyond the training range is limited. Workpiece surface roughness estimation showed around 8% error compared to the experimental Ra values. Overall, the ANN-based approach enables real-time tool wear monitoring, reducing the risk of damage and optimizing productivity. [ABSTRACT FROM AUTHOR]

We theoretically investigate microscopic origins of vibronic coupling (VC) contributing to singlet fission (SF) dynamics in pentacene and its halogenated derivatives. The features of VCs related to diabatic exciton states and interstate electronic couplings (Holstein and Peierls couplings, respectively) are interpreted by the VC density (VCD) analysis, which allows one to clarify the relationship between the chemical structure and VC as spatial contribution. It is found for the pentacene dimer face-to-edge configuration in a herringbone crystal that characteristic intermolecular vibrations with low frequencies exhibit strong Holstein couplings for the intermediate charge-transfer (CT) exciton states as well as Peierls couplings. From VCD analysis, the comprising density of the intermolecular CT and that of the intermolecular vibration are found to be constructively mixed in the intermolecular space, leading to the enhancement of VC. Moreover, in order to assess the chemical modification manner for controlling VC, we design several halogenated pentacene derivatives with slip-stack configurations. Our strategy to enhance VCD by halogenation is found to be rational, whereas the peaks of VC spectra for the CT states in the slip-stack packings are observed in high frequency regions. We compare their SF dynamics based on the quantum master equation explicitly including the exciton state-dependent VCs. From the analysis on relative relaxation factors between the adiabatic exciton states, their difference in the SF rate is highlighted by exciton configurations in addition to VCs. The present study is expected to be a first step toward efficient SF based on the design of VC in terms of both the chemical structure and intermolecular packing. [ABSTRACT FROM AUTHOR]

Theoretical molecular design of efficient nonlinear optical (NLO) systems using singlet fission (SF) is performed for butterfly-shaped acenes with/without nitrogen and sulfur substitutions using quantum chemical calculations, exciton dynamics simulations, and Marcus theory. It is found that these large systems meet the energy level matching conditions of efficient SF and exhibit superior third-order NLO properties (second hyperpolarizability γ at the molecular scale) to a typical SF molecule, pentacene. In addition, we investigate SF rates and γ in the correlated triplet pair [1(TT)] state generated by SF for various slip-stacked dimer models of these systems. For molecular packing with relatively large 1(TT) yields, a significant increase in γ/monomer in the 1(TT) state is observed, which is in good agreement with the electronic-coupling-based design guidelines obtained from our previous study. In particular, the butterfly-shaped acenes involving heteroatoms are found to exhibit a significant increase in γ/monomer as compared to the other systems. By analyzing the excitation properties in the 1(TT) state and intermolecular orbital interactions, we clarify the origin of such γ enhancement. The obtained results contribute to the construction of design guidelines for efficient SF-induced-NLO materials and demonstrate that butterfly-shaped acenes have the potential to surpass conventional NLO systems. [ABSTRACT FROM AUTHOR]

Background Ventricular arrhythmias (VAs) are common after a left ventricular assist device (LVAD) implantation. Further, the majority of post-LVAD ventricular tachycardias (VTs) are secondary to a preexisting cardiomyopathy substrate. Intraoperative ablation of patients with recurrent preoperative VTs may reduce post-LVAD VTs. Case summary A 59-year-old female with advanced heart failure due to non-ischaemic cardiomyopathy (LV ejection fraction = 24%) and recurrent VTs was referred for an LVAD implantation as a bridge to a heart transplant (INTERMACS Profile-5A). The previous endocardial ablation failed due to an epicardial arrhythmogenic substrate. Therefore, open-chest epicardial mapping during the LVAD implantation was indicated and three target areas of the arrhythmogenic substrate were found, which were ablated by radiofrequency applications. To minimize the cardiopulmonary bypass time, cardiopulmonary bypass was initiated after ablation, and then, an LVAD was implanted. An additional 68 min was required for mapping and ablation. All procedures were performed without any complications, and the post-operative course was uneventful. Thereafter, no VT episodes were observed without any anti-arrhythmic drugs during a 15-month follow-up with LVAD support. Discussion Intraoperative epicardial mapping and ablation during an LVAD implantation can play an important role in the management of LVAD recipients with recurrent VAs. [ABSTRACT FROM AUTHOR]

Introduction: An easy-to-use, multiuse, single-patient, electromechanical autoinjector, the SMARTCLIC®/CLICWISE® injection device, was recently developed to improve the self-administration options available to patients with chronic inflammatory disease treated with biologic agents. An extensive series of studies were conducted to guide the design and development of this device and to ensure its safety and effectiveness. Methods: Participants in two user preference studies and three formative human factor (HF) studies evaluated evolving iterations of the autoinjector device, dose dispenser cartridge, graphical user interface, and informational materials; participants in a summative HF test subsequently assessed the final proposed commercially representative product. In the user preference studies, rheumatologists and patients with chronic inflammatory disease, interviewed online and in-person, provided feedback on the design and functionality of four prototypes. In the HF studies, the safety, effectiveness, and usability of adapted prototypes were assessed under simulated-use conditions by patients with chronic inflammatory disease, caregivers, and healthcare professionals (HCPs). The safety and effectiveness of the final refined device and system were confirmed in a summative HF test by patients and HCPs in simulated-use scenarios. Results: Rheumatologists (n = 204) and patients (n = 39) interviewed in the two user preference studies provided feedback on the device size, feature ergonomics, and usability that guided prototype development in the subsequent formative HF studies. Observations from patients, caregivers, and HCPs (n = 55) participating in the latter studies yielded additional critical design revisions that culminated in development of the final device and system. Of 106 injection simulations conducted in the summative HF test, all resulted in successful medication delivery, and no potential harms were associated with injection-related use events. Conclusion: Findings from this research facilitated development of the SmartClic/ClicWise autoinjector device and demonstrated that it could be used safely and effectively by participants representative of the intended-use population of patients, lay caregivers, and HCPs. [ABSTRACT FROM AUTHOR]

Owing to its lightweight and excellent shock-absorbing properties, aluminum foam is used in automotive parts and construction materials. If a nondestructive quality assurance method can be established, the application of aluminum foam will be further expanded. In this study, we attempted to estimate the plateau stress of aluminum foam via machine learning (deep learning) using X-ray computed tomography (CT) images of aluminum foam. The plateau stresses estimated by machine learning and those actually obtained using the compression test were almost identical. Consequently, it was shown that plateau stress can be estimated by training using the two-dimensional cross-sectional images obtained nondestructively via X-ray CT imaging. [ABSTRACT FROM AUTHOR]

Acute type A aortic dissection (ATAAD) is a life-threatening disease, which often causes cardiac tamponade, rupture, and malperfusion. ATAAD is associated with a high hospital mortality rate. Open aortic surgery for ATAAD is always required to save the patient, particularly elderly patients. Tear-oriented surgery is recommended as the frontline treatment for ATAAD, and hemiarch replacement (HAR) is sufficient because the primary entry is often observed in the ascending aorta (60%–70%). However, HAR has some drawbacks, such as new creation of an anastomotic entry and unfavorable distal aortic remodeling during long-term follow-up. Although total arch replacement (TAR) is a demanding procedure, it is another useful option for ATAAD. Proper patient selection for TAR is controversial. Standardized procedure for TAR, including the optimal brain protection methods and the use of excellent sealed vascular prosthetic grafts, has been established over the past decades. Therefore, TAR is increasingly being selected for HAR in patients who are young or have enlarged aortic arch, severely dissected supra-aortic arch vessels, or hereditary thoracic aortic disorders. The emerging technology of commercially available frozen elephant trunk accelerated the application of TAR, facilitates distal anastomosis, and improves distal aortic remodeling. Although further evidence is required, TAR could be the best choice for HAR for selected patients. Currently, appropriate selection of the surgical technique is important to maximize the benefits of open surgery for ATAAD. [ABSTRACT FROM AUTHOR]

The chemical and structural modification of organoborosilicate thin films was attempted by using alcohol-induced deboronation. A photocurable organoborosilicate was synthesized from 3-methacryloxypropyltrimethoxysilane and boric acid via a catalyst- and solvent-free and non-aqueous alcohol condensation process. The formation of Si-O-B linkage was suggested by 29Si NMR spectroscopy. A colorless and transparent thin film of the organoborosilicate was prepared by UV irradiation. According to Fourier transform infrared spectroscopy, a peak attributed to the stretching vibration of borate disappeared after the alcohol treatment. Moreover, atomic force microscopy revealed the surface structural change of the thin film via the deboronation process. These results indicate that the borate was eliminated by the treatment, suggesting that this method enables to apply to the direct nanofabrication. Highlights: A photocurable organoborosilicate was synthesized via catalyst- and solvent-free alcohol condensation. Borate was eliminated from the organoborosilicate thin film in the presence of methanol vapor. The thin film changed in chemical composition and structure due to methanol vapor treatment. The deboronation from organoborosilicate is expected to apply to a new type of nanofabrication. [ABSTRACT FROM AUTHOR]

Chiral inorganic materials have attracted increasing attention in the fields such as catalysis, electronics, photonics, and sensing. A new class of functional materials with chirality is extensively explored. Herein, we demonstrate the synthesis of nanometric nickel layered hydroxide salt (Ni-LHS) modified with chiral amino acids, (D- or L-) phenylalanine (PHE). An alkalization reaction in a starting mixture of nickel-phenylalanine aqua complexes was induced by using propylene oxide, leading to intercalate and adsorb phenylalanine on the surface and into the interlayers of Ni-LHS in an in-situ manner. The chiral molecules also act as surface modifier to inhibit the extensive crystal growth and aggregation, to form Ni-LHS with a diameter of 2–3 nm in a state of stablly-suspended in a solvent. It was also found that Ni-LHS exhibit induced circular dichroism (ICD) in the spectral range of d-d transitions of Ni(II) metal centres. The layered nanomaterials with chiroptical response demonstrated here is a promising option as an advanced adsorbent for detection of molecules. Highlights: Synthesis of nanometric nickel layered hydroxide salt accommodating chiral amino acids is achieved. Epoxide-mediated alkalization reaction is adopted for the synthesis of the stable sol of the nano hydroxide. The material is found to exhibit induced circular dichroism (ICD) in visible light range. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES The goal of this study was to evaluate the fate of the downstream aorta following total arch replacement. METHODS Between October 1999 and March 2018, a total of 740 patients underwent total arch replacement. After excluding connective tissue disease, previous descending or thoracoabdominal aortic surgery, patients without adequate preoperative images or operative mortality, late outcomes consisting of additional surgery for distal dilation and distal aortic events were evaluated in 623 survivors (240 aortic dissections, including 139 patients with acute dissection and 383 with a non-dissection aneurysm). The mean follow-up was 5.0 ± 4.0 years. RESULTS The mean preoperative maximum diameter of the descending aorta was 36.9 ± 8.0 mm. An elephant trunk was inserted in 232 patients, including 183 patients with aortic dissection. Freedom from additional surgery for distal dilation was 88.5% at 5 years and 80.2% at 10 years. Freedom from distal aortic events was 81.9% at 5 years and 70.5% at 10 years. Multivariable regression analysis demonstrated that the preoperative diameter of the descending aorta was a significant risk factor for unfavourable distal aortic events. Computed tomography evaluation demonstrated a significant increase in the descending aortic diameter over time (P  < 0.001). Positive aortic remodelling was observed in the proximal descending (P  < 0.001) to mid-descending (P  < 0.001) aorta exclusively in patients with acute aortic dissection. CONCLUSIONS The diameter of the descending aorta increased significantly after total arch replacement, particularly in the distal descending aorta. The preoperative descending aortic diameter portended a significant risk for unfavourable distal aortic events. [ABSTRACT FROM AUTHOR]

Sumanene derivatives fused by quinones and acenes were synthesized through Friedel‐Crafts double acylation, followed by reductive aromatization. Single‐crystal X‐ray diffraction analysis on synthesized quinone and acene derivatives revealed the one‐dimensional (1D) columnar stackings predominated by the concave‐convex alignment from sumanene moiety. The thus‐prepared sumanene‐fused acenes exhibited higher solubility to organic solvent and significant stability against aerobic oxidation than the pristine acenes. [ABSTRACT FROM AUTHOR]

The degree of pore filling is an important parameter for defining guest@MOF properties in applications including electronics, optics, and gas separation. However, the interplay of key aspects of host–guest interactions, such as a quantitative description of the guest alignment or the structural integrity of the host as function of pore filling are yet to be determined. Polarisation‐dependent infrared spectroscopy in attenuated total reflection configuration combined with gas sorption allowed to simultaneously study the orientation of the guest molecule and structural changes of the MOF framework during the pore filling process. Thereby we found, that initially randomly oriented guest molecules align with increasing pore filling during adsorption from the gas phase. At the same time, the framework itself undergoes a reversible, guest molecule‐dependent rotation of the aromatic linker and a linker detachment process, which induce defects. [ABSTRACT FROM AUTHOR]

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A more rapid and less complicated test to diagnose pertussis is required in clinical settings. We need to detect Bordetella pertussis, which mainly causes pertussis, as early as possible, because pertussis is more likely to become severe in infants, and people around them can easily become a source of infection due to its strong infectivity. Nevertheless, methods that can detect B. pertussis rapidly and efficiently are lacking. Therefore, we developed a new immunochromatographic antigen kit (ICkit) for the early diagnosis of pertussis. The ICkit detects B. pertussis antigens in a nasopharyngeal swab without equipment and provides the result in about 15 min with a simple procedure. Additionally, a prospective study to evaluate the ICkit was conducted in 11 medical institutions, involving 195 cases with suspected pertussis. Compared with the real-time polymerase chain reaction (rPCR), the sensitivity and specificity of the ICkit were 86.4% (19/22) and 97.1% (168/173), respectively. The ICkit detected the antigen in both children and adults. Furthermore, the ICkit detected the antigen until the 25th day from the onset of cough, when rPCR detected the antigen. Thus, the ICkit demonstrated a high correlation with rPCR and would help diagnose pertussis more rapidly and efficiently. [ABSTRACT FROM AUTHOR]

Processing oriented metal–organic frameworks (MOFs) as thin films is a key challenge for their application to device fabrication. However, typical fabrication methods cannot generate precisely oriented crystals on commercially relevant scales (i.e., cm2). This limits access to applications that require anisotropic functional properties (e.g., separation, optics, and electronics). Currently, highly oriented copper‐based MOFs are synthesized via the addition of the organic MOF component to an ethanolic solution of manually aligned Cu(OH)2 nanobelt films. In this work, the optimization of a semi‐automatic method for the fabrication of precisely oriented MOF films that affords a 100% yield of high quality ceramic films at the centimeter scale is reported. This improved fabrication protocol will facilitate the progress of heteroepitaxially grown MOFs for molecular separators and micro‐opto‐electronic devices. [ABSTRACT FROM AUTHOR]

The host–guest system TCNQ@Cu3(BTC)2 (TCNQ = 7,7,8,8-tetracyanoquinodimethane, BTC = 1,3,5-benzenetricarboxylate) exhibits semiconducting properties with potential applications in thin-film devices, such as field-effect transistors and thermoelectric films. Although controlling its crystallographic orientation is important for the efficient use of its electrical properties in advanced semiconductors, the fabrication of Cu3(BTC)2 thin films with both in-plane and out-of-plane orientations (three-dimensionally oriented thin films) remains a challenge. Here, we report on the fabrication of three-dimensionally oriented Cu3(BTC)2 thin films via heteroepitaxial growth on Cu(OH)2. The epitaxial growth direction of Cu3(BTC)2 is determined by lattice matching at the Cu3(BTC)2/Cu(OH)2 interface and interface bonding (local chemical connection matching; spatial matching of Cu atoms across the interface). The epitaxial growth approach enables the fabrication of oriented TCNQ@Cu3(BTC)2 thin films, where the {111} lattice plane, which can be a conducting path, is oriented both parallel and perpendicular to the substrate. Owing to the in-plane orientation of the {111} lattice plane in the oriented TCNQ@Cu3(BTC)2 film, we have, for the first time, achieved MOF thin films with anisotropic electrical properties in the in-plane direction. Moreover, we show that it is possible to fabricate oriented MOF patterns by integration with UV lithography technology. The oriented MOF patterns with anisotropic conduction will pave the way for next-generation smart electronic devices. [ABSTRACT FROM AUTHOR]

Assessment of frailty is important for risk stratification among the elderly with severe aortic stenosis (AS) when considering interventions such as surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). However, evidence of the impact of preoperative frailty on short-term postoperative outcomes or functional recovery is limited. This retrospective study included 234 consecutive patients with severe AS who underwent SAVR or TAVR at Kobe University Hospital between Dec 2013 and Dec 2019. Primary outcomes were postoperative complications, postoperative 6-min walking distance (6MWD), and home discharge rates. The mean age was 82 ± 6.6 years. There were 169 (SAVR: 80, TAVR: 89) and 65 (SAVR: 20, TAVR: 45) patients in the non-frail and frail groups, respectively (p = 0.02). The postoperative complication rates in the frail group were significantly higher than those in the non-frail group [30.8% (SAVR: 35.0%, TAVR: 28.9%) vs. 10.7% (SAVR: 15.0%, TAVR: 6.7%), p < 0.001]. The home discharge rate in the non-frail group was significantly higher than that in the frail group [85.2% (SAVR: 81.2%, TAVR: 88.8%) vs. 49.2% (SAVR: 55.0%, TAVR: 46.7%), p < 0.001]. The postoperative 6MWD in the non-frail group was significantly longer than that in the frail group [299.3 ± 87.8 m (SAVR: 321.9 ± 90.8 m, TAVR: 281.1 ± 81.3 m) vs. 141.9 ± 92.4 m (SAVR: 167.8 ± 92.5 m, TAVR: 131.6 ± 91.3 m), p < 0.001]. The TAVR group did not show a decrease in the 6MWD after intervention, regardless of frailty. We report for the first time that preoperative frailty was strongly associated with postoperative complications, 6MWD, and home discharge rates following both SAVR and TAVR. Preoperative frailty assessment may provide useful indications for planning better individualized therapeutic interventions and supporting comprehensive intensive care before and after interventions. [ABSTRACT FROM AUTHOR]

Objective: Presenting our experience of treating patients with organ malperfusion secondary to acute aortic dissection.Patients: Among 383 patients who underwent aortic repair for acute type A aortic dissection from 1999 to 2017, 107 patients were operated on because of vascular complications. Fourteen patients had coronary, 50 had brain, 3 had paraplegia, 13 had superior mesenteric artery, 21 had lower limb, and 16 had combined organ malperfusion. Age was 65.8 years.Results: In coronary malperfusion, three had a preoperative percutaneous coronary intervention, and two had mechanical support. All underwent repair of the aorta. Hospital mortality was 28.5%. Fifty patients had brain malperfusion. Hemiplegia was found in 28 patients, transient ischemic attack in 10, and coma in 12. The level of consciousness was severe in 12, moderate in 18, and mild in 20. Twenty-eight percent died of a stroke. Nine had direct perfusion from the right common carotid artery, and the consciousness level was improved in 5 patients. Eight patients had mesenteric malperfusion. Four patients had a central aorta repair first, and four patients had peripheral intervention first. Three patients had a bypass grafting to the superior mesenteric artery, and one had a catheter intervention. Postoperative mortality was found in four patients due to bowel necrosis and six required resections of the bowel.Conclusion: Acute organ malperfusion caused by the aortic dissection requires accurate and prompt diagnosis to proceed with an appropriate intervention before repairing the central aorta for preventing irreversible organ damage. [ABSTRACT FROM AUTHOR]

Multilayered metal–organic frameworks (MOF) thin films, called MOF-on-MOF thin films, generate integrated and multiple functionalities toward high-performance sensing, electrochemical, and optical devices. Although epitaxy at the MOF/MOF interfaces in these multilayered MOF films plays a crucial role for high functionalities, the effect of structural consistency at a molecular scale at the epitaxial interface on the quality of the films (e.g., crystallite size and degree of orientation of MOF-on-MOF thin films) has not been explored. Here, we report the factors governing such physical parameters by revealing a relationship between lattice mismatch ratios and orientations of MOF-on-MOF thin films with epitaxial interfaces (referred as to "e-MoM thin films"). Highly oriented e-MoM thin films were successfully obtained by considering not only lattice mismatch ratios but also stacking order depending on the lattice parameters of MOF components. Because of the chemical and structural tunability of e-MoM materials, the present finding will offer insight into fabricating e-MoM thin films for designing future MOF-based devices. [ABSTRACT FROM AUTHOR]

Acrylic rubber (ACM) nanocomposites reinforced with cellulose nanocrystals (CNCs) were prepared and the properties were characterized. CNCs were produced by hydrochloric acid hydrolysis of microcrystalline cellulose powder and used without further chemical modification of the surfaces. The CNCs were already aggregated in aqueous suspension. However, their aggregated sizes and uniform distribution in the ACM did not change with increase in the concentration of CNC. This result suggested good compatibility of the CNC with ACM. Fourier-transform infrared/attenuated total reflection spectroscopy revealed that the good compatibility could be attributed to attractive interactions between CNC and ACM. The good compatibility led to an increase in breaking stress of the ACM/CNC nanocomposites, up to about 10 MPa at a high concentration of 24 phr of CNC. Thermal decomposition of the nanocomposites occurred due to first the CNC followed by the ACM. More weight residues of the nanocomposites were found above 400 °C with increase in the concentration of CNC. The char produced by the decomposition of CNC is suggested the act as a flame retardant for ACM. In addition, the swelling ratio of the ACM/CNC nanocomposites against hydrophobic solvents decreased with increase in the concentration of CNC. The hydrophilic properties of the unmodified CNC from the surface hydroxyl groups increased the oil-resistant properties of the ACM. [ABSTRACT FROM AUTHOR]

OBJECTIVES We aimed to identify predictors of postoperative permanent neurological deficits (PNDs) and evaluate the early management of cerebral perfusion in patients undergoing surgical repair of acute type A aortic dissection with cerebral malperfusion. METHODS Between October 2009 and September 2018, a total of 197 patients with acute type A aortic dissection underwent aortic replacement. Of these, 42 (21.3%) patients had an imaging cerebral malperfusion (ICM). ICM was assessed preoperatively, which also revealed whether dissected supra-aortic branch vessels were occluded or narrowed by a thrombosed false lumen. After September 2017, early reperfusion and extra-anatomic revascularization were performed in cases with ICM. RESULTS Hospital mortality rates for cases with ICM were 4.8% (2/42). Before September 2017, PND were observed in 6 patients (54.5%) with preoperative neurological symptoms (n  = 11), and 7 patients (33.3%) without neurological symptoms (n  = 21) in patients with ICM. Occlusion or severe stenosis of supra-aortic branch vessels (odds ratio, 7.66; P  <   0.001), regardless of preoperative clinical neurological symptoms, was a risk factor for PND. After September 2017, 7 of 10 patients with ICM underwent early reperfusion and extra-anatomic revascularization. PND did not occur in any of these 7 patients. CONCLUSIONS Occlusion or severe stenosis of supra-aortic branch vessels is a predictor of PND risk in patients undergoing surgery for acute type A aortic dissection. Early reperfusion and extra-anatomic revascularization may reduce the risk of neurological complications in patients with ICM, with or without neurological symptoms. [ABSTRACT FROM AUTHOR]

Molecular structures of siloxane materials should be highly controlled for achieving advanced functionalities. However, it is still difficult to precisely control the structure of siloxane materials by the sol–gel processing. In the present study, we focused on the silanol groups in the intermediate oligomers and resultant siloxane materials as a key structural unit for controlling the molecular structure. Thermal stability and chemical reactivity of silanol groups were found to be highly dependent on the steric effects of the surrounding side chains and siloxane skeletons. The present work suggests that controlling the steric effects around silanol groups in the intermediate oligomers allows modulating the crosslink density of siloxane skeletons. The selective molecular modification tunes the structure and chemical properties of the resultant siloxane materials. Highlights: Hydroxyl groups in oraganically modified siloxane oligomers exhibit a diffrent reactivity depending on the local environments. Molecular structures of siloxane materials should be highly controlled for achieving advanced functionalities. The selective molecular modification tunes the structure and chemical properties of the resultant siloxane materials. [ABSTRACT FROM AUTHOR]

Objectives: To review the outcomes of bicuspid aortic valve repair with the reimplantation technique. Patients and methods: From 2006 to 2018, 46 patients with bicuspid aortic valve underwent the reimplantation procedure for aortic valve repair. Those patients were included in this study. The mean age was 45 ± 15 years and 44 were male. Preoperative echocardiography showed a mean ventriculoaortic junction diameter of 28 ± 3 mm. The mean diameter at the sinus of Valsalva was 41 ± 9 mm. The minimum cusp height was 19 ± 3 mm. Regarding cusp repair technique, central plication was used in 45 patients, free margin reinforcement in 10 patients, and patch repair in 4 patients. Follow-up was performed by annual echocardiography. Results: There were no hospital deaths. All patients were found with either no/trivial or mild AR on postoperative transesophageal echocardiography. The postoperative ventriculoaortic junction diameter was 23 ± 2 mm and 83 ± 17% preoperatively. Freedom from moderate AR was 85 ± 6% at 5 years, and freedom from reoperation was 93 ± 4% at 5 years. Conclusions: Reimplantation for bicuspid aortic valve repair showed acceptable mid-term outcomes. [ABSTRACT FROM AUTHOR]

The article presents guidelines on working group for revision of guidelines for the use of Palivizumab in Japan. Topics include the precautions and indications on the drug's information leaflet, the appropriate use of this agent should be used on a patient by patient basis; and referring to guidelines issued by healthcare societies and other professional academic organizations.

Accumulating evidence suggests that human pluripotent stem cell-derived cardiomyocytes can affect "heart regeneration", replacing injured cardiac scar tissue with concomitant electrical integration. However, electrically coupled graft cardiomyocytes were found to innately induce transient post-transplant ventricular tachycardia in recent large animal model transplantation studies. We hypothesised that these phenomena were derived from alterations in the grafted cardiomyocyte characteristics. In vitro experiments showed that human embryonic stem cell-derived cardiomyocytes (hESC-CMs) contain nodal-like cardiomyocytes that spontaneously contract faster than working-type cardiomyocytes. When transplanted into athymic rat hearts, proliferative capacity was lower for nodal-like than working-type cardiomyocytes with grafted cardiomyocytes eventually comprising only relatively matured ventricular cardiomyocytes. RNA-sequencing of engrafted hESC-CMs confirmed the increased expression of matured ventricular cardiomyocyte-related genes, and simultaneous decreased expression of nodal cardiomyocyte-related genes. Temporal engraftment of electrical excitable nodal-like cardiomyocytes may thus explain the transient incidence of post-transplant ventricular tachycardia, although further large animal model studies will be required to control post-transplant arrhythmia. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide Open in new tab Download slide OBJECTIVES Valve repair for aortic insufficiency (AI) requires a tailored surgical approach determined by the leaflet and aortic disease. In this study, we used a repair-oriented system for the classification of AI, and we elucidated long-term outcomes of aortic root reimplantation with this classification system. METHODS From 1999 to 2018, a total of 197 patients underwent elective reimplantation (mean age: 52.7 ± 17.7 years; 80% male). The aortic valve was tricuspid in 143 patients, bicuspid in 51 patients and quadricuspid in 3 patients. A total of 93 patients had type I AI (aortic dilatation), 57 patients had type II AI (cusp prolapse) and 47 patients had type III AI (restrictive). In total, 104 of the 264 patients (39%) had more than 1 identified mechanism. RESULTS In-hospital mortality was 0.5% (1/197). Mid-term follow-up (mean follow-up duration: 5.5 years) revealed a late mortality rate of 4.2% (9/197). Aortic valve reoperation was performed on 16 patients (8.0%). Rates of freedom from aortic valve replacement and freedom from aortic valve-related events at 10 years of follow-up were 87.0 ± 4.0% and 60.6 ± 6.0%, respectively; patients with type Ib AI (98.3 ± 1.7%; 80.7 ± 7.5%) had better outcomes than patients with type III AI (59.6 ± 15.6%; 42.2 ± 13.1%, P  = 0.01). In patients with types II and III AI who had bicuspid aortic valves, rates of freedom from aortic valve-related events at 5 years of follow-up were 95.2 ± 4.7% and 71.7 ± 9.1%, respectively (P  = 0.03). CONCLUSIONS This repair-oriented system for classifying AI could help to predict the durable aortic valve repair techniques. Patient selection according to the classification is particularly important for long-term durability. Clinical trial registration number B190050. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the mid-term outcomes of transarterial embolization (TAE) for type II endoleak after endovascular abdominal aortic aneurysm repair (EVAR) and investigate the predictors of sac enlargement after embolization.Materials and Methods: We conducted a retrospective analysis of 55 patients [48 men and 7 women, median age 79.0 (interquartile ranges 74-82) years] who underwent TAE for type II endoleak from 2010 to 2018. The aneurysmal sac enlargement, endoleaks, aneurysm-related adverse event rate, and reintervention rate were evaluated. Patients' characteristics and clinical factors were evaluated for their association with sac enlargement.Results: Fifty-five patients underwent TAE with technical success and were subsequently followed for a median of 636 (interquartile ranges 446-1292) days. The freedom from sac enlargement rates at 1, 3, and 5 years was 73.2%, 32.0%, and 26.7%, respectively. After initial TAE, the recurrent type II, delayed type I, and occult type III endoleak were identified in 39 (71%), 5 (9%), and 3 (5%) patients, respectively. Although a patient had aorto-duodenal fistula, there was no aneurysm-related death. The freedom from reintervention rates was 84.6%, 35.7%, and 17.0%, respectively. In the multivariate analysis, sac diameter > 55 mm at initial TAE (hazard ratios, 3.23; 95% confidence intervals, 1.22-8.58; P < 0.05) was a significant predictor of sac enlargement.Conclusion: TAE for type II endoleak was not effective in preventing sac enlargement, and reinterventions were required among the mid-term follow-up. The sac diameter > 55 mm at initial TAE was a significant predictor of sac enlargement. [ABSTRACT FROM AUTHOR]

There has been no report about in vivo active cholesterol-lowering dipeptide in any protein origin, despite their potential health benefits. Cattle heart protein hydrolysate ultra-filtrate (HPHU, molecular weight < ca. 1,000 Da peptide mixture) exhibits cholesterol-lowering activity in hypercholesterolemic rats, but the active peptide in HPHU that lowers serum cholesterol levels and its molecular mechanism are unknown. In this study, we separated and purified HPHU to identify a novel cholesterol-lowering dipeptide (phenylalanine-proline, FP) and characterized the mechanism underlying its effects in vivo and in vitro. We identified FP as an active peptide from HPHU by MALDI-TOF mass spectrometry. FP significantly decreased serum total and non-HDL cholesterol and hepatic cholesterol levels in rats. FP significantly increased serum HDL cholesterol, accompanied by a significant decrease in the atherogenic index. FP also significantly increased fecal cholesterol and acidic steroid excretion. Moreover, FP significantly decreased ATP-binding cassette transporter A1 (ABCA1) expression in the rat jejunum and reduced cholesterol absorption in Caco-2 cells. We found a novel cholesterol-lowering dipeptide FP that could improve cholesterol metabolism via the down-regulation of intestinal ABCA1. The cholesterol-lowering action induced by FP was disappeared in PepT1KO mice. FP-induced cholesterol-lowering action is mediated via PepT1 in mice. [ABSTRACT FROM AUTHOR]

Degradation mechanism of stacked high-k gate dielectrics has been studied with metal-oxide-semiconductor capacitors having HfAlOX/SiO2 films of various thickness combinations. A large leakage current with a peaked shape, named as the low-voltage peak current (LVPC), has been observed in the low-voltage region even in the initial current–voltage characteristics. It has been shown that a main part of LVPC is the transient current component controlled by the process of hole injection to traps in the vicinity of the HfAlOX/SiO2 interface through the interfacial SiO2 layer. By the electrical stress, both the transient and the steady-state current components monotonically increase with time having different rates. Steady-state component has significantly larger rate than the transient component, and the same rate with the stress-induced leakage current (SILC) observed in the high-voltage region, indicating that the steady-state component of LVPC should be regarded as the SILC in the higher-voltage region extending down to the lower gate voltage region where the LVPC is observed. [ABSTRACT FROM AUTHOR]