Search

Thrombotic manifestations, mainly venous thromboembolism (VTE) and stroke, are the most common and potentially life-threatening presentations of antiphospholipid syndrome (APS). The management of APS requires the assessment of the antiphospholipid antibodies (aPL) profile, of concurrent systemic lupus erythematosus or other systemic autoimmune diseases and the presence of risk factors for cardiovascular disease and bleeding. Anticoagulation with vitamin K antagonists (VKA) remains the cornerstone of therapy for thrombotic APS. As platelets play a central role in APS, low-dose aspirin is the first option for primary thromboprophylaxis in asymptomatic aPL carriers, and also plays a role as combination therapy with VKAs in arterial thrombosis. Treatment with direct oral anticoagulants (DOACs) could be considered in certain low-risk situations, although they are not recommended in patients with arterial thrombosis or triple positive aPL. Adjuvant therapies such as hydroxychloroquine and statins may be useful in complex settings such as thrombotic recurrences or high risk of bleeding. In this article, we review the evidence and the recommendations of the guidelines for the treatment of APS, and provide a critical and practical approach of its management from our clinical perspective.

Two-dimensional (2D) materials have attracted tremendous interest ever since the isolation of atomically thin sheets of graphene in 2004 due to the specific and versatile properties of these materials. However, the increasing production and use of 2D materials necessitate a thorough evaluation of the potential impact on human health and the environment. Furthermore, harmonized test protocols are needed with which to assess the safety of 2D materials. The Graphene Flagship project (2013–2023), funded by the European Commission, addressed the identification of the possible hazard of graphene-based materials as well as emerging 2D materials including transition metal dichalcogenides, hexagonal boron nitride, and others. Additionally, so-called green chemistry approaches were explored to achieve the goal of a safe and sustainable production and use of this fascinating family of nanomaterials. The present review provides a compact survey of the findings and the lessons learned in the Graphene Flagship.

The objective of this study has been to discover the mediating and moderating effect of peer support, family supportand teacher supportin the relationship between emotional intelligenceand suicidal ideationin adolescents. For this purpose, a total of 898 adolescents have participated (MAge = 13.55, SD = 1.66) responding to the WLEIS Scale, the Perceived Social Support Scale, the adaptation of the School Climate Scale, and the Suicide Risk Inventory. The results indicate how: (1) teacher supportand family supportmediate the relationship between emotional intelligenceand suicidal ideation; (2) regardless of gender and age, family supportmoderates the relationship between emotional intelligenceand suicidal ideation, with emotional intelligencehelping to reduce suicidal ideationonly when there is medium or high family support; (3) peer supportand age moderate the relationship between emotional intelligenceand suicidal ideation, with peer supporthelping emotional intelligencereduce suicidal ideationonly with older adolescents. These results showed how, in addition to working emotional intelligencein adolescents, introducing the participation of families in the learning process as far as possible, as well as encouraging quality relationships between peers, could have special effects in reducing one of the main causes of adolescent death, such as suicidal behaviour.

Self-assembling peptides are being applied both in the biomedical area and as building blocks in nanotechnology. Their applications are closely linked to their modes of self-assembly, which determine the functional nanostructures that they form. This work brings together two structural elements that direct nanoscale self-association in divergent directions: proline as a β-breaker and the β-structure-associated diphenylalanine motif, into a single tripeptide sequence. Amino acid chirality was found to resolve the tension inherent to these conflicting self-assembly instructions. Stereoconfiguration determined the ability of each of the eight possible Pro-Phe-Phe stereoisomers to self-associate into diverse nanostructures, including nanoparticles, nanotapes, or fibrils, which yielded hydrogels with gel-to-sol transition at a physiologically relevant temperature. Three single-crystal structures and all-atom molecular dynamics simulations elucidated the ability of each peptide to establish key interactions to form long-range assemblies (i,e., stacks leading to gelling fibrils), medium-range assemblies (i.e., stacks yielding nanotapes), or short-range assemblies (i.e., dimers or trimers that further associated into nanoparticles). Importantly, diphenylalanine is known to serve as a binding site for pathological amyloids, potentially allowing these heterochiral systems to influence the fibrillization of other biologically relevant peptides. To probe this hypothesis, all eight Pro-Phe-Phe stereoisomers were tested in vitroon the Alzheimer’s disease-associated Aβ(1–42) peptide. Indeed, one nonfibril-forming stereoisomer effectively inhibited Aβ fibrillization through multivalent binding between diphenylalanine motifs. This work thus defined heterochirality as a useful feature to strategically develop future therapeutics to interfere with pathological processes, with the additional value of resistance to protease-mediated degradation and biocompatibility.

Solution-processed semiconducting transition metal dichalcogenides are at the centre of an ever-increasing research effort in printed (opto)electronics. However, device performance is limited by structural defects resulting from the exfoliation process and poor inter-flake electronic connectivity. Here, we report a new molecular strategy to boost the electrical performance of transition metal dichalcogenide-based devices via the use of dithiolated conjugated molecules, to simultaneously heal sulfur vacancies in solution-processed transition metal disulfides and covalently bridge adjacent flakes, thereby promoting percolation pathways for the charge transport. We achieve a reproducible increase by one order of magnitude in field-effect mobility (µFE), current ratio (ION/IOFF) and switching time (τS) for liquid-gated transistors, reaching 10−2cm2V−1s−1, 104and 18 ms, respectively. Our functionalization strategy is a universal route to simultaneously enhance the electronic connectivity in transition metal disulfide networks and tailor on demand their physicochemical properties according to the envisioned applications.

Diphenylalanine is an amyloidogenic building block that can form a versatile array of supramolecular materials. Its shortcomings, however, include the uncontrolled hierarchical assembly into microtubes of heterogeneous size distribution and well-known cytotoxicity. This study rationalized heterochirality as a successful strategy to address both of these pitfalls and it provided an unprotected heterochiral dipeptide that self-organized into a homogeneous and optically clear hydrogel with excellent ability to sustain fibroblast cell proliferation and viability. Substitution of one l-amino acid with its d-enantiomer preserved the ability of the dipeptide to self-organize into nanotubes, as shown by single-crystal XRD analysis, whereby the pattern of electrostatic and hydrogen bonding interactions of the backbone was unaltered. The effect of heterochirality was manifested in subtle changes in the positioning of the aromatic side chains, which resulted in weaker intermolecular interactions between nanotubes. As a result, d-Phe-l-Phe self-organized into homogeneous nanofibrils with a diameter of 4 nm, corresponding to two layers of peptides around a water channel, and yielded a transparent hydrogel. In contrast with homochiral Phe-Phe stereoisomer, it formed stable hydrogels thermoreversibly. d-Phe-l-Phe displayed no amyloid toxicity in cell cultures with fibroblast cells proliferating in high numbers and viability on this biomaterial, marking it as a preferred substrate over tissue-culture plastic. Halogenation also enabled the tailoring of d-Phe-l-Phe self-organization. Fluorination allowed analogous supramolecular packing as confirmed by XRD, thus nanotube formation, and gave intermediate levels of bundling. In contrast, iodination was the most effective strategy to augment the stability of the resulting hydrogel, although at the expense of optical transparency and biocompatibility. Interestingly, iodine presence hindered the supramolecular packing into nanotubes, resulting instead into amphipathic layers of stacked peptides without the occurrence of halogen bonding. By unravelling fine details to control these materials at the meso- and macro-scale, this study significantly advanced our understanding of these systems.

Short peptide hydrogels are attractive biomaterials but typically suffer from limited mechanical properties. Inclusion of other nanomaterials can serve the dual purpose of hydrogel reinforcement and of conferring additional physicochemical properties (e.g., self-healing, conductivity), as long as they do not hamper peptide self-assembly. In particular, nanocarbons are ideal candidates, and their physicochemical properties have demonstrated great potential in nanocarbon-polymer gel biomaterials for tissue engineering or drug delivery. Recently, increasing interest in supramolecular hydrogels drove research also on their enhancement with nanocarbons. However, little is known on the effect of nanocarbon morphology on the self-assembly of short peptides, which are among the most popular hydrogel building blocks. In this work, three different oxidized nanocarbons (i.e., carbon nanotube or CNT as 1D material, graphene oxide sheet or GO as 2D material, and carbon nanohorn or CNH as 3D material) were evaluated for their effects on the self-assembly of the unprotected tripeptide Leu-DPhe-DPhe at physiological conditions. Supramolecular hydrogels were obtained in all cases, and viscoelastic properties were clearly affected by the nanocarbons, which increased stiffness and resistance to applied stress. Notably, self-healing behavior was observed only in the case of CNTs. Tripeptide–nanotube interaction was noted already in solution prior to self-assembly, with the tripeptide acting as a dispersing agent in phosphate buffer. Experimental and in silicoinvestigation of the interaction between peptide and CNTs suggests that the latter acts as nucleation templates for self-assembly and reassembly. Overall, we provide useful insights for the future design of composite biomaterials with acquired properties.

Aerosols can act as cloud condensation nuclei and/or ice-nucleating particles (INPs), influencing cloud properties. In particular, INPs show a variety of different and complex mechanisms when interacting with water during the freezing process. To gain a fundamental understanding of the heterogeneous freezing mechanisms, studies with proxies for atmospheric INPs must be performed. Graphene and its derivatives offer suitable model systems for soot particles, which are ubiquitous aerosols in the atmosphere. In this work, we present an investigation of the ice nucleation activity (INA) of different types of graphene and graphene oxides. Immersion droplet freezing experiments as well as additional analytical analyses, such as X-ray photoelectron spectroscopy, Raman spectroscopy, and transmission electron microscopy, were performed. We show within a group of samples that a highly ordered graphene lattice (Raman G band intensity >50%) can support ice nucleation more effectively than a lowly ordered graphene lattice (Raman G band intensity <20%). Ammonia-functionalized graphene revealed the highest INA of all samples. Atmospheric ammonia is known to play a primary role in the formation of secondary particulate matter, forming ammonium-containing aerosols. The influence of functionalization on interactions between the particle interface and water molecules, as well as on hydrophobicity and agglomeration processes, is discussed.

The assembly of aligned carbon nanotubes (CNTs) into fibers (CNTFs) is a convenient approach to exploit and apply the unique physico–chemical properties of CNTs in many fields. CNT functionalization has been extensively used for its implementation into composites and devices. However, CNTF functionalization is still in its infancy because of the challenges associated with preservation of CNTF morphology. Here, we report a thorough study of the gas-phase functionalization of CNTF assemblies using ozone which was generated in situ from a UV source. In contrast with liquid-based oxidation methods, this gas-phase approach preserves CNTF morphology, while notably increasing its hydrophilicity. The functionalized material is thoroughly characterized by Raman spectroscopy, X-ray photoelectron spectroscopy, transmission electron microscopy, and scanning electron microscopy. Its newly acquired hydrophilicity enables CNTF electrochemical characterization in aqueous media, which was not possible for the pristine material. Through comparison of electrochemical measurements in aqueous electrolytes and ionic liquids, we decouple the effects of functionalization on pseudocapacitive reactions and quantum capacitance. The functionalized CNTF assembly is successfully used as an active material and a current collector in all-solid supercapacitor flexible devices with an ionic liquid-based polymer electrolyte.

El objetivo del presente estudio ha sido el de conocer el efecto mediador y moderador del apoyo entre iguales, del apoyo familiary del apoyo docenteen la relación entre inteligencia emocionale ideación suicidaen adolescentes. Para este fin, han participado un total de 898 adolescentes (MEdad=13.55, DT=1.66), quienes han respondido a la Escala WLEIS, a la Escala de Apoyo Social Percibido,a la adaptación de la Escala de Clima Escolar, y al Inventario de Riesgo Suicida. Los resultados señalan cómo: (1) el apoyo docentey el apoyo familiarmedian la relación entre inteligencia emocionale ideación suicida; (2) independientemente del sexo y la edad, el apoyo familiarmodera la relación entre inteligencia emocionale ideación suicida, observando cómo la inteligencia emocionalayuda a reducir la ideación suicidasolo cuando existe medio o alto apoyo familiar; (3) el apoyo entre igualesy la edad moderan la relación entre inteligencia emocionale ideación suicida, observando cómo el apoyo entre igualesayuda a que la inteligencia emocionalreduzca la ideación suicidasolamente con adolescentes de mayor edad. Estos resultados evidencian como, además de tener que trabajar la inteligencia emocionalen adolescentes, en la medida de lo posible, introducir también la participación de las familias en los procesos de aprendizaje, así como fomentar las relaciones de calidad entre iguales podría acarrear especiales efectos para reducir una de las principales causas de muerte adolescente, como es el caso de la conducta suicida.

Introducción:El burnoutes un síndrome psicosocial causado por situaciones estresantes en el ámbito laboral. Afecta al 30-60% de los profesionales médicos. El objetivo de este estudio es realizar un análisis comparativo de su frecuencia antes y después del brote de la COVID-19 en los médicos adjuntos de Medicina Interna españoles.

Introduction:Ablation outcomes in persistent atrial fibrillation (AF) are suboptimal.Hypothesis:Characterizing the adenosine effects in non-invasive panoramic mapping can guide ablation to increase long-term freedom of arrhythmias.Methods:Persistent AF patients (N=25, mean±SD: 15.3±8.4 mo) underwent non-invasive panoramic mapping (CardioInsight, Medtronic) twice at baseline (B1 and B2) and then during 12 mg adenosine (Ado) peak effect. Reproducible rotational domains (≥2 rotations) were thereafter ablated (3.2±1.3 sites/patient). Data were exported to determine dominant frequencies (DFs) using short FFT technique with 0.1 Hz resolution and correlation with simultaneous intracardiac recordings (p<0.001).Results:Areas with stable DFs at B1 and B2 (

In recent years, we have witnessed to fast developments in the medicinal field of hydrogels containing various forms of integrated nanostructured carbon that adds interesting mechanical, thermal, and electronic properties. Besides key advances in tissue engineering (especially for conductive tissue, such as for the brain and the heart), there has been innovation also in the area of drug delivery on-demand, with engineered hydrogels capable of repeated response to light, thermal, or electric stimuli. This mini-review focusses on the most promising developments as applied to the gelation of protein/ peptide (including self-assembling amino acids and low-molecular-weight gelators), polysaccharide, and/or synthetic polymer components in medicine. The emerging field of graphene-only hydrogels is also briefly discussed, to give the reader a full flavor of the rising new paradigms in medicine that are made possible through the integration of nanostructured carbon (e.g., carbon nanotubes, nanohorns, nanodiamonds, fullerene, etc.). Nanocarbons are offering great opportunities to bring on a revolution in therapy that the modern medicinal chemist needs to master, to realise their full potential into powerful therapeutic solutions for the patient.

Nowadays, the unrelenting growth of the digital universe calls for radically novel strategies for data processing and storage. An extremely promising and powerful approach relies on the development of logic-in-memory (LiM) devices through the use of floating gate and ferroelectric technologies to write and erase data in a memory operating as a logic gate driven by electrical bias. In this work, we report an alternative approach to realize the logic-in-memory based on two-dimensional (2D) transition metal dichalcogenides (TMDs) where multiple memorized logic output states have been established via the interface with responsive molecular dipoles arranged in supramolecular arrays. The collective dynamic molecular dipole changes of the axial ligand coordinated onto self-assembled metal phthalocyanine nanostructures on the surface of 2D TMD enables large reversible modulation of the Fermi level of both n-type molybdenum disulfide (MoS2) and p-type tungsten diselenide (WSe2) field-effect transistors (FETs), to achieve multiple memory states by programming and erasing with ultraviolet (UV) and with visible light, respectively. As a result, logic-in-memory devices were built up with our supramolecular layer/2D TMD architecture where the output logic is encoded by the motion of the molecular dipoles. Our strategy relying on the dynamic control of the 2D electronics by harnessing the functions of molecular-dipole-induced memory in a supramolecular hybrid layer represents a versatile way to integrate the functional programmability of molecular science into the next generation nanoelectronics.