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We present and compare the design and performance of two 850 GHz radial probe fed superconductor-insulator-superconductor mixers, where the antenna is aligned perpendicular to the E-Plane of the input full-height rectangular waveguide connected to a multiple flare-angles smooth-walled horn. Both designs are comprised of 0.5 µm2 hybrid niobium/aluminium-nitride/niobium-nitride tunnel junction, fabricated on top of a niobium titanium nitride ground plane with an Al wiring layer. The entire superconducting circuit is supported with a 40 µm thick quartz substrate. The major difference between the two designs is the method used to cancel out the parasitic junction capacitance for broadband performance. The first design utilises two identical junctions connected in parallel with a short transmission line to convert the capacitance of one junction into the equivalent inductance of the other junction, commonly known as the twin-junction tuning scheme; whilst the second design employs an end-loaded scheme with only one tunnel junction. We found that both methods offer similar radio frequency performances, with close to 2× the double sideband quantum noise temperature, but the twin-junction design is more resilient to fabrication tolerances. However, the end-loaded design offers a much better intermediate frequency (IF) bandwidth performance, made possible by the sub-micron and high current density tunnel junction technology. The improved IF performance is important for many millimetre (mm) and sub-mm observatories, such as future upgrades of Atacama Large Millimetre/sub-mm Array receivers, as well as forthcoming space-borne far-infrared missions. Therefore, we conclude that the single-junction mixer design is the preferred option for THz applications, as long as the fabrication error can be minimised within a certain limit.

Background Despite similar survival rates, breast-conserving therapy (BCT) remains a distant second choice after simple mastectomy for patients with early-stage breast cancer in Singapore. Uptake of reconstruction after mastectomy is also low (18 per cent). The aim of this study was to explore the factors influencing a patient's choice for mastectomy when eligible for BCT, and why patients decline reconstruction after mastectomy. Methods Patients from the National Cancer Centre Singapore, who were eligible for BCT but chose mastectomy without reconstruction, between December 2014 and December 2015 were included. An interviewer-administered questionnaire focusing on patients' reasons for choosing mastectomy over BCT and not opting for immediate breast reconstruction after mastectomy was used. Tumour characteristics were retrieved from medical records. Spearman's rank correlation coefficient, Mann-Whitney U and Kruskal-Wallis tests were used to analyse the correlation between the patient's self-rated influential factors and variables. Statistical significance was taken as P

Introduction Several studies highlighted an increased risk of cardiovascular disease (CVD) in HIV-HCV co-infected patients without clearly identifying specific virologic factors associated with atherosclerotic CVD (ASCVD) events. Purpose Hence, we analyzed data collection from the French nationwide ANRS CO13 HEPAVIH cohort to determine the incidence of ASCVD events in HIV-HCV co-infected patients and the predictive factors associated with its occurrence. Methods The French multicenter nationwide ANRS CO13 HEPAVIH clinic-based cohort collected prospective clinical and biological data from HIV-HCV co-infected patients followed-up in 28 different university hospitals between December 2005 to November 2016. Participants with at least one year of follow-up were included. Primary outcome was the occurrence of major ASCVD events (cardiovascular death, acute coronary syndrome, coronary revascularization and stroke). Secondary outcomes were total ASCVD events including major ASCVD events and minor ASCVD events (peripheral arterial disease [PAD]). Incidence rates were estimated using Aalen-Johansen method and factors associated with ASCVD identified with Cox proportional hazards models. Results A total of 1213 patients were included: median age 45.4 years [42.1–49.0], 70.3% men, current smoking 70.2%, overweight 19.5%, liver cirrhosis 18.9%, chronic alcohol consumption 7.8%, diabetes mellitus (5.9%), personal history of CVD 2.7%, and statins use 4.1%. After a median follow-up of 5.1 years [3.9–7.0], 44 participants experienced at least one ASCVD event (26 major ASCVD event, and 20 a minor event). Incidences for total, major and minor ASCVD events were of 6.98 [5.19; 9.38], 4.01 [2.78; 6.00], and 3.17 [2.05; 4.92] per 1000 person-years, respectively. Personal history of CVD (Hazard Ratio (HR)=13.94 [4.25–45.66]), high total cholesterol (HR=1.63 [1.24–2.15]), low HDL cholesterol (HR=0.08 [0.02–0.34]) and undetectable HIV viral load (HR=0.41 [0.18–0.96]) were identified as independent factors associated with major ASCVD events while cirrhosis status, liver fibrosis and HCV sustained viral response were not. Cumulative incidence of CV events Conclusion HIV-HCV co-infected patients experience a high incidence of ASCVD events both coronary and peripheral artery diseases. Traditional CV risk factors are the main determinants of ASCVD whereas undetectable HIV viral load seems to be protective. Management of cholesterol abnormalities and controlling viral load are essential to modify this high cardiovascular risk. Acknowledgement/Funding Agence Natoinale de Recherche sur le SIDA et les Hépatites virales

Summary Background Coronary heart disease is rapidly increasing in developing countries, but access to cardiac rehabilitation and secondary prevention remains low. In this study, we aimed to assess the effectiveness of a smartphone-based cardiac rehabilitation and secondary prevention programme delivered via the social media platform WeChat (SMART-CR/SP). Methods In this parallel-group, single-blind, randomised controlled trial, we recruited patients aged 18 years or older with coronary heart disease who had received percutaneous coronary interventions from a large tertiary hospital in Shanghai, China. Participants were randomly assigned (1:1) by block randomisation to either a 2-month intensive programme followed by a 4-month step-down phase of SMART-CR/SP or to usual care. In the SMART-CR/SP group, participants received comprehensive cardiac rehabilitation and secondary prevention via WeChat. The usual care group received standard outpatient cardiology follow-up but without formal cardiac rehabilitation and secondary prevention. Assessments were done at baseline, 2 months, 6 months, and 12 months. The primary outcome was change in functional capacity from baseline, measured by 6-min walk distance, at 2 months and 6 months. Analysis was by intention to treat. Research personnel involved in assessments were blinded to group allocation. Adverse-event analysis was based on percentage of patients who discontinued the study owing to adverse events. SMART-CR/SP programme-related safety issues were also recorded. This study was registered with the Chinese Clinical Trial Registry, number ChiCTR-INR-16009598. Findings Between Nov 17, 2016, and March 18, 2017, 312 patients (mean age 60·5 years [SD 9·2]), of whom 58 (19%) were female and 254 (81%) were male, were recruited and subsequently randomly assigned to SMART-CR/SP (n=156) or usual care (n=156). The improvement in 6-min walk distance at 2 months was significantly greater in the SMART-CR/SP group (from 489·2 m [99·4] at baseline to 539·1 m [68·0]) than in the control group (from 485·0 m [93·5] at baseline to 517·8 m [74.6]), with an adjusted mean difference of 20·64 m (95% CI 7·50–33·77; p=0·034). This improvement was maintained at 6 months (mean 6-min walk distance 543·4 m [67·5] in the SMART-CR/SP group vs 523·5 m [60·2] in the control group), with a mean between-group difference of 22·29 m (8·19–36·38; p=0·027). No adverse events or SMART-CR/SP programme-related safety issues were reported by participants during the study. Interpretation SMART-CR/SP was found to be a cardiac rehabilitation and secondary prevention service model with high efficacy and accessibility and to be easy to use. These results justify the implementation of similar models of care on a broader scale. Funding Curtin University.

Background: Coronary heart disease (CHD) is rapidly increasing in developing countries, but access to cardiac rehabilitation and secondary prevention (CR/SP) remains low. We assessed the effectiveness of SMARTphone and WeChat-based CR/SP (SMART-CR/SP) in the first randomised controlled trial (RCT) of a dedicated social media-based CR/SP program for patients with CHD. Methods: In this parallel-group, single-blind, RCT, CHD patients from a large tertiary hospital in Shanghai, China were randomised (1:1) to an eight-week 'intensive', followed by a 16-week 'step down' program of SMART-CR/SP, or usual care. Assessments were conducted at baseline, eight and 24 weeks. The primary outcome was functional capacity measured by six-minute walk test distance (6MWTD). Secondary outcomes included CHD knowledge, and risk factor control. Analysis was by intention-to-treat. Findings: Between November 17, 2016 and March 18, 2017, 312 patients (mean age, 60.5 [SD 9.2] years, 81.4% male) were randomised to SMART-CR/SP (n=156) or usual care (n=156). The mean increase in 6MWTD was greater at both eight (46.5 vs. 20.9 m; 95% CI 9.6 to 41.5; p=0.002) and 24 weeks (54.2 vs. 26.2 m; 95% CI 10.9 to 44.9; p=0.001) in the SMART-CR/SP group versus controls. The SMART-CR/SP group had a better knowledge of CHD score at eight (17.9 vs. 13.8; 95% CI 2.84 to 5.44; p

Introduction The burden of cardiovascular disease (CVD) is rapidly increasing in developing countries, however access to cardiac rehabilitation and secondary prevention (CR/SP) in these countries is limited. Alternative delivery models that are low-cost and easy to access are urgently needed to address this service gap. The objective of this study is to investigate whether a smartphone and social media-based (WeChat) home CR/SP programme can facilitate risk factor monitoring and modification to improve disease self-management and health outcomes in patients with coronary heart disease (CHD), after percutaneous coronary intervention (PCI) therapy. Methods and analysis We propose a single-blind, randomised controlled trial of 300 patients post-PCI with follow-up over 12 months. The intervention group will receive a smartphone-based and WeChat-based CR/SP programme providing education and support for risk factor monitoring and modification. SMART-CR/SP incorporates core components of modern CR/SP: physical activity tracking with interactive feedback and goal setting; education modules addressing CHD understanding and self-management; remote blood pressure monitoring and strategies to improve medication adherence. Furthermore, a dedicated data portal and a CR/SP coach will facilitate individualised supervision and counselling. The control group will receive usual care but no formal CR/SP programme. The primary outcome is change in exercise capacity measured by 6 minute walk test distance. Secondary outcomes include knowledge and awareness of CHD, risk factor status, medication adherence, psychological well-being and quality of life, major cardiovascular events, re-hospitalisations and all-cause mortality. To assess the feasibility and patients’ acceptance of the intervention, a process evaluation will be performed at the conclusion of the study. Ethics and dissemination Ethics approval was granted by both the Human Research Ethics Committee of Fudan University Zhongshan Hospital (HREC B2016-058) and Curtin University Human Research Ethics Office (HRE2016-0120). Results will be disseminated via peer-reviewed publications and presentations at conferences. Clinical trial registration number ChiCTR-INR-16009598; Pre-results.

The most commonly utilized class of chemotherapeutic agents administered as a first-line therapy are antimitotic drugs; however, their clinical success is often impeded by chemoresistance and disease relapse. Hence, a better understanding of the cellular pathways underlying escape from cell death is critical. Mitotic slippage describes the cellular process where cells exit antimitotic drug-enforced mitotic arrest and “slip” into interphase without proper chromosome segregation and cytokinesis. The current report explores the cell fate consequence following mitotic slippage and assesses a major outcome following treatment with many chemotherapies, therapy-induced senescence. It was found that cells postslippage entered senescence and could impart the senescence-associated secretory phenotype (SASP). SASP factor production elicited paracrine protumorigenic effects, such as migration, invasion, and vascularization. Both senescence and SASP factor development were found to be dependent on autophagy. Autophagy induction during mitotic slippage involved the autophagy activator AMPK and endoplasmic reticulum stress response protein PERK. Pharmacologic inhibition of autophagy or silencing of autophagy-related ATG5 led to a bypass of G1 arrest senescence, reduced SASP-associated paracrine tumorigenic effects, and increased DNA damage after S-phase entry with a concomitant increase in apoptosis. Consistent with this, the autophagy inhibitor chloroquine and microtubule-stabilizing drug paclitaxel synergistically inhibited tumor growth in mice. Sensitivity to this combinatorial treatment was dependent on p53 status, an important factor to consider before treatment. Implications: Clinical regimens targeting senescence and SASP could provide a potential effective combinatorial strategy with antimitotic drugs. Mol Cancer Res; 16(11); 1625–40. ©2018 AACR.

Lafarge Infrastructure Team had constructed Malaysia's first hybrid concrete pavement using Jointed Plain Concrete Pavement (JPCP) and Roller Compacted Concrete (RCC) at Lafarge's Kanthan Cement Plant, Ipoh, Malaysia. The main purpose of the project is to showcase and study construction challenges in combining JPCP and RCC hybrid product for road solutions. The progress and pavement performance were monitored recorded and detailed through tests and site observation reports. JPCP pavement was constructed using two (2) type of construction methods; slip form and fixed form, while RCC pavement was laid and constructed using an asphalt paver set. The Quality Assurance & Control (QA/QC) monitored comprises of concrete design mix, concrete slump, concrete delivery, joints insertion, concrete curing, compaction, profile levels, saw cut and sequence of construction activities. Throughout the study, we have managed to table out the "Challenges and Best Practices" on the construction methods which mainly involves labours, machinery and material. All the information has been taken into consideration, to prepare a comprehensive report for the project. The study will enhance the knowledge and understanding for road owners, concrete suppliers, consultants and contractors in understanding the right application of JPCP and RCC in the future. We able to share and propose few best practices based on the challenges that we had face.