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This paper describes the design of the avionics architecture for military unmanned aerial vehicles considering the airworthiness requirements for the first time. This design considers the redundancy in the system data bus and the power system and the data link system to meet the system safety requirements of the airworthiness requirements of military UAVs. This avionics architecture design has been verified through the system integration test and the flight test after manufacturing the UAV.

In a power plant that uses seawater as a coolant, a debris filter is required to remove foreign substances from the seawater, and differential pressure leads to a decrease in the coolant flow rate, leading to a decrease in power generation efficiency. In this study, analysis was performed under different initial flow velocity conditions of 1.5m/s, 2.0m/s, and 2.5m/s for a debris filter used in a power plant to understand flow characteristics in CTCS. The flow and differential pressure characteristics of a CTCS with an installed debris filter were considered in a comparative analysis of velocity, pressure, and turbulent kinetic energy distribution. The results confirmed that a vortex was generated in the pipe with the debris filter, apparently due to the collision of the flow with the bracket of the debris filter. As the flow rate increased, the range of the vortex increased, causing a loss in flow.

Objectives The aim of this study was to determine whether 1 month of dual-antiplatelet therapy (DAPT) followed by aspirin monotherapy after polymer-free drug-coated stent (PF-DCS) implantation is noninferior to 6 to 12 months of DAPT after biodegradable-polymer drug-eluting stent (BP-DES) implantation. Background It is necessary to determine the optimal minimal duration of DAPT followed by aspirin monotherapy after percutaneous coronary intervention (PCI). Methods In this trial, 3,020 patients with coronary artery disease considered for PCI for noncomplex lesions were randomized to 1-month DAPT after PF-DCS (n = 1,507) or 6- to 12-month DAPT after BP-DES (n = 1,513). The primary endpoint was the 1-year composite of cardiac death, nonfatal myocardial infarction, target vessel revascularization, stroke, or major bleeding (noninferiority hypothesis margin of 3%). Results The primary endpoint occurred in 88 patients (5.9%) in the 1-month DAPT after PF-DCS group and 98 patients (6.5%) in the 6- to 12-month DAPT after BP-DES group (absolute difference −0.7%; upper limit of 1-sided 97.5% confidence interval: 1.33%; P Conclusions Among patients who underwent PCI for noncomplex lesions, 1-month DAPT followed by aspirin monotherapy after PF-DCS implantation was noninferior to 6- to 12-month DAPT after BP-DES implantation for the 1-year composite of cardiovascular events or major bleeding. The present findings need to be interpreted in the setting of different types of stents according to antiplatelet strategy. (A Randomized Controlled Comparison Between One Versus More Than Six Months of Dual Antiplatelet Therapy After Biolimus A9-Eluting Stent Implantation; NCT02513810 )

Fire accidents can occur on in-service ships and offshore installations due to the spillage of fuels from components such as storage tanks and valves under accidental and extreme conditions. In such accidents, the liquefied fuel spread area on the decks are affected by ship motion and properties of the fuel, which may cause a pool fire to develop into a large-scale fire, resulting in casualties and severe damage to property and the environment. Therefore, the effects of surface spread extent on the structural response of ships and offshore installations should be examined. Additional safety measures are particularly necessary on ships with large compartments, such as Ro-Ro ships. However, these fire hazards and their preventive measures have not been sufficiently explored. Thus, in this study, fuel discharge experiments were conducted to investigate the fuel spreading behavior at different substrate slopes and discharge rates. Based on the results, empirical formulae that predict the spreading extent of liquefied fuel in large compartments were derived. Additionally, the proposed formulae were used to investigate the variation of heat release rate in different spillage scenarios.

Rationale: Inflammation plays a pivotal role in the pathogenesis of the acute coronary syndrome. Detecting plaques with high inflammatory activity and specifically treating those lesions can be crucial to prevent life-threatening cardiovascular events. Methods: Here, we developed a macrophage mannose receptor (MMR)-targeted theranostic nanodrug (mannose-polyethylene glycol-glycol chitosan-deoxycholic acid-cyanine 7-lobeglitazone; MMR-Lobe-Cy) designed to identify inflammatory activity as well as to deliver peroxisome proliferator-activated gamma (PPARγ) agonist, lobeglitazone, specifically to high-risk plaques based on the high mannose receptor specificity. The MMR-Lobe-Cy was intravenously injected into balloon-injured atheromatous rabbits and serial in vivo optical coherence tomography (OCT)-near-infrared fluorescence (NIRF) structural-molecular imaging was performed. Results: One week after MMR-Lobe-Cy administration, the inflammatory NIRF signals in the plaques notably decreased compared to the baseline whereas the signals in saline controls even increased over time. In accordance with in vivo imaging findings, ex vivo NIRF signals on fluorescence reflectance imaging (FRI) and plaque inflammation by immunostainings significantly decreased compared to oral lobeglitazone group or saline controls. The anti-inflammatory effect of MMR-Lobe-Cy was mediated by inhibition of TLR4/NF-κB pathway. Furthermore, acute resolution of inflammation altered the inflamed plaque into a stable phenotype with less macrophages and collagen-rich matrix. Conclusion: Macrophage targeted PPARγ activator labeled with NIRF rapidly stabilized the inflamed plaques in coronary sized artery, which could be quantitatively assessed using intravascular OCT-NIRF imaging. This novel theranostic approach provides a promising theranostic strategy for high-risk coronary plaques.

The aim of this paper is to present a fire test database on the collapse of a full-scale steel stiffened plate structure without passive fire protection under lateral patch loading. Steel plate pan...

A significant proportion of proteins comprise multiple domains. Domain-domain docking is a tool that predicts multi-domain protein structures when individual domain structures can be accurately predicted but when domain orientations cannot be predicted accurately. GalaxyDomDock predicts an ensemble of domain orientations from given domain structures by docking. Such information would also be beneficial in elucidating the functions of proteins that have multiple states with different domain orientations. GalaxyDomDock is an ab initio domain-domain docking method based on GalaxyTongDock, a previously developed protein-protein docking method. Infeasible domain orientations for the given linker are effectively screened out from the docked conformations by a geometric filter, using the Dijkstra algorithm. In addition, domain linker conformations are predicted by adopting a loop sampling method FALC. The proposed GalaxyDomDock outperformed existing ab initio domain-domain docking methods, such as AIDA and Rosetta, in performance tests on the Rosetta benchmark set of two-domain proteins. GalaxyDomDock also performed better than or comparable to AIDA on the AIDA benchmark set of two-domain proteins and two-domain proteins containing discontinuous domains, including the benchmark set in which each domain of the set was modeled by the recent version of AlphaFold. The GalaxyDomDock web server is freely available as a part of GalaxyWEB at http://galaxy.seoklab.org/domdock.

Objective: The goal of this study was to determine the impact of late-acquired stent malapposition (LASM) on long-term clinical outcomes in patients treated with coronary stent implantation. Approach and Results: We investigated major adverse cardiac event during 10 years after 6-month intravascular ultrasound examination using our previous studies database. A total of 732 patients treated with bare-metal stent (54 LASM versus 678 non-LASM) and 529 patients treated with first-generation drug-eluting stent (82 LASM versus 447 non-LASM), who did not have clinical event or censoring at the time of follow-up intravascular ultrasound, were included for the present analysis. major adverse cardiac event was defined as the composite of cardiac death, target vessel–related myocardial infarction, target lesion revascularization and stent thrombosis. Multivariable adjustment and inverse probability weight were performed to consider baseline differences. After multivariable adjustment, LASM was related to a greater risk of major adverse cardiac event (hazard ratio, 1.666 [95% CI, 1.041–2.665]; P =0.0333) and very-late stent thrombosis (hazard ratio, 3.529 [95% CI, 1.153–10.798]; P =0.0271) than non-LASM in patients treated with first-generation drug-eluting stent, but not in those treated with bare-metal stent. Results were consistent after inverse probability weight. Among patients with LASM of first-generation drug-eluting stent, no late stent thrombosis occurred in patients who continued to receive dual antiplatelet therapy. Conclusions: The relationship between LASM and major adverse cardiac event might depend on the type of implanted stents during the long-term follow-up, highlighting the clinical significance of polymers and drugs in drug-eluting stent system.

Background and aims There are limited data comparing clinical outcomes among new-generation drug-eluting stents (DES) in ST-segment elevation myocardial infarction (STEMI) patients with multivessel coronary artery disease (MVD) who underwent primary percutaneous coronary intervention (PCI) with culprit-only or multivessel PCI. We investigated 1-year clinical outcomes between biodegradable-polymer (BP)-coated biolimus-eluting stent (BES) and durable-polymer (DP)-coated DES in STEMI patients with MVD who underwent two different reperfusion strategies. Methods A total of 4255 patients were enrolled and divided into two groups, a culprit-only (n = 2571, BP- [n = 264] or DP-DES [n = 2307]) or a multivessel PCI group (n = 1684, BP- [n = 145] or DP-DES [n = 1539]). The primary endpoint was major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction (re-MI), and total repeat revascularization. The secondary endpoint was the incidence of definite or probable stent thrombosis (ST). Results BP-BES and DP-DES showed a similar 1-year adjusted hazard ratio (HR) for MACE (culprit-only, adjusted hazard ratio [HR], 1.114; p = 0.740; multivessel, HR, 0.564; p = 0.167) and ST (culprit-only, HR, 1.110, p = 0.891; multivessel, HR, 0.375; p = 0.402). The adjusted HR for all-cause death, re-MI, and repeat revascularization were similar between the two groups. In the total population, the culprit-only PCI group showed a higher incidence of total repeat revascularization than the multivessel PCI group. Conclusions BP-BES and DP-DES showed comparable safety and efficacy in STEMI patients with MVD who underwent primary PCI with two different reperfusion strategies during a 1-year follow-up period.

Search is one of the most popular and important web services. The inverted index is the standard data structure adopted by most full-text search engines. Recently, custom hardware accelerators for inverted index search have emerged to demonstrate much higher throughput than the conventional CPU or GPU. However, less attention has been paid to addressing the memory capacity pressure with inverted index. The conventional DDRx DRAM memory system significantly increases the system cost to make a terabyte-scale main memory. Instead, a shared memory pool composed of storage-class memory (SCM) devices is a promising alternative for scaling memory capacity at a much lower cost. However, this SCM-based pooled memory poses new challenges caused by the limited bandwidth of both SCM devices and the shared interconnect to the host CPU. Thus, we propose BOSS, the first near-data processing (NDP) architecture for inverted index search on SCM-based pooled memory, which maintains high throughput of query processing in this bandwidth- constrained environment. BOSS mitigates the impact of low bandwidth of SCM devices by employing early-termination search algorithms, reducing the footprint of intermediate data, and introducing a programmable decompression module that can select the best compression scheme for a given inverted index. Furthermore, BOSS includes a top-k selection module in hardware to substantially reduce the host-accelerator bandwidth consumption. Compared to Apache Lucene, a production-grade search engine library, running on 8 CPU cores, BOSS achieves a geomean speedup of 8.1× on various complex query types, while reducing the average energy consumption by 189×.

The aim of this study was to determine whether 1 month of dual-antiplatelet therapy (DAPT) followed by aspirin monotherapy after polymer-free drug-coated stent (PF-DCS) implantation is noninferior to 6 to 12 months of DAPT after biodegradable-polymer drug-eluting stent (BP-DES) implantation.It is necessary to determine the optimal minimal duration of DAPT followed by aspirin monotherapy after percutaneous coronary intervention (PCI).In this trial, 3,020 patients with coronary artery disease considered for PCI for noncomplex lesions were randomized to 1-month DAPT after PF-DCS (n = 1,507) or 6- to 12-month DAPT after BP-DES (n = 1,513). The primary endpoint was the 1-year composite of cardiac death, nonfatal myocardial infarction, target vessel revascularization, stroke, or major bleeding (noninferiority hypothesis margin of 3%).The primary endpoint occurred in 88 patients (5.9%) in the 1-month DAPT after PF-DCS group and 98 patients (6.5%) in the 6- to 12-month DAPT after BP-DES group (absolute difference -0.7%; upper limit of 1-sided 97.5% confidence interval: 1.33%; P 0.001 for noninferiority). The occurrence of major bleeding was not different (1.7% vs 2.5%; P = 0.136). There was no difference in the occurrence of stent thrombosis (0.7% vs 0.8%; P = 0.842).Among patients who underwent PCI for noncomplex lesions, 1-month DAPT followed by aspirin monotherapy after PF-DCS implantation was noninferior to 6- to 12-month DAPT after BP-DES implantation for the 1-year composite of cardiovascular events or major bleeding. The present findings need to be interpreted in the setting of different types of stents according to antiplatelet strategy. (A Randomized Controlled Comparison Between One Versus More Than Six Months of Dual Antiplatelet Therapy After Biolimus A9-Eluting Stent Implantation; NCT02513810).

A 65-year-old man developed 3-vessel stent thrombosis after percutaneous coronary intervention with aspirin and clopidogrel. Platelet tests revealed clopidogrel resistance, which resolved after changing clopidogrel to ticagrelor. Although routine platelet tests after stenting are not recommended, these tests may be considered to identify the cause of stent thrombosis and modify antiplatelet therapy.

Background: Ticagrelor monotherapy after 3 months dual antiplatelet therapy (DAPT) with aspirin and ticagrelor can reduce bleeding without increasing ischemic events after percutaneous coronary intervention (PCI). However, the impact of this approach among the patient with diabetes remains unknown.Methods: This was a sub-analysis of the Ticagrelor Monotherapy after 3 months in the Patients Treated with New Generation Sirolimus Eluting Stent for Acute Coronary Syndrome (TICO) trial. After successful PCI, the patients were randomly assigned to ticagrelor monotherapy after 3-months DPAT or to ticagrelor-based 12-months DAPT. We compared ischemic events and bleeding events between the patients with diabetes and without diabetes for 12 months. Ischemic events were defined as death, myocardial infarction, ischemic stroke, transient ischemic attack, stent thrombosis, and any revascularizations. Bleeding events were defined according to the Thrombolysis in Myocardial Infarction (TIMI) criteria and Bleeding Academic Research Consortium (BARC) definition.Results: Between August 2015 and October 2018, 3,056 patients were enrolled in the TICO trial, of which 835 (27.3%) had diabetes mellitus. Diabetes mellitus was associated with all evaluated ischemic and bleeding events. No significant differences in any ischemic events were observed in patients with diabetes between ticagrelor monotherapy after 3-months DAPT and ticagrelor-based 12-months DAPT (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.45–1.52, p = 0.540). In patients with diabetes, the overall incidence of bleeding complications during the 12-months follow-up period did not differ between the two treatment groups (HR 0.83, 95% CI 1.48–1.43, p = 0.505). However, ticagrelor monotherapy was significantly reduced both any TIMI bleeding and BARC three or five bleeding events in diabetes patients in the 3-months landmark analysis, after 3-months DAPT period (HR 0.20, 95% CI 0.07–0.59, p = 0.003).Conclusion: In diabetic patients, ticagrelor monotherapy showed a lower incidence of bleeding complications after 3-months DAPT period, without increasing ischemic complications, compared with ticagrelor-based 12-months DAPT (ClinicalTrials.gov Identifier: NCT02494895).

Previous pathologic, intravascular imaging, and clinical studies have investigated the association between adverse cardiac events and stent malapposition, including acute stent malapposition (ASM, that is detected at index procedure) and late stent malapposition (LSM, that is detected during follow-up) that can be further classified into late-persistent stent malapposition (LPSM, ASM that remains at follow-up) or late-acquired stent malapposition (LASM, newly developed stent malapposition at follow-up that was not present immediately after index stent implantation). ASM has not been associated with adverse cardiac events compared with non-ASM, even in lesions with large-sized malapposition. The clinical outcomes of LSM may depend on its subtype. The recent intravascular ultrasound studies with long-term follow-up have consistently demonstrated that LASM steadily increased the risk of thrombotic events in patients with first-generation drug-eluting stents (DESs). This association has not yet been identified in LPSM. Accordingly, it is reasonable that approaches to stent malapposition should be based on its relationship with clinical outcomes. ASM may be tolerable after successful stent implantation, whereas prolonged anti-thrombotic medications and/or percutaneous interventions to modify LASM may be considered in selected patients with first-generation DESs. However, these treatments are still questionable due to lack of firm evidences.

We compared the clinical impact of renin-angiotensin system inhibitors (RASI) on long-term clinical outcomes between ST-segment elevation (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) after successful percutaneous coronary intervention (PCI) with drug eluting stents (DES) because of the paucity of published data.A total of 24,960 acute myocardial infarction (AMI) patients who underwent PCI with DES and were prescribed the RASI were enrolled and divided into two groups, the STEMI group (n = 14,061) and the NSTEMI group (n = 10,899). The clinical endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death, cardiac death (CD), recurrent myocardial infarction (re-MI), total coronary revascularization (target lesion revascularization [TLR], target vessel revascularization [TVR], non-TVR) during 2 years.After propensity score-matched (PSM) analysis, two PSM groups (6762 pairs, n = 13,524, C-statistic = 0.682) were generated. All-cause death (hazard ratio [HR], 1.386; 95% confidence interval [CI], 1.114-1.725; p = 0.003) and CD (HR, 1.358; 95% CI, 1.041-1.770; p = 0.024) rates were significantly higher in NSTEMI patients. However, the incidence of MACE, re-MI, total revascularization, TLR, TVR, non-TVR was not significantly different between the two groups. In addition, old age (≥65years), decreased left ventricular ejection fraction (50%), hypertension, creatine kinase isoenzyme level, cardiogenic shock, cardiopulmonary resuscitation on admission, and PCI within 24 h were common significant independent risk factors of all-cause death and CD.The mortality reduction capability of RASI was more prominent in the STEMI patients compared with the NSTEMI patients.

Objectives: This study sought to measure early strut coverage in patients receiving drug-eluting stents (DESs) and to explore the feasibility of short-term dual antiplatelet therapy (DAPT) ...

Objectives This study sought to evaluate the optimal duration of dual antiplatelet therapy (DAPT) after the implantation of a drug-eluting stent (DES) in elderly patients. Background Qualified studies to evaluate the optimal duration of DAPT in elderly patients have been very limited. Methods Using 6 randomized trials that compared short-term (≤6 months) and long-term (12 months) DAPT, individual participant data meta-analysis was performed in elderly patients (≥65 years of age). The primary study outcome was the 12-month risk of a composite of myocardial infarction, definite or probable stent thrombosis, or stroke. The major secondary outcome was the 12-month risk of major bleeding. Results The primary outcome risk did not significantly differ between patients receiving short-term and long-term DAPT (hazard ratio [HR]: 1.12; 95% confidence interval [CI]: 0.88 to 1.43; p = 0.3581) in the overall group of study participants. In subgroup analysis, a significant interaction between age and DAPT duration was observed for primary outcome risk (p for interaction = 0.0384). In the subset of younger patients ( Conclusions Short-term DAPT after new-generation DES implantation may be more beneficial in elderly patients than in younger patients.

Background: We investigated whether optical coherence tomography (OCT) guidance would reduce nonoptimal bioresorbable vascular scaffold (BVS) deployment. Methods: This was a randomized controlled trial. Patients who required percutaneous coronary intervention for ischemic heart disease were recruited from 2 centers in Korea. The enrolled patients were randomly assigned to receive either OCT-guided BVS (Absorb; Abbott Vascular) implantation or angiography-guided BVS implantation using an optimized technique. The primary outcome was nonoptimal deployment, which was a composite outcome of the following parameters assessed by OCT: a minimal scaffold area 2 , residual area stenosis >20%, incomplete apposition of the scaffold struts >5%, major edge dissection, or scaffold disruption. The secondary outcome was a procedural complication defined by the occurrence of no reflow, coronary perforation, or flow-limiting dissection. Results: Between September 2016 and January 2018, 88 patients (90 lesions) were assigned to OCT guidance, while 88 patients (89 lesions) were assigned to angiography guidance. The recruitment was prematurely terminated in March 2018 because the manufacturer stopped supplying BVS. Postprocedural OCT data were available for 88 lesions with OCT guidance and for 88 lesions with angiography guidance. There was nonoptimal BVS deployment postprocedurally in 35.2% of patients in the OCT-guidance group and in 38.6% in the angiography-guidance group (absolute difference, −3.7% [95% CI, −19.0% to 11.6%]; P =0.64). There were no procedural complications in either group. Conclusions: OCT-guided BVS implantation did not reduce the incidence of nonoptimal deployment compared to that of angiography-guided BVS implantation (using optimized techniques). Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02894697.

Power management and task placement pose two of the greatest challenges for future many-core processors in data centers. With hundreds of cores on a single die, cores experience varying memory latencies and cannot individually regulate voltage and frequency, therefore calling for new approaches to scheduling and power management. This work presents NuPow, a hierarchical scheduling and power management framework for architectures with multiple cores per voltage and frequency domain and non-uniform memory access (NUMA) properties. NuPow considers the conflicting goals of grouping virtual machines (VMs) with similar load patterns while also placing them as close as possible to the accessed data. Implemented and evaluated on existing hardware, NuPow achieves significantly better performance per watt compared to competing approaches.

Background The effects of severe acute stent malapposition ( ASM ) after drug‐eluting stent implantation on long‐term clinical outcomes are not clearly understood. We evaluated long‐term clinical outcomes of severe ASM using optical coherence tomography. Methods and Results We pooled patient‐ and lesion‐level data from 6 randomized studies. Five studies investigated follow‐up drug‐eluting stent strut coverage and one investigated ASM . In this data set, a total of 436 patients with 444 lesions underwent postintervention optical coherence tomography examination and these data were included in the analysis. Severe ASM was defined as lesions with ≥400 μm of maximum malapposed distance or ≥1 mm of maximum malapposed length. Composite events (cardiac death, target lesion–related myocardial infarction, target lesion revascularization, and stent thrombosis) were compared between patients with and without severe ASM . The postintervention optical coherence tomography findings indicated that 62 (14.2%) patients had lesions with ≥400 μm of maximum malapposed distance and 186 (42.7%) patients had lesions with ≥1 mm of maximum malapposed length. The 5‐year clinical follow‐up was completed in 371 (86.1%) of the eligible 431 patients. The cumulative rate of composite events was similar among the patients in each group during 5‐year follow‐up: 3.3% in patients with ASM ≥400 μm of maximum malapposed distance versus 3.1% in those with no ASM or ASM P =0.89), and 1.2% in patients with ASM ≥1 mm of maximum malapposed length versus 4.6% in those with no ASM or ASM P =0.06). Conclusions During the 5‐year follow‐up, ASM severity was not associated with long‐term clinical outcomes in patients treated with drug‐eluting stents.

Background and aims The impact of late drug-eluting stent (DES) malapposition detected by optical coherence tomography (OCT) on long-term clinical outcomes has not been clearly established. We evaluated long-term clinical outcomes of late stent malapposition (LSM) detected by OCT in a qualified study population. Methods A total of 428 patients were selected from previous randomized OCT studies that evaluated the degree of strut coverage of different DESs at a 3–12-month follow-up OCT examination. These patients were assigned to one of two groups based on the presence (n = 136) or absence (n = 292) of LSM on follow-up OCT images (performed at 7.0 ± 3.4 months after DES implantation). The cumulative rates of composite events (cardiac death, target-vessel-related myocardial infarction, target-vessel revascularization, and stent thrombosis) were compared between the two groups. Results During 73.7 ± 18.3 months of follow-up, cardiac death or (very) late stent thrombosis did not occur in either group. The cumulative rate of composite events was similar among the patients in each group (6.2% in patients with LSM vs. 11.7% in those without LSM) [hazard ratio (HR) = 0.569, 95% confidence interval (CI) = 0.257–1.257, p = 0.163]. Target vessel-related myocardial infarction occurred in 0.7% of patients with LSM vs. 1.5% of those without LSM (HR = 0.521, 95% CI = 0.058–4.670, p = 0.560). Target-vessel revascularization was performed in 5.4% of patients with LSM vs. 10.2% of those without LSM (HR = 0.574, 95% CI = 0.246–1.343, p = 0.201). Conclusions Cardiac death or (very) late stent thrombosis did not occur in patients with OCT-detected LSM during long-term follow-up. The presence of OCT-detected LSM was not associated with adverse clinical events.

Resumen Introduccion y objetivos Hay poca informacion sobre la utilidad de la ecocardiografia intravascular (IVUS) en el tratamiento de lesiones coronarias largas con stents farmacoactivos de segunda generacion. Se evaluaron por IVUS los predictores de eventos adversos cardiovasculares mayores (MACE) a los 12 meses del implante de stents liberadores de everolimus para el tratamiento de lesiones coronarias largas. Metodos Se incluyo a un total de 804 pacientes, procedentes de 2 ensayos clinicos aleatorizados, a los que se exploro por IVUS despues del implante de un stent liberador de everolimus largo (≥ 28 mm). Los MACE se definieron como la combinacion de eventos de muerte cardiaca, infarto de miocardio y revascularizacion de la lesion diana. Resultados Se produjeron MACE en 24 pacientes (3,0%) en 12 meses. En el analisis de regresion de Cox multivariable, los factores ecocardiograficos independientes predictivos fueron el area luminal minima de la lesion diana tras la intervencion (HR = 0,623; IC95%, 0,433-0,895; p = 0,010) y el cociente ALM/area luminal del segmento de referencia distal (HR = 0,744; IC95%, 0,572-0,969; p = 0,028). Los valores del ALM y del cociente ALM/area luminal del segmento de referencia distal que predecian mejor que pacientes sufririan MAC diferenciandolos de los que no los tendrian fueron 5,0 mm2 y 1,0 respectivamente. Los pacientes con ALM Conclusiones Los pacientes con un un ALM medida con IVUS tras la intervencion

Background The assessment of fractional flow reserve (FFR) in coronary lesions determines the strategy of percutaneous coronary intervention. However, the association between FFR and characteristics of the underlying coronary plaque has not been sufficiently investigated. Methods A total of 110 coronary lesions in 106 patients were evaluated using both FFR and optical coherence tomography (OCT). Coronary plaques were classified into fibrous, fibrocalcific, or fibroatheroma according to OCT evaluation at the site of minimal lumen area. Plaque microstructures such as cap thickness, macrophage accumulation, intimal vasculature, or cholesterol crystals were also evaluated. Results Lesions with FFR ≤ 0.8 showed a higher frequency of fibroatheroma, macrophage accumulation, and cholesterol crystals when compared to those with FFR > 0.8. The angle of lipid was wider in lesions with FFR ≤ 0.8 (145.1 ± 63.0° vs. 120.7 ± 48.9°, p = 0.047), and the longitudinal length was longer in those with FFR ≤ 0.8 (4.2 ± 2.8 mm vs. 2.5 ± 2.9 mm, p = 0.007). However, multiple linear regression analysis revealed that the morphological characteristics of plaques assessed by OCT were not independently associated with FFR. Minimal lumen area [coefficient, 0.035; 95% confidence interval (CI), 0.022–0.048; p p = 0.001) assessed by OCT significantly correlated with FFR. Conclusion The morphological characteristics of coronary plaque derived from OCT are not directly related to FFR.

While glassy materials can be made from virtually every class of liquid (metallic, molecular, covalent, and ionic), to date, formation of glasses in which structural units impart porosity on the nanoscopic level remains undeveloped. In view of the well-established porosity of metal-organic frameworks (MOFs) and the flexibility of their design, we have sought to combine their formation principles with the general versatility of glassy materials. Although the preparation of glassy MOFs can be achieved by amorphization of crystalline frameworks, transparent glassy MOFs exhibiting permanent porosity accessible to gases are yet to be reported. Here, we present a generalizable chemical strategy for making such MOF glasses by assembly from viscous solutions of metal node and organic strut and subsequent evaporation of a plasticizer-modulator solvent. This process yields glasses with 300 m(2)/g internal surface area (obtained from N2 adsorption isotherms) and a 2 nm pore-pore separation. On a volumetric basis, this porosity (0.33 cm(3)/cm(3)) is 3 times that of the early MOFs (0.11 cm(3)/cm(3) for MOF-2) and within range of the most porous MOFs known (0.60 cm(3)/cm(3) for MOF-5). We believe the porosity originates from a 3D covalent network as evidenced by the disappearance of the glass transition signature as the solvent is removed and the highly cross-linked nanostructure builds up. Our work represents an important step forward in translating the versatility and porosity of MOFs to glassy materials.