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Objective: To investigate the influence of age at onset of spinal cord injury on length of stay, inpatient therapy and nursing hours, independence at discharge and risk of institutionalization.Design: Retrospective cohort study.Participants: A total of 250 patients with a newly acquired traumatic or non-traumatic spinal cord injury undergoing primary inpatient rehabilitation in a Swiss spinal cord injury specialized clinic between 2017 and 2019.Methods: Multiple regression analysis was used to determine if age, in addition to clinical characteristics (co-morbidities, secondary complications and spinal cord injury severity), affects inpatient rehabilitation parameters (length of stay, daily nursing hours and daily therapy hours), independence at discharge (Spinal Cord Independence Measure III) and place of discharge (private residence vs institution).Results: Chronological age correlated with the number of co-morbidities and secondary complications. Older age was associated with increased daily nursing care and reduced independence at discharge. However, both were also influenced by co-morbidities, secondary complications and severity of spinal cord injury. Length of stay and daily therapy hours were age-independent. Odds for institutionalization after discharge increased significantly, by 1.03-fold per year of age.Conclusion: Age at onset of spinal cord injury predicted inpatient nursing care, independence at discharge and the risk of institutionalization after primary inpatient rehabilitation. Co-morbidities, secondary complications and severity of spinal cord injury were also important influencing factors. LAY ABSTRACTThe age at which people have a spinal cord injury is increasing, and there has been a shift from traumatic towards more non-traumatic causes, particularly at an advanced age. The aim of this study was to determine the influence of age at onset of spinal cord injury on the inpatient rehabilitation process and on independence at discharge. A total of 250 patients, with a median age of 57.0 years, undergoing primary inpatient rehabilitation in a Swiss spinal cord injury specialized clinic were included in the study. Older age was associated with a higher number of co-morbidities and more secondary complications. Age significantly predicted daily nursing hours, but not length of stay or daily therapy hours. Moreover, older age was associated with reduced independence at discharge and increased the risk of institutionalization after discharge. In addition to age, co-morbidities, secondary complications and severity of spinal cord injury were important influencing factors.

Mastergradsoppgave i treningsfysiologi Bakgrunn: Prevalensen av fedme, hyperglykemi og diabetes øker rundt om i verden, derfor er det viktig å finne enkle og effektive metoder for å forhindre økning. Det finnes indikasjoner på at styrketrening bedrer glukosemetabolismen hos personer med fedme og diabetes type 2, men litteraturen viser sprikende funn. Formål: Formålet med denne studien er å undersøke effekten av 13 uker med styrketrening på forskjellige glukosemål hos personer med fedme. Metode: Tolv personer med fedme (50,3±4,2 år) i intervensjonsgruppen står til åtte personer i kontrollgruppen med fedme (43,6 ± 6,2 år). Intervensjonsgruppen gjennomførte 13 uker med progressiv styrketrening, to ganger i uken. Tilvenningstrening ble gjennomført i tre uker før 10 uker med styrketrening. En oral glukosetoleranse-test (OGTT) ble gjennomført syv uker før styrketreningsintervensjonen, rett før tilvenningsperioden og 48 timer etter siste gjennomførte treningsøkt, der blodglukoseverdier ble målt ved hjelp av fingerstikk. Resultat: Personer med fedme har redusert glukosetoleranse i forhold til personer med kroppsmasseindeks (KMI)

The COVID-19 pandemic severely upended cultural and creative production, consumption, and interactions in cities. Open green spaces, parks, forests, and gardens—green infrastructure—were instead utilized by citizens as a substitute for stimulating social interactions, sustainable tourism, and green growth. (1) The purpose of this research is to understand whether the availability of green infrastructure relates to the Cultural and Creative Cities Monitor (CCCM) benchmarking project developed by the Joint Research Centre of the European Commission performance. Does new evidence suggest revising the CCCM conceptual framework and related urban policies, especially in relation to the EU Green Deal? (2) Data from OpenStreetMap was used to count the amount of green infrastructure in 184 European Cities covered by the CCM and was then correlated with the sub-indices of the CCCM. (3) We found a moderately positive correlation of green infrastructure with the cultural vibrancy of a city and a weak positive correlation with the enabling environment of a city. (4) In light of the COVID-19 pandemic, the EU Green Deal and several other policy initiatives aimed at urban greening, we recommend that the CCCM include an Urban Nature sub-index as one of the performance indicators of the CCCM. An Urban Nature sub-index will broaden the goal of the CCCM by providing policymakers with a better understanding of actions and strategies to allow culture to contribute to social inclusion and green growth strategies in cities.

Denne masteroppgaven er en integrert litteraturgjennomgang av musikkterapeutisk litteratur som omhandler musikkterapi og forebygging i grunnskolen. Forskningsspørsmålet er: Hva sier litteratur mellom(fra) 2008-2018 om forebyggende arbeid med musikkterapi med barn i grunnskolen (6-16 år)? Underproblemstillingen retter fokuset mot hvilket fokus den musikkterapeutiske litteraturen har hatt i forskningen frem til nå. Oppgaven begrenser seg, som det kommer frem av forskningsspørsmålet, til litteratur som har blitt publisert i løpet av de siste ti årene. Målet med studien er å få en bredere forståelse for hvilke forebyggende tiltak som allerede finnes i grunnskolen, og hva som kan være musikkterapien sitt tilskudd til dette. I teoridelen trekkes viktigere teoretiske perspektiver frem for definisjon av begrep men også belysning av fokusområde i oppgaven. Videre analyserer og drøfter jeg ulike fokusområder som kommer frem av resultatet i denne masteroppgaven. Disse fokusområdene blir gjennom en konstruktivistisk analyse av resultatdelen sett i lys av humanistiske, ressursorienterte, relasjonelle og teorier fra pedagogikken for å få frem nyanser i analyse og diskusjonsdel. Det kommer frem av resultatdelen at det finnes lite musikkterapeutisk forskning på forebyggende tiltak i grunnskolen, samtidig som analyse og diskusjonsdelen viser til et behov for flere tiltak ved tidlig innsats. Musikkterapeutisk forskning som allerede finnes, og som jeg vil presentere senere i oppgaven, baserer seg i hovedsak på sekundærforebyggende tiltak der målet er å henholdsvis stanse sykdomsutviklingen og bedre negative symptom. Studien konkluderer med et behov for mer forskning på området, for i nesteomgang skape en ny arena for musikkterapeutisk praksis. This master thesis is based upon an integrated literature review of music therapeutic literature and prevention in elementary school. The research question is: What does literature between 2008-2018 say regarding preventive work with music therapy with children in primary school (6-16 years)? I will try to find out what focus music therapeutic literature has had on research until now. The task, as stated by the research question, is limited to literature that has been published in the last ten years. The aim of this study is to get a broader understanding of what preventive measures already exist in elementary school, and what may be the contribution of music therapy. Furthermore, I will analyze and discuss different focus areas that emerge from the results of this Master Thesis. These focus areas, through a constructivist analysis of the results, are seen in the light of a humanistic and resource-oriented view in addition to theories from pedagogy, to bring out nuances in the analysis and discussion. It appears from the results that there has been little music therapy research on preventive measures in elementary school. The analysis and discussion section indicate a need for more early intervention efforts. The Music therapeutic research that already exists, and that I will present later on, is mainly based on secondary prevention measures, whose goal is to stop disease from developing. The study concludes with a need for more research in the field, to create a new arena for music therapeutic practice. Masteroppgave i musikkterapi MUTP350

AIMS Our aim was to compare the safety and efficacy of a novel, ultrathin strut, biodegradable polymer sirolimus-eluting stent (BP-SES) with a thin strut, durable polymer everolimus-eluting stent (DP-EES) in a pre-specified subgroup of patients with acute ST-segment elevation myocardial infarction (STEMI) enrolled in the BIOSCIENCE trial. METHODS AND RESULTS The BIOSCIENCE trial is an investigator-initiated, single-blind, multicentre, randomised non-inferiority trial (NCT01443104). Randomisation was stratified according to the presence or absence of STEMI. The primary endpoint, target lesion failure (TLF), is a composite of cardiac death, target vessel myocardial infarction, and clinically indicated target lesion revascularisation within 12 months. Between February 2012 and May 2013, 407 STEMI patients were randomly assigned to treatment with BP-SES or DP-EES. At one year, TLF occurred in seven (3.4%) patients treated with BP-SES and 17 (8.8%) patients treated with DP-EES (RR 0.38, 95% CI: 0.16-0.91, p=0.024). Rates of cardiac death were 1.5% in the BP-SES group and 4.7% in the DP-EES group (RR 0.31, 95% CI: 0.08-1.14, p=0.062); rates of target vessel myocardial infarction were 0.5% and 2.6% (RR 0.18, 95% CI: 0.02-1.57, p=0.082), respectively, and rates of clinically indicated target lesion revascularisation were 1.5% in the BP-SES group versus 2.1% in the DP-EES group (RR 0.69, 95% CI: 0.16-3.10, p=0.631). There was no difference in the risk of definite stent thrombosis. CONCLUSIONS In this pre-specified subgroup analysis, BP-SES was associated with a lower rate of target lesion failure at one year compared to DP-EES in STEMI patients. These findings require confirmation in a dedicated STEMI trial.

Our goal was to evaluate the impact of the discontinuation times of dual antiplatelet therapy with clopidogrel, prasugrel or ticagrelor on postoperative bleeding rates and the use of blood products in patients undergoing isolated urgent coronary artery bypass grafting (CABG).We retrospectively analysed 334 patients with acute coronary syndrome undergoing urgent CABG at the University Hospital Basel. A total of 262 patients continued to take dual antiplatelet therapy during the surgery (72 received clopidogrel; 68, prasugrel; and 122, ticagrelor). They were stratified by the discontinuation time of dual antiplatelet therapy (24 h, 24-48 h, 48-72 h and72 h). Seventy-two patients taking acetylsalicylic acid (ASA) as monotherapy served as a comparison group.Median postsurgical bleeding rates were significantly higher with ticagrelor if it was discontinued24 h [1220 ml, interquartile range (IQR) 978-1520 ml; P 0.001], 24-48 h (1200 ml, IQR 800-1550 ml; P 0.001) and 48-72 h (1100 ml, IQR 845-1245 ml; P = 0.036) but not if discontinued72 h (700 ml, IQR 520-825 ml; P = 0.22) and with prasugrel if discontinued24 h (1320 ml, IQR 900-1950 ml; P 0.001) but not if discontinued 24-48 h (1050 ml, IQR 638-1438 ml; P = 0.089) or72 h (750 ml, IQR 488-1040; P = 0.63) compared to ASA monotherapy (800 ml, IQR 593-1043 ml). The postsurgical use of blood products compared to ASA monotherapy (0, IQR 0-2 units) was significantly higher with ticagrelor and prasugrel if discontinued24 h (2.5 units, IQR 0-6; P 0.001 and 2 units, IQR 1-6; P 0.001, respectively).Discontinuation of ticagrelor and prasugrel for more than 72 h before urgent CABG was not associated with higher bleeding rates compared to treatment with ASA monotherapy. In contrast, discontinuation for less than 24 h was associated with higher use of blood products. For ticagrelor, this study supports evidence and recent guidelines proposing a shorter discontinuation time of 3 days and raises the question of whether the same could be true for prasugrel.

AIMS A novel ultrathin-strut biodegradable polymer sirolimus-eluting stent (Orsiro™, Biotronik, Bülach, Switzerland; BP-SES) was shown to be superior to a thin-strut durable polymer everolimus-eluting stent (Xience™ Xpedition/Alpine, Abbott Vascular, Santa Clara, USA; DP-EES) with respect to the primary endpoint of target lesion failure (TLF) at 12 months in the prespecified subgroup of patients with ST-segment elevation myocardial infarction (STEMI) included in the BIOSCIENCE trial. We designed a large-scale, randomized, clinical trial to assess the clinical superiority of ultrathin-strut BP-SES over thin-strut DP-EES among patients with STEMI undergoing primary percutaneous coronary intervention. METHODS AND RESULTS BIOSTEMI (NCT02579031) is a prospective, multicentre, randomized, controlled, superiority trial that will randomly assign 1'250 patients with STEMI undergoing primary percutaneous coronary intervention to treatment with BP-SES or DP-EES. The primary endpoint of TLF, a composite of cardiac death, target vessel re-infarction, and clinically-indicated target lesion revascularisation within 12 months, will be analysed with Bayesian models applied to the BIOSTEMI dataset (n=1'250) using robustified historical priors to incorporate historical information from the BIOSCIENCE STEMI subgroup (n=407). CONCLUSIONS The BIOSTEMI trial will determine whether ultrathin-strut BP-SES are superior to thin-strut DP-EES with respect to TLF in patients with STEMI undergoing primary percutaneous coronary intervention.

Background\ud\udProphylaxis for gastrointestinal stress ulceration is frequently given to patients in the intensive care unit (ICU), but its risks and benefits are unclear.\udMethods\ud\udIn this European, multicenter, parallel-group, blinded trial, we randomly assigned adults who had been admitted to the ICU for an acute condition (i.e., an unplanned admission) and who were at risk for gastrointestinal bleeding to receive 40 mg of intravenous pantoprazole (a proton-pump inhibitor) or placebo daily during the ICU stay. The primary outcome was death by 90 days after randomization.\udResults\ud\udA total of 3298 patients were enrolled; 1645 were randomly assigned to the pantoprazole group and 1653 to the placebo group. Data on the primary outcome were available for 3282 patients (99.5%). At 90 days, 510 patients (31.1%) in the pantoprazole group and 499 (30.4%) in the placebo group had died (relative risk, 1.02; 95% confidence interval [CI], 0.91 to 1.13; P=0.76). During the ICU stay, at least one clinically important event (a composite of clinically important gastrointestinal bleeding, pneumonia, Clostridium difficile infection, or myocardial ischemia) had occurred in 21.9% of patients assigned to pantoprazole and 22.6% of those assigned to placebo (relative risk, 0.96; 95% CI, 0.83 to 1.11). In the pantoprazole group, 2.5% of patients had clinically important gastrointestinal bleeding, as compared with 4.2% in the placebo group. The number of patients with infections or serious adverse reactions and the percentage of days alive without life support within 90 days were similar in the two groups.\udConclusions\ud\udAmong adult patients in the ICU who were at risk for gastrointestinal bleeding, mortality at 90 days and the number of clinically important events were similar in those assigned to pantoprazole and those assigned to placebo. (Funded by Innovation Fund Denmark and others; SUP-ICU ClinicalTrials.gov number, NCT02467621. opens in new tab.)

AIMS A novel ultrathin-strut biodegradable polymer sirolimus-eluting stent (Orsiro™, Biotronik, Bulach, Switzerland; BP-SES) was shown to be superior to a thin-strut durable polymer everolimus-eluting stent (Xience™ Xpedition/Alpine, Abbott Vascular, Santa Clara, USA; DP-EES) with respect to the primary endpoint of target lesion failure (TLF) at 12 months in the prespecified subgroup of patients with ST-segment elevation myocardial infarction (STEMI) included in the BIOSCIENCE trial. We designed a large-scale, randomized, clinical trial to assess the clinical superiority of ultrathin-strut BP-SES over thin-strut DP-EES among patients with STEMI undergoing primary percutaneous coronary intervention. METHODS AND RESULTS BIOSTEMI (NCT02579031) is a prospective, multicentre, randomized, controlled, superiority trial that will randomly assign 1'250 patients with STEMI undergoing primary percutaneous coronary intervention to treatment with BP-SES or DP-EES. The primary endpoint of TLF, a composite of cardiac death, target vessel re-infarction, and clinically-indicated target lesion revascularisation within 12 months, will be analysed with Bayesian models applied to the BIOSTEMI dataset (n=1'250) using robustified historical priors to incorporate historical information from the BIOSCIENCE STEMI subgroup (n=407). CONCLUSIONS The BIOSTEMI trial will determine whether ultrathin-strut BP-SES are superior to thin-strut DP-EES with respect to TLF in patients with STEMI undergoing primary percutaneous coronary intervention.

AIMS We sought to assess the performance of drug-eluting stents combining an ultrathin cobalt-chromium platform with a biodegradable polymer across categories of increasing SYNTAX score (SS). METHODS AND RESULTS Patients included in the BIOSCIENCE trial and randomly allocated to treatment with biodegradable polymer sirolimus-eluting stents (BP-SES) or durable polymer everolimus-eluting stents (DP-EES) were categorised according to SS tertiles (low 15). The primary endpoint, target lesion failure (TLF), was defined as a composite of cardiac death, target vessel myocardial infarction and clinically indicated target lesion revascularisation. The patient-oriented endpoint (POCE) included death, myocardial infarction, or any repeat revascularisation. The SS was available in 2,041 out of 2,119 patients (96.3%). At two-year follow-up, patients with an SS >15 experienced higher rates of both TLF and POCE as compared to patients with medium and low SS (14.5% vs. 8.1% and vs. 5.9%, p

Background No data are available on the long‐term performance of ultrathin strut biodegradable polymer sirolimus‐eluting stents ( BP ‐ SES ). We reported 2‐year clinical outcomes of the BIOSCIENCE (Ultrathin Strut Biodegradable Polymer Sirolimus‐Eluting Stent Versus Durable Polymer Everolimus‐Eluting Stent for Percutaneous Coronary Revascularisation) trial, which compared BP ‐ SES with durable‐polymer everolimus‐eluting stents ( DP ‐ EES ) in patients undergoing percutaneous coronary intervention. Methods and Results A total of 2119 patients with minimal exclusion criteria were assigned to treatment with BP ‐ SES (n=1063) or DP ‐ EES (n=1056). Follow‐up at 2 years was available for 2048 patients (97%). The primary end point was target‐lesion failure, a composite of cardiac death, target‐vessel myocardial infarction, or clinically indicated target‐lesion revascularization. At 2 years, target‐lesion failure occurred in 107 patients (10.5%) in the BP ‐ SES arm and 107 patients (10.4%) in the DP ‐ EES arm (risk ratio [ RR ] 1.00, 95% CI 0.77–1.31, P =0.979). There were no significant differences between BP ‐ SES and DP ‐ EES with respect to cardiac death ( RR 1.01, 95% CI 0.62–1.63, P =0.984), target‐vessel myocardial infarction ( RR 0.91, 95% CI 0.60–1.39, P =0.669), target‐lesion revascularization ( RR 1.17, 95% CI 0.81–1.71, P =0.403), and definite stent thrombosis ( RR 1.38, 95% CI 0.56–3.44, P =0.485). There were 2 cases (0.2%) of definite very late stent thrombosis in the BP ‐ SES arm and 4 cases (0.4%) in the DP ‐ EES arm ( P =0.423). In the prespecified subgroup of patients with ST ‐segment elevation myocardial infarction, BP ‐ SES was associated with a lower risk of target‐lesion failure compared with DP ‐ EES ( RR 0.48, 95% CI 0.23–0.99, P =0.043, P interaction =0.026). Conclusions Comparable safety and efficacy profiles of BP ‐ SES and DP ‐ EES were maintained throughout 2 years of follow‐up. Clinical Trial Registration URL : https://www.clinicaltrials.gov . Unique identifier: NCT 01443104.

Among patients with acute ST-segment elevation myocardial infarction (STEMI), early-generation drug-eluting stents (DES) have been associated with a reduction in target-vessel revascularization compared with bare-metal stents after primary percutaneous coronary intervention. However, this early

Aim To investigate the putative modifying effect of dual antiplatelet therapy (DAPT) use on the incidence of stent thrombosis at 3 years in patients randomized to Endeavor zotarolimus-eluting stent (E-ZES) or Cypher sirolimus-eluting stent (C-SES). Methods and results Of 8709 patients in PROTECT, 4357 were randomized to E-ZES and 4352 to C-SES. Aspirin was to be given indefinitely, and clopidogrel/ticlopidine for ≥3 months or up to 12 months after implantation. Main outcome measures were definite or probable stent thrombosis at 3 years. Multivariable Cox regression analysis was applied, with stent type, DAPT, and their interaction as the main outcome determinants. Dual antiplatelet therapy adherence remained the same in the E-ZES and C-SES groups (79.6% at 1 year, 32.8% at 2 years, and 21.6% at 3 years). We observed a statistically significant (P = 0.0052) heterogeneity in treatment effect of stent type in relation to DAPT. In the absence of DAPT, stent thrombosis was lower with E-ZES vs. C-SES (adjusted hazard ratio 0.38, 95% confidence interval 0.19, 0.75; P = 0.0056). In the presence of DAPT, no difference was found (1.18; 0.79, 1.77; P = 0.43). Conclusion A strong interaction was observed between drug-eluting stent type and DAPT use, most likely prompted by the vascular healing response induced by the implanted DES system. These results suggest that the incidence of stent thrombosis in DES trials should not be evaluated independently of DAPT use, and the optimal duration of DAPT will likely depend upon stent type (Clinicaltrials.gov number NCT00476957)

BackgroundDual antiplatelet therapy (DAPT) prevents thrombotic events after coronary stent implantation but may induce bleedings, specifically in elderly patients. However, a competitive risk analysis is lacking.ObjectivesTo assess the determinants of major bleeding and the balance between the competing risks of major bleeding and thrombotic events during prasugrel-based DAPT after stent implantation.MethodsOverall, 2,291 patients randomized to drug-eluting or bare metal stents and treated with prasugrel 10mg/day for 1 year were followed over 2 years for major bleeding (BARC 3/5) and thrombotic events (cardiac death, myocardial infarction, definitive/probable stent thrombosis). Prasugrel dose was reduced to 5mg in patients >75 years and/or ResultsTwo-year rates of major bleeding and thrombotic events were 2.9% and 9.0%, respectively. The only independent predictor of major bleeding was age (hazard ratio per year increase 1.05 [1.02,1.07], pConclusionsIn prasugrel-based DAPT, age is the strongest risk factor for major bleeding, increasing exponentially >65 years. In younger patients, thrombotic events represent a higher risk than bleeding, while thrombotic and bleeding risks were similar in older patients. Important clinical implications relate to prasugrel dose in the elderly, duration of DAPT and the competing risk balance necessitating individualized treatment decisions.

Background— Ultrathin strut biodegradable polymer sirolimus-eluting stents (BP-SES) proved noninferior to durable polymer everolimus-eluting stents (DP-EES) for a composite clinical end point in a population with minimal exclusion criteria. We performed a prespecified subgroup analysis of the Ultrathin Strut Biodegradable Polymer Sirolimus-Eluting Stent Versus Durable Polymer Everolimus-Eluting Stent for Percutaneous Coronary Revascularisation (BIOSCIENCE) trial to compare the performance of BP-SES and DP-EES in patients with diabetes mellitus. Methods and Results— BIOSCIENCE trial was an investigator-initiated, single-blind, multicentre, randomized, noninferiority trial comparing BP-SES versus DP-EES. The primary end point, target lesion failure, was a composite of cardiac death, target-vessel myocardial infarction, and clinically indicated target lesion revascularization within 12 months. Among a total of 2119 patients enrolled between February 2012 and May 2013, 486 (22.9%) had diabetes mellitus. Overall diabetic patients experienced a significantly higher risk of target lesion failure compared with patients without diabetes mellitus (10.1% versus 5.7%; hazard ratio [HR], 1.80; 95% confidence interval [CI], 1.27–2.56; P =0.001). At 1 year, there were no differences between BP-SES versus DP-EES in terms of the primary end point in both diabetic (10.9% versus 9.3%; HR, 1.19; 95% CI, 0.67–2.10; P =0.56) and nondiabetic patients (5.3% versus 6.0%; HR, 0.88; 95% CI, 0.58–1.33; P =0.55). Similarly, no significant differences in the risk of definite or probable stent thrombosis were recorded according to treatment arm in both study groups (4.0% versus 3.1%; HR, 1.30; 95% CI, 0.49–3.41; P =0.60 for diabetic patients and 2.4% versus 3.4%; HR, 0.70; 95% CI, 0.39–1.25; P =0.23, in nondiabetics). Conclusions— In the prespecified subgroup analysis of the BIOSCIENCE trial, clinical outcomes among diabetic patients treated with BP-SES or DP-EES were comparable at 1 year. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01443104.

The aim of the present study was to investigate the effect of the initial protein and mineral composition on the formation of whey protein microgels at a protein concentration of 4 wt%. As a model system, both demineralized α-lactalbumin (α-la) and β-lactoglobulin (β-lg) were mixed at 20/80, 50/50 and 80/20 α-la/β-lg ratios and heated (85 °C, 15 min) in the pH range 5.7–6.2. Pure dispersions of α-la were not forming microgels but rather precipitates (12%) and a majority of soluble aggregates (83%). Upon mixing with β-lg, microgels were only obtained for the 20/80 ratio at pH 5.7 or for pure β-lg at pH 5.8. Interestingly, the latter ratio was close to the natural composition occurring in most of the commercial whey protein isolates (WPIs). For higher ratios, particles were more or less aggregated and not spherical. As for α-la alone, most of the denatured proteins formed soluble aggregates. These results might be explained by the fact that α-la reduced the hydrophobic attractive forces involved in microgel formation, shifting the equilibrium towards the soluble aggregates pathway. This assumption was confirmed by the very low surface hydrophobicity of the soluble aggregates determined by ANS binding experiments. The conversion yield from native protein into microgels was about 51% for the 20/80 α-la/β-lg model mixture, whereas it was higher (70–85%) for commercial WPIs under similar experimental conditions. To test the possible effect of the initial mineral composition of the commercial WPIs, these products were demineralized and their ability to form microgels was tested again. After demineralisation, WPIs behaved very similarly to the 20/80 α-la/β-lg model system, the yield of conversion into microgels dropping to about 65% at pH 5.7. It was therefore concluded that in addition to the α-la/β-lg mixing ratio that was controlling hydrophobic interactions between denatured proteins that was accounting for about 50% of the microgel conversion yield, the initial mineral composition of WPIs contributed to another 20–35% yield as it was modulating the repulsive forces between the denatured proteins, promoting aggregation.

The out-of-plane permeability of 25 mm-long chopped glass fibre bundle beds was measured. These bundles, used in sheet moulding compound (SMC) composites, have an elliptical cross-section with the major axis perpendicular to the flow direction. An adapted experimental set-up was developed, which prevented flow along the sides of the packed bundle bed. The set-up was tested with needled glass fibre mats, and satisfactory agreement was found with previous results. The transverse permeability of the loose SMC bundle beds was then measured and linked to the bundle sizing type, geometry and volume fraction. Finally, the results could be well described by models taking into account the elliptical nature of the bundles.

Drug eluting stents with biodegradable polymer have been developed to address the risk of very late adverse events. COMPARE II is one of the largest randomized studies comparing the biodegradable polymer-coated biolimus-eluting stent (BES; Nobori®) with second-generation durable polymer-coated

Refinements in stent design affecting strut thickness, surface polymer, and drug release have improved clinical outcomes of drug-eluting stents. We aimed to compare the safety and efficacy of a novel, ultrathin strut cobalt-chromium stent releasing sirolimus from a biodegradable polymer with a thin strut durable polymer everolimus-eluting stent.We did a randomised, single-blind, non-inferiority trial with minimum exclusion criteria at nine hospitals in Switzerland. We randomly assigned (1:1) patients aged 18 years or older with chronic stable coronary artery disease or acute coronary syndromes undergoing percutaneous coronary intervention to treatment with biodegradable polymer sirolimus-eluting stents or durable polymer everolimus-eluting stents. Randomisation was via a central web-based system and stratified by centre and presence of ST segment elevation myocardial infarction. Patients and outcome assessors were masked to treatment allocation, but treating physicians were not. The primary endpoint, target lesion failure, was a composite of cardiac death, target vessel myocardial infarction, and clinically-indicated target lesion revascularisation at 12 months. A margin of 3·5% was defined for non-inferiority of the biodegradable polymer sirolimus-eluting stent compared with the durable polymer everolimus-eluting stent. Analysis was by intention to treat. The trial is registered with ClinicalTrials.gov, number NCT01443104.Between Feb 24, 2012, and May 22, 2013, we randomly assigned 2119 patients with 3139 lesions to treatment with sirolimus-eluting stents (1063 patients, 1594 lesions) or everolimus-eluting stents (1056 patients, 1545 lesions). 407 (19%) patients presented with ST-segment elevation myocardial infarction. Target lesion failure with biodegradable polymer sirolimus-eluting stents (69 cases; 6·5%) was non-inferior to durable polymer everolimus-eluting stents (70 cases; 6·6%) at 12 months (absolute risk difference -0·14%, upper limit of one-sided 95% CI 1·97%, p for non-inferiority0·0004). No significant differences were noted in rates of definite stent thrombosis (9 [0·9%] vs 4 [0·4%], rate ratio [RR] 2·26, 95% CI 0·70-7·33, p=0·16). In pre-specified stratified analyses of the primary endpoint, biodegradable polymer sirolimus-eluting stents were associated with improved outcome compared with durable polymer everolimus-eluting stents in the subgroup of patients with ST-segment elevation myocardial infarction (7 [3·3%] vs 17 [8·7%], RR 0·38, 95% CI 0·16-0·91, p=0·024, p for interaction=0·014).In a patient population with minimum exclusion criteria and high adherence to dual antiplatelet therapy, biodegradable polymer sirolimus-eluting stents were non-inferior to durable polymer everolimus-eluting stents for the combined safety and efficacy outcome target lesion failure at 12 months. The noted benefit in the subgroup of patients with ST-segment elevation myocardial infarction needs further study.Clinical Trials Unit, University of Bern, and Biotronik, Bülach, Switzerland.