Superhard Phases of Simple Substances and Binary Compounds of the B-C-N-O System: from Diamond to the Latest Results (a Review)

The basic known and hypothetic one- and two-element phases of the B-C-N-O system (both superhard phases having diamond and boron structures and precursors to synthesize them) are described. The attention has been given to the structure, basic mechanical properties, and methods to identify and characterize the materials. For some phases that have been recently described in the literature the synthesis conditions at high pressures and temperatures are indicated.Comment: Review on superhard B-C-N-O phase

Portal Vein Embolization is Associated with Reduced Liver Failure and Mortality in High-Risk Resections for Perihilar Cholangiocarcinoma

Background: Preoperative portal vein embolization (PVE) is frequently used to improve future liver remnant volume (FLRV) and to reduce the risk of liver failure after major liver resection. Objective: This paper aimed to assess postoperative outcomes after PVE and resection for suspected perihilar cholangiocarcinoma (PHC) in an international, multicentric cohort. Methods: Patients undergoing resection for suspected PHC across 20 centers worldwide, from the year 2000, were included. Liver failure, biliary leakage, and hemorrhage were classified according to the respective International Study Group of Liver Surgery criteria. Using propensity scoring, two equal cohorts were generated using matching parameters, i.e. age, sex, American Society of Anesthesiologists classification, jaundice, type of biliary drainage, baseline FLRV, resection type, and portal vein resection. Results: A total of 1667 patients were treated for suspected PHC during the study period. In 298 patients who underwent preoperative PVE, the overall incidence of liver failure and 90-day mortality was 27% and 18%, respectively, as opposed to 14% and 12%, respectively, in patients without PVE (p < 0.001 and p = 0.005). After propensity score matching, 98 patients were enrolled in each cohort, resulting in similar baseline and operative characteristics. Liver failure was lower in the PVE group (8% vs. 36%, p < 0.001), as was biliary leakage (10% vs. 35%, p < 0.01), intra-abdominal abscesses (19% vs. 34%, p = 0.01), and 90-day mortality (7% vs. 18%, p = 0.03). Conclusion: PVE before major liver resection for PHC is associated with a lower incidence of liver failure, biliary leakage, abscess formation, and mortality. These results demonstrate the importance of PVE as an integral component in the surgical treatment of PHC

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Flow-pattern evolution of the last British Ice Sheet

We present a 10-stage reconstruction of the evolution in ice-flow patterns of the last British Ice Sheet from build-up to demise derived from geomorphological evidence. 100 flowsets identified in the subglacial bedform record (drumlins, mega-scale glacial lineations, and ribbed moraine) are combined with ancillary evidence (erratic-transport paths, absolute dates and a semi-independently reconstructed retreat pattern) to define flow patterns, ice divides and ice-sheet margins during build-up, maximum glaciation and retreat. Overprinting and cross-cutting of landform assemblages are used to define the relative chronology of flow patterns and a tentative absolute chronology is presented based on a collation of available dates for ice advance and retreat. The ice-flow configuration of the last British Ice Sheet was not static. Some ice divides were remarkably stable, persisting through multiple stages of the ice-sheet evolution, whereas others were transient features existing for a short time and/or shifting in position 10s km. The 10 reconstructed stages of ice-sheet geometry capture two main modes of operation; first as an integrated ice sheet with a broadly N–S orientated ice divide, and second as a multi-domed ice sheet orientated parallel with the shelf edge. A thick integrated ice sheet developed as ice expanded out of source areas in Scotland to envelop southerly ice caps in northern England and Wales, and connect with the Irish Ice Sheet to the west and the Scandinavian Ice Sheet across the North Sea. Following break-up of ice over the North Sea, ice streaming probably drove mass loss and ice-sheet thinning to create a more complex divide structure, where ice-flow patterns were largely controlled by the form of the underlying topography. Ice surface lowering occurred before separation of, and retreat to, multiple ice centres centred over high ground. We consider this 10-stage reconstruction of the evolution in ice-sheet configuration to be the simplest palaeo-glaciological interpretation of the flowsets identified from the geomorphological record and their relative timing. This empirically-based reconstruction of flow-pattern geometry provides a framework for more detailed local and regional studies and numerical modelling to provide robust explanations of the observed changes in ice-sheet structure in terms of climate and glacial dynamics. As a minimum, numerical model outputs should be able to reproduce the identified flowset patterns in space and satisfy their chronological order