Angiographic progression of coronary artery disease and the development of myocardial infarction

AbstractThere are few data on angiographic coronary artery anatomy in patients whose coronary artery disease progresses to myocardial infarction. In this retrospective analysis, progression of coronary artery disease between two cardiac catheterization procedures is described in 38 patients: 23 patients (Group I) who had a myocardial infarction between the two studies and 15 patients (Group II) who presented with one or more new total occlusions at the second study without sustaining an intervening infarction.In Group I the median percent stenosis on the initial angiogram of the artery related to the infarct at restudy was significantly less than the median percent stenosis of lesions that subsequently were the site of a new total occlusion in Group II (48 versus 73.5%, p < 0.05). In the infarctrelated artery in Group I, only 5 (22%) of 23 lesions were initially >70%, whereas in Group II, 11 (61%) of 18 lesions that progressed to total occlusion were initially >70% (p < 0.01). In Group I, patients who developed a Q wave infarction had less severe narrowing at initial angiography in the subsequent infarct-related artery (34%) than did patients who developed a non-Q wave infarction (80%) (p < 0.05). Univariate and multivariate analysis of angiographic and clinical characteristics present at initial angiography in Group I revealed proximal lesion location as the only significant predictor of evolution of lesions ≥ 50% to infarction.This irrespective study suggests that myocardial infarction frequently develops from previously nonsevere lesions. In addition, it is often difficult to predict the location of a subsequent infarct from analysis of the first coronary angiogram. Non-Q wave infarction is usually preceded by a more severe pre-existing stenosis than is a Q wave infarction, perhaps indicating some degree of prior myocardial protection. A prospective evaluation will be necessary to confirm these findings

PaLM 2 Technical Report

We introduce PaLM 2, a new state-of-the-art language model that has better multilingual and reasoning capabilities and is more compute-efficient than its predecessor PaLM. PaLM 2 is a Transformer-based model trained using a mixture of objectives. Through extensive evaluations on English and multilingual language, and reasoning tasks, we demonstrate that PaLM 2 has significantly improved quality on downstream tasks across different model sizes, while simultaneously exhibiting faster and more efficient inference compared to PaLM. This improved efficiency enables broader deployment while also allowing the model to respond faster, for a more natural pace of interaction. PaLM 2 demonstrates robust reasoning capabilities exemplified by large improvements over PaLM on BIG-Bench and other reasoning tasks. PaLM 2 exhibits stable performance on a suite of responsible AI evaluations, and enables inference-time control over toxicity without additional overhead or impact on other capabilities. Overall, PaLM 2 achieves state-of-the-art performance across a diverse set of tasks and capabilities. When discussing the PaLM 2 family, it is important to distinguish between pre-trained models (of various sizes), fine-tuned variants of these models, and the user-facing products that use these models. In particular, user-facing products typically include additional pre- and post-processing steps. Additionally, the underlying models may evolve over time. Therefore, one should not expect the performance of user-facing products to exactly match the results reported in this report

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Lead iodide as a buffer layer in UV-induced degradation of CH3NH3PbI3 films

Encapsulated CH3NH3PbI3 films, the 'work horse' of the organic–inorganic perovskite-based photovoltaics, grown by one step- and two step- deposition methods, were used to study the effect of the film preparation method on their photostability. Time dependent light absorption decay under exposure to concentrated sunlight was used to estimate the degradation of the films. Films deposited by one step showed a significant decrease in the CH3NH3PbI3 absorbance when illuminated through the substrate, while films obtained through two step deposition exhibited almost no photodegradation under similar sunlight exposure. On the other hand, both types of films degraded significantly when irradiated through the top encapsulation. Unreacted PbI2 present near the substrate is suggested to be responsible for enhancing the photostability of the films obtained by two step deposition. Here, remnant PbI2 works as a UV filter and reduces UV light-induced degradation. The results demonstrate the significance of the preparation method in determining photochemical stability of the perovskite films, due to favorable property of remnant PbI2 in the absorber as a UV-protective layer

Evaluation of local oxygen flux produced by photoelectrochemical hydroxide oxidation by scanning electrochemical microscopy

Abstract Several in-situ electrochemical approaches have been developed for performing a localized photoelectrochemical investigation of the photoanode. One of the techniques is scanning electrochemical microscopy (SECM), which probes local heterogeneous reaction kinetics and fluxes of generated species. In traditional SECM analysis of photocatalysts, evaluation of the influence of radiation on the rate of studied reaction requires an additional dark background experiment. Here, using SECM and an inverted optical microscope, we demonstrate the determination of O2 flux caused by light-driven photoelectrocatalytic water splitting. Photocatalytic signal and dark background are recorded in a single SECM image. We used an indium tin oxide electrode modified with hematite (α-Fe2O3) by electrodeposition as a model sample. The light-driven flux of oxygen is calculated by analysis of SECM image recorded in substrate generation/tip collection mode. In photoelectrochemistry, the qualitative and quantitative knowledge of oxygen evolution will open new doors for understanding the local effects of dopants and hole scavengers in a straightforward and conventional manner

Electrocatalyst on Insulating Support?: Hollow Silica Spheres Loaded with Pt Nanoparticles for Methanol Oxidation

Electrocatalytic oxidation of methanol on silica hollow spheres, loaded with platinum nanoparticles (Pt-SiO₂-HS), is reported. The functionalized hollow silica spheres were prepared by the surfactant (lauryl ester of tyrosine) template-assisted synthesis. These spheres were loaded with platinum nanoparticles by γ-radiolysis. Energy-dispersive X-ray analysis (EDAX) and X-ray photoelectron spectroscopy (XPS) analyses confirmed presence of Si and Pt in the composite. High-resolution transmission electron microscopy showed the formation of uniformly deposited Pt nanoparticles over the hollow spheres with a predominant Pt­(111) lattice plane on the surface. In spite of the poor conducting nature of the silica support, the oxidation potential and current density per unit mass for methanol oxidation were noted to be ca. 0.72 V vs NHE and 270 mA mg^–1, respectively, which are among the best values reported in its class. The composite did not show any sign of a degradation even after repeated use. In fact, the anodic current was found to increase under constant polarization, which is attributed to a facile reaction between adsorbed CO with a surface hydroxyl group present on the silica support. These results are in favor of Pt-SiO₂-HS as a promising electrocatalyst material in the direct methanol fuel cell (DMFC) applications

Self-Assembly for Two Types of J-Aggregates: Cis-Isomers of Dye on the Carbon Nanotube Surface and Free Aggregates of Dye Trans-Isomers

Development of novel nanoscale devices requires unique functional nanomaterials. Furthermore, chemical design of different nanoparticles in one unit is a complex task, particularly the application of self-assembly J-aggregates, which can substantially advance the nanomaterial's properties due to resonant delocalization of excitons. Here, we have demonstrated for the first time formation of resonantly coherent J-aggregates on carbon nanotubes with highly efficient energy transfer from the aggregates to the nanotubes. All the energy of photons absorbed by the aggregates is conveyed to the nanotubes, completely quenching the J-band emission and photosensitizing the nanotubes. Overall, we discovered formation of two types of J-aggregates, where one type is related to self-assembly of cis-isomers on the nanotube surface and the second type is associated to self-organizing trans-isomers into free J-aggregates without the nanotubes. Importantly, the J-aggregates on carbon nanotubes with strong energy transfer peaks of photoluminescence in the near infrared range are of high interest for practical applications on biomedical imaging and nanoscale optoelectronic and nanophotonic devices