Statin intensity and postoperative mortality following open repair of intact abdominal aortic aneurysm.

BackgroundThere is a lack of evidence for the association between intensive statin therapy and outcomes following vascular surgery. The aim of this study was to evaluate the association between perioperative statin intensity and in-hospital mortality following open abdominal aortic aneurysm (AAA) repair.MethodsPatients undergoing open AAA repair between 2009 and 2015 were identified from the Premier Healthcare Database. Statin use was classified into low, moderate and high intensity, based on American College of Cardiology/American Heart Association guidelines. Supratherapeutic intensity was defined as doses higher than the recommended guidelines. Multivariable logistic regression analyses were undertaken to assess the association between statin intensity and postoperative major adverse events and in-hospital mortality.ResultsOf 6497 patients undergoing open AAA repair, 3217 (49·5 per cent) received perioperative statin. Statin users were more likely to present with three or more co-morbidities than non-users (26·5 versus 21·8 per cent; P < 0·001). Unadjusted postoperative mortality was significantly lower in statin users (2·6 versus 6·3 per cent; P < 0·001); however, there was no difference in the risk of developing major adverse events. Multivariable analysis showed that statin use was associated with lower odds of death (odds ratio 0·41, 95 per cent c.i. 0·31 to 0·54). Moderate, high and supratherapeutic statin intensities were not associated with lower odds of death or major adverse events compared with low-intensity statin therapy.ConclusionStatin use is associated with lower odds of death in hospital following open AAA repair. High-intensity statins were not associated with lower morbidity or mortality

Multiscale approaches to high efficiency photovoltaics

While renewable energies are achieving parity around the globe, efforts to reach higher solar cell efficiencies becomes ever more difficult as they approach the limiting efficiency. The so-called third generation concepts attempt to break this limit through a combination of novel physical processes and new materials and concepts in organic and inorganic systems. Some examples of semi-empirical modelling in the field are reviewed, in particular for multispectral solar cells on silicon (french ANR project MULTISOLSI). Their achievements are outlined, and the limits of these approaches shown. This introduces the main topic of this contribution, which is the use of multiscale experimental and theoretical techniques to go beyond the semi-empirical understanding of these systems. This approach has already led to great advances at modelling which have led to modelling software which is widely known. Yet a survey of the topic reveals a fragmentation of efforts across disciplines, firstly, such as organic and inorganic fields, but also between the high efficiency concepts such as hot carrier cells and intermediate band concepts. We show how this obstacle to the resolution of practical research obstacles may be lifted by inter-disciplinary cooperation across length scales, and across experimental and theoretical fields, and finally across materials systems. We present a European COST Action MultiscaleSolar kicking off in early 2015 which brings together experimental and theoretical partners in order to develop multiscale research in organic and inorganic materials. The goal of this defragmentation and interdisciplinary collaboration is to develop understanding across length scales which will enable the full potential of third generation concepts to be evaluated in practise, for societal and industrial applications.Comment: Draft paper accompanying a plenary presentation to the World Renewable Energy Conference WREC 2015, June 2015, Bucharest. In press (IOP

Moslem geographers 800-1300 A.D.

Thesis (M.A.)--University of Illinois at Urbana-Champaign, 1952.Includes bibliographical references

How fast can vanadium dioxide neuron-mimicking devices oscillate? Physical mechanisms limiting the frequency of vanadium dioxide oscillators

The frequency of vanadium dioxide (VO2) oscillators is a fundamental figure of merit for the realization of neuromorphic circuits called oscillatory neural networks (ONNs) since the high frequency of oscillators ensures low-power consuming, real-time computing ONNs. In this study, we perform electrothermal 3D technology computer-aided design (TCAD) simulations of a VO2 relaxation oscillator. We find that there exists an upper limit to its operating frequency, where such a limit is not predicted from a purely circuital model of the VO2 oscillator. We investigate the intrinsic physical mechanisms that give rise to this upper limit. Our TCAD simulations show that it arises a dependence on the frequency of the points of the curve current versus voltage across the VO2 device corresponding to the insulator-to-metal transition (IMT) and metal-to-insulator transition (MIT) during oscillation, below some threshold values of $C_{\mathrm{ext}}$. This implies that the condition for the self-oscillatory regime may be satisfied by a given load-line in the low-frequency range but no longer at higher frequencies, with consequent suppression of oscillations. We note that this variation of the IMT/MIT points below some threshold values of $C_{\mathrm{ext}}$ is due to a combination of different factors: intermediate resistive states achievable by VO2 channel and the interplay between frequency and heat transfer rate. Although the upper limit on the frequency that we extract is linked to the specific VO2 device we simulate, our findings apply qualitatively to any VO2 oscillator. Overall, our study elucidates the link between electrical and thermal behavior in VO2 devices that sets a constraint on the upper values of the operating frequency of any VO2 oscillator

Current Status and Opportunities of Organic Thin-Film Transistor Technologies

Ajudes: National Key Research and Development Program of "Strategic Advanced Electronic Materials" under Grant 2016YFB0401100 and in part by the NSFC of China under Grant 61274083 and Grant 61334008.Attributed to its advantages of super mechanical flexibility, very low-temperature processing, and compatibility with low cost and high throughput manufacturing, organic thin-film transistor (OTFT) technology is able to bring electrical, mechanical, and industrial benefits to a wide range of new applications by activating nonflat surfaces with flexible displays, sensors, and other electronic functions. Despite both strong application demand and these significant technological advances, there is still a gap to be filled for OTFT technology to be widely commercially adopted. This paper providesa comprehensive reviewof the current status of OTFT technologies ranging from material, device, process, and integration, to design and system applications, and clarifies the real challenges behind to be addressed

A clinical genetic method to identify mechanisms by which pain causes depression and anxiety

BACKGROUND: Pain patients are often depressed and anxious, and benefit less from psychotropic drugs than pain-free patients. We hypothesize that this partial resistance is due to the unique neurochemical contribution to mood by afferent pain projections through the spino-parabrachial-hypothalamic-amygdalar systems and their projections to other mood-mediating systems. New psychotropic drugs for pain patients might target molecules in such brain systems. We propose a method to prioritize molecular targets by studying polymorphic genes in cohorts of patients undergoing surgical procedures associated with a variable pain relief response. We seek molecules that show a significant statistical interaction between (1) the amount of surgical pain relief, and (2) the alleles of the gene, on depression and anxiety during the first postoperative year. RESULTS: We collected DNA from 280 patients with sciatica due to a lumbar disc herniation, 162 treated surgically and 118 non-surgically, who had been followed for 10 years in the Maine Lumbar Spine Study, a large, prospective, observational study. In patients whose pain was reduced >25% by surgery, symptoms of depression and anxiety, assessed with the SF-36 Mental Health Scale, improved briskly at the first postoperative measurement. In patients with little or no surgical pain reduction, mood scores stayed about the same on average. There was large inter-individual variability at each level of residual pain. Polymorphisms in three pre-specified pain-mood candidate genes, catechol-O-methyl transferase (COMT), serotonin transporter, and brain-derived neurotrophic factor (BDNF) were not associated with late postoperative mood or with a pain-gene interaction on mood. Although the sample size did not provide enough power to persuasively search through a larger number of genes, an exploratory survey of 25 other genes provides illustrations of pain-gene interactions on postoperative mood – the mu opioid receptor for short-term effects of acute sciatica on mood, and the galanin-2 receptor for effects of unrelieved post-discectomy pain on mood one year after surgery. CONCLUSION: Genomic analysis of longitudinal studies of pain, depression, and anxiety in patients undergoing pain-relieving surgery may help to identify molecules through which pain alters mood. Detection of alleles with modest-sized effects will require larger cohorts

Truly form-factor–free industrially scalable system integration for electronic textile architectures with multifunctional fiber devices

Funding Information: This work was supported by the European Commission (H2020, 1D-NEON, grant agreement ID: 685758). J.M.K. and L.G.O. acknowledge the support from the U.K. Research and Innovation (EPSRC, EP/P027628/1). We thank Y. Bernstein and J. Faulkner for helping with grammar check. Funding Information: Acknowledgments Funding:ThisworkwassupportedbytheEuropeanCommission(H2020,1D-NEON,grant agreementID:685758).J.M.K.andL.G.O.acknowledgethesupportfromtheU.K.Researchand Innovation(EPSRC,EP/P027628/1).W ethankY .BernsteinandJ.Faulknerforhelpingwith grammarcheck.Authorcontributions:S.L.andJ.M.K.conceivedtheproject.S.L.,L.G.O.,P .B., R.Martins,andJ.M.K.supervisedtheproject.S.L.andH.L.developedF-PD.S.L.,Y .-W .L., G.-H.A., D.-W .S., J.I.S.,andS.C.developedF-SC.C.L.F ., A.S.,R.I.,P .B., andR.Martinsdevelopedfiber transistor.S.L.,H.L.,andS.C.developedF-LED.ThefiberdeviceswereevaluatedbyS.L.,H.W .C., D.-W .S., H.L.,S.J.,S.D.H.,S.Y .B., S.Z.,W .H.-C., Y .-H.S., X.-B.F ., T .H.L., J.-W .J., andY .K. The developmentofweavingprocesswasconductedbyS.L.,H.W .C., F .M.M., P .J., andV .G.C. Thelaser interconnectionwasdevelopedbyS.L.,H.W .C., K.U.,M.E.,andM.S.Thetextiledemonstrations werecharacterizedbyS.L.,H.W .C., D.-W .S., J.Y ., S.S.,U.E.,S.N.,A.C.,A.M.,R.Momentè,J.G.,N.D., S.M.,C.-H.K.,M.L.,A.N.,D.J.,M.C.,andY .C. ThismanuscriptwaswrittenbyS.L.andJ.M.K.and reviewed by H.W .C., D.-W .S., M.C.,L.G.O., P .B., E.F ., and G.A.J.A. All authors discussed the results andcommentedonthemanuscript.Competinginterests:Theauthorsdeclarethattheyhave nocompetinginterests.Dataandmaterialsavailability:Alldataneededtoevaluatethe conclusionsinthepaperarepresentinthepaperand/ortheSupplementaryMaterials. Publisher Copyright: Copyright © 2023 The Authors, some rights reserved.An integrated textile electronic system is reported here, enabling a truly free form factor system via textile manufacturing integration of fiber-based electronic components. Intelligent and smart systems require freedom of form factor, unrestricted design, and unlimited scale. Initial attempts to develop conductive fibers and textile electronics failed to achieve reliable integration and performance required for industrial-scale manufacturing of technical textiles by standard weaving technologies. Here, we present a textile electronic system with functional one-dimensional devices, including fiber photodetectors (as an input device), fiber supercapacitors (as an energy storage device), fiber field-effect transistors (as an electronic driving device), and fiber quantum dot light-emitting diodes (as an output device). As a proof of concept applicable to smart homes, a textile electronic system composed of multiple functional fiber components is demonstrated, enabling luminance modulation and letter indication depending on sunlight intensity.publishersversionpublishe

HER2-enriched subtype and novel molecular subgroups drive aromatase inhibitor resistance and an increased risk of relapse in early ER+/HER2+ breast cancer

BACKGROUND: Oestrogen receptor positive/ human epidermal growth factor receptor positive (ER+/HER2+) breast cancers (BCs) are less responsive to endocrine therapy than ER+/HER2- tumours. Mechanisms underpinning the differential behaviour of ER+HER2+ tumours are poorly characterised. Our aim was to identify biomarkers of response to 2 weeks’ presurgical AI treatment in ER+/HER2+ BCs. METHODS: All available ER+/HER2+ BC baseline tumours (n=342) in the POETIC trial were gene expression profiled using BC360™ (NanoString) covering intrinsic subtypes and 46 key biological signatures. Early response to AI was assessed by changes in Ki67 expression and residual Ki67 at 2 weeks (Ki672wk). Time-To-Recurrence (TTR) was estimated using Kaplan-Meier methods and Cox models adjusted for standard clinicopathological variables. New molecular subgroups (MS) were identified using consensus clustering. FINDINGS: HER2-enriched (HER2-E) subtype BCs (44.7% of the total) showed poorer Ki67 response and higher Ki672wk (p<0.0001) than non-HER2-E BCs. High expression of ERBB2 expression, homologous recombination deficiency (HRD) and TP53 mutational score were associated with poor response and immune-related signatures with High Ki672wk. Five new MS that were associated with differential response to AI were identified. HER2-E had significantly poorer TTR compared to Luminal BCs (HR 2.55, 95% CI 1.14–5.69; p=0.0222). The new MS were independent predictors of TTR, adding significant value beyond intrinsic subtypes. INTERPRETATION: Our results show HER2-E as a standardised biomarker associated with poor response to AI and worse outcome in ER+/HER2+. HRD, TP53 mutational score and immune-tumour tolerance are predictive biomarkers for poor response to AI. Lastly, novel MS identify additional non-HER2-E tumours not responding to AI with an increased risk of relapse

General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multi-centre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)

3D microscopy image analysis : from image enhancement to quantitative analysis of arterial tissues

Le système cardiovasculaire est responsable du transfert de l’oxygène et des nutriments vers tout le corps et l’aorte y joue un rôle essentiel. La portion supérieure de l’aorte, appelée aorte thoracique ascendante, est critique puisqu’elle doit supporter la pression élevée du sang pompé par le coeur. Ceci est possible grâce à la microstructure de l’aorte qui est principalement composée de fibres (collagène et élastine). Cependant, avec le vieillissement, des changements peuvent toucher cette microstructure et causer des pathologies comme les anévrismes. L’étude de cette microstructure est possible grâce à plusieurs modalités d’imagerie comme la microscopie à deux photons et la génération de seconde harmonique qui offre une bonne résolution 3D. Cependant, les images collectées peuvent présenter des artéfacts comme du bruit et des discontinuités de quelques fibres. L’analyse quantitative des images acquises permet de caractériser la géométrie et la morphologie des fibres ainsi que la composition du spécimen considéré.Cette thèse a pour objectif, en premier lieu, d’améliorer des images 3D de seconde harmonique de fibres de collagène. Pour se faire, une combinaison d’un filtre directionnel 3D (pour remédier au problème de discontinuité) et de transformées "top-hat" à une et trois dimensions (pour réduire le bruit) est proposée. En second lieu, l’intérêt est porté sur l’analyse quantitative de ces images et en particulier l’estimation de l’orientation des fibres de collagène dans l’espace 3D. Une nouvelle approche basée sur l’apprentissage profond est présentée. Une base de données d’images 3D de fibres synthétiques est développée pour entrainer le réseau de neurones proposé.The cardiovascular system is responsible of transferring nutrients and oxygen to all the body and the aorta plays an essential role. The upper portion of the aorta, called ascending thoracic aorta, is a critical section since it has to support the high pressure blood pumped by the heart. This is made possible thanks to the microstructure of the aortic wall, mainly composed of fibers (collagen and elastin). With aging, changes may occur on the aortic microstructure and may cause some diseases such as aneurysms. Studying this microstructure is helpful to understand its functions. To this end, several imaging modalities were used especially the multi-photon microscopy and Second Harmonic Generation (SHG) due to its good resolution in 3D. However, SHG images may present some artifacts such as noise in addition to some discontinuities on certain fibers. The study of this microstructure is based on the quantitative analysis of acquired 3D images to extract information about the geometry and the morphology of collagen fibers and the composition of the considered specimen.The goal of this thesis is, first, to enhance 3D SHG images of collagen fibers in order to make them suitable for a quantitative analysis. To this end, a combination of a 3D directional filter (to deal with fibers discontinuities) and a 1D and a 3D top-hat transforms (to reduce the noise) is proposed. The second part of this thesis focuses on the quantitative analysis of these images and in particular, orientations estimation of collagen fibers in the 3D space. A new approach based on deep learning is introduced. A dataset of 3D images of synthetic fibers is developed to train the proposed neural network