Clinical outcomes of state-of-the-art percutaneous coronary revascularization in patients with de novo three vessel disease: 1-year results of the SYNTAX II study

Aims: To investigate if recent technical and procedural developments in percutaneous coronary intervention (PCI) significantly influence outcomes in appropriately selected patients with three-vessel (3VD) coronary artery disease. Methods and results: The SYNTAX II study is a multicenter, all-comers, open-label, single arm study that investigated the impact of a contemporary PCI strategy on clinical outcomes in patients with 3VD in 22 centres from four European countries. The SYNTAX-II strategy includes: heart team decision-making utilizing the SYNTAX Score II (a clinical tool combining anatomical and clinical factors), coronary physiology guided revascularisation, implantation of thin strut bio-resorbable-polymer drug-eluting stents, intravascular ultrasound (IVUS) guided stent implantation, contemporary chronic total occlusion revascularisation techniques and guideline-directed medical therapy. The rate of major adverse cardiac and cerebrovascular events (MACCE [composite of all-cause death, cerebrovascular event, any myocardial infarction and any revascularisation]) at one year was compared to a predefined PCI cohort from the original SYNTAX-I trial selected on the basis of equipoise 4-year mortality between CABG and PCI. As an exploratory endpoint, comparisons were made with the historical CABG cohort of the original SYNTAX-I trial. Overall 708 patients were screened and discussed within the heart team; 454 patients were deemed appropriate to undergo PCI. At one year, the SYNTAX-II strategy was superior to the equipoise-derived SYNTAX-I PCI cohort (MACCE SYNTAX-II 10.6% vs. SYNTAX-I 17.4%; HR 0.58, 95% CI 0.39-0.85, P= 0.006). This difference was driven by a significant reduction in the incidence of MI (HR 0.27, 95% CI 0.11-0.70, P= 0.007) and revascularisation (HR 0.57, 95% CI 0.37-0.9, P = 0.015). Rates of all-cause death (HR 0.69, 95% CI 0.27-1.73, P = 0.43) and stroke (HR 0.69, 95% CI 0.10-4.89, P = 0.71) were similar. The rate of definite stent thrombosis was significantly lower in SYNTAX-II (HR 0.26, 95% CI 0.07-0.97, P = 0.045). Conclusion: At one year, clinical outcomes with the SYNTAX-II strategy were associated with improved clinical results compared to the PCI performed in comparable patients from the original SYNTAX-I trial. Longer term follow-up is awaited and a randomized clinical trial with contemporary CABG is warranted

Classification of current anticancer immunotherapies

During the past decades, anticancer immunotherapy has evolved from a promising therapeutic option to a robust clinical reality. Many immunotherapeutic regimens are now approved by the US Food and Drug Administration and the European Medicines Agency for use in cancer patients, and many others are being investigated as standalone therapeutic interventions or combined with conventional treatments in clinical studies. Immunotherapies may be subdivided into “passive” and “active” based on their ability to engage the host immune system against cancer. Since the anticancer activity of most passive immunotherapeutics (including tumor-targeting monoclonal antibodies) also relies on the host immune system, this classification does not properly reflect the complexity of the drug-host-tumor interaction. Alternatively, anticancer immunotherapeutics can be classified according to their antigen specificity. While some immunotherapies specifically target one (or a few) defined tumor-associated antigen(s), others operate in a relatively non-specific manner and boost natural or therapy-elicited anticancer immune responses of unknown and often broad specificity. Here, we propose a critical, integrated classification of anticancer immunotherapies and discuss the clinical relevance of these approaches

Effect of boron on post irradiation tensile properties of reduced activation ferritic steel (F-82H) irradiated in HFIR

Reduced activation ferritic/martensitic steel, F-82H (Fe-8Cr-2W-V-Ta), was irradiated in the High Flux Isotope Reactor (HFIR) to doses between 11 and 34 dpa at 400 and 500 C. Post irradiation tensile tests were performed at the nominal irradiation temperature in vacuum. Some specimens included {sup 10}B or natural boron (nB) to estimate the helium effect on tensile properties. Tensile properties including the 0.2% offset yield stress, the ultimate tensile strength, the uniform elongation and the total elongation were measured. The tensile properties were not dependent on helium content in specimens irradiated to 34 dpa, however {sup 10}B-doped specimens with the highest levels of helium showed slightly higher yield strength and less ductility than boron-free specimens. Strength appears to go through a peak, and ductility through a trough at about 11 dpa. The irradiation to more than 21 dpa reduced the strength and increased the elongation to the unirradiated levels. Ferritic steels are one of the candidate alloys for nuclear fusion reactors because of their good thermophysical properties, their superior swelling resistance, and the low corrosion rate in contact with potential breeder and coolant materials

Fracture toughness of irradiated candidate materials for ITER first wall/blanket structures

Disk compact specimens of candidate materials for first wall/blanket structures in ITER have been irradiated to damage levels of about 3 dpa at nominal irradiation temperatures of either 90 or 250{degrees}C. These specimens have been tested over a temperature range from 20 to 250{degrees}C to determine J-integral values and tearing moduli. The results show that irradiation at these temperatures reduces the fracture toughness of austenitic stainless steels, but the toughness remains quite high. The toughness decreases as the test temperature increases. Irradiation at 250{degrees}C is more damaging than at 90{degrees}C, causing larger decreases in the fracture toughness. Ferritic-martensitic steels are embrittled by the irradiation, and show the lowest toughness at room temperature

Personal or social? Designing mobile interactions for co-located interaction

Personal mobile devices such as mobile phones, tablets, fitness wristbands, and smart watches are becoming ubiquitous and widely involved in our daily activities. However, these devices are designed and considered by the users as personal-not as shared or collaborative. As a response to this, the workshop aims to explore the design of new application ideas for mobile devices that explicitly encourage users to engage in face-to-face interaction. The research question is firstly how to design for face-to-face interactions. Secondly, it is how we can utilize various possibilities e.g. combining mobile devices (e.g. phones + tablets); extending commercial mobile-devices with hardware peripherals; utilizing social networks, geo-location services or proximity-based connections; or utilizing software to turn the personal devices into tools of face-to-face interactions. Copyright is held by the owner/author(s)