Five-year safety and efficacy of leadless pacemakers in a Dutch cohort

BACKGROUND: Adequate real-world safety and efficacy of leadless pacemakers (LPs) have been demonstrated up to 3 years after implantation. Longer-term data are warranted to assess the net clinical benefit of leadless pacing.OBJECTIVE: The purpose of this study was to evaluate the long-term safety and efficacy of LP therapy in a real-world cohort.METHODS: In this retrospective cohort study, all consecutive patients with a first LP implantation from December 21, 2012, to December 13, 2016, in 6 Dutch high-volume centers were included. The primary safety endpoint was the rate of major procedure- or device-related complications (ie, requiring surgery) at 5-year follow-up. Analyses were performed with and without Nanostim battery advisory-related complications. The primary efficacy endpoint was the percentage of patients with a pacing capture threshold ≤2.0 V at implantation and without ≥1.5-V increase at the last follow-up visit.RESULTS: A total of 179 patients were included (mean age 79 ± 9 years), 93 (52%) with a Nanostim and 86 (48%) with a Micra VR LP. Mean follow-up duration was 44 ± 26 months. Forty-one major complications occurred, of which 7 were not advisory related. The 5-year major complication rate was 4% without advisory-related complications and 27% including advisory-related complications. No advisory-related major complications occurred a median 10 days (range 0-88 days) postimplantation. The pacing capture threshold was low in 163 of 167 patients (98%) and stable in 157 of 160 (98%).CONCLUSION: The long-term major complication rate without advisory-related complications was low with LPs. No complications occurred after the acute phase and no infections occurred, which may be a specific benefit of LPs. The performance was adequate with a stable pacing capture threshold.</p

The effects of material formulation and manufacturing process on mechanical and thermal properties of epoxy/clay nanocomposites

A holistic study was conducted to investigate the combined effect of three different pre-mixing processes, namely mechanical mixing, ultrasonication and centrifugation, on mechanical and thermal properties of epoxy/clay nanocomposites reinforced with different platelet-like montmorillonite (MMT) clays (Cloisite Na+, Cloisite 10A, Cloisite 15 or Cloisite 93A) at clay contents of 3–10 wt%. Furthermore, the effect of combined pre-mixing processes and material formulation on clay dispersion and corresponding material properties of resulting composites was investigated using X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM), flexural and Charpy impact tests, Rockwell hardness tests and differential scanning calorimetry (DSC). A high level of clay agglomeration and partially intercalated/exfoliated clay structures were observed regardless of clay type and content. Epoxy/clay nanocomposites demonstrate an overall noticeable improvement of up to 10 % in the glass transition temperature (Tg) compared to that of neat epoxy, which is interpreted by the inclusion of MMT clays acting as rigid fillers to restrict the chain mobility of epoxy matrices. The impact strength of epoxy/clay nanocomposites was also found to increase by up to 24 % with the addition of 3 wt% Cloisite Na+ clays. However, their flexural strength and hardness diminished when compared to those of neat epoxy, arising from several effects including clay agglomeration, widely distributed microvoids and microcracks as well as weak interfacial bonding between clay particles and epoxy matrices, as confirmed from TEM and SEM results. Overall, it is suggested that an improved technique should be used for the combination of pre-mixing processes in order to achieve the optimal manufacturing condition of uniform clay dispersion and minimal void contents

Sliding Wear Behavior of Al2O3-TiO2 Coatings Fabricated by the Suspension Plasma Spraying Technique

[EN] The friction and dry sliding wear behavior of alumina and alumina-titania near-nanometric coatings were examined. Coatings were obtained by the suspension plasma spraying technique. Dry sliding wear tests were performed on a ball-on-disk tribometer, with an Al2O3 ball as counterpart material, a normal load of 2 N, a sliding distance of 1200 m and a sliding speed of 0.1 m/s. The effect of including TiO2 in the fabricated coatings on friction coefficient behavior, wear rates and wear damage patterns was determined. The addition of TiO2 to the coatings was found to greatly increase wear resistance by, for example, 2.6-fold for 40 wt% of TiO2. The analysis of the wear surface was correlated with microstructural parameters, mechanical properties and wear rates.The authors wish to thank for the Spanish Ministry of Economy and Competitiveness (MAT2012-38364-C03) and the Autonomous Government of Valencia for funding for the stay in SPCTS-UMR CNRS (France), and the French FCENANOSURF consortium funded by the French Ministry and Industry and local governments of Region Centre and Region Limousin.Klyatskina, E.; Espinosa Fernández, L.; Darut, G.; Segovia López, EF.; Salvador Moya, MD.; Montavon, G.; Agorges, H. (2015). Sliding Wear Behavior of Al2O3-TiO2 Coatings Fabricated by the Suspension Plasma Spraying Technique. Tribology Letters. 59(1):1-9. https://doi.org/10.1007/s11249-015-0530-5S19591Pawlowski, L.: The Science and Engineering of Thermal Spray Coatings. Wiley: Hoboken (2008)Lampe, Th, Eisenberg, S., Cabeo, E.R.: Plasma surface engineering in the automotive industry—trends and future prospective. Surf. Coat. 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Technol. 194(1), 58–67 (2005)Sathish, S., Geetha, M., Aruna, S.T., Balaji, N., Rajam, K.S., Asokamani, R.: Sliding wear behavior of plasma sprayed nanoceramic coatings for biomedical applications. Wear 271, 934–941 (2011)Pawlowski, L.: Finely grained nanometric and submicrometric coatings by thermal sparing: a review. Surf. Coat. Technol. 202, 4318–4328 (2008)Xiao, D., Wang, Y., Strutt, P.: Fabrication and evaluation of plasma sprayed nanostructured alumina–titania coatings with superior properties. Mater. Sci. Eng. 301, 80–89 (2001)Tjong, S.C., Chen, H.: Nanocrystalline materials and coatings. Mater. Sci. Eng. 45, 1–88 (2004)Fauchais, P., Montavon, G., Bertrand, G.: From powders to thermally sprayed coatings. J. Therm. Spray Technol. 19, 56–80 (2010)Lima, R.S., Marple, B.R.: Thermal spray coatings engineered from nanostructured ceramic agglomerated powders for structural, thermal barrier and biomedical applications: a review. J. Therm. 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Protein docking prediction using predicted protein-protein interface

<p>Abstract</p> <p>Background</p> <p>Many important cellular processes are carried out by protein complexes. To provide physical pictures of interacting proteins, many computational protein-protein prediction methods have been developed in the past. However, it is still difficult to identify the correct docking complex structure within top ranks among alternative conformations.</p> <p>Results</p> <p>We present a novel protein docking algorithm that utilizes imperfect protein-protein binding interface prediction for guiding protein docking. Since the accuracy of protein binding site prediction varies depending on cases, the challenge is to develop a method which does not deteriorate but improves docking results by using a binding site prediction which may not be 100% accurate. The algorithm, named PI-LZerD (using Predicted Interface with Local 3D Zernike descriptor-based Docking algorithm), is based on a pair wise protein docking prediction algorithm, LZerD, which we have developed earlier. PI-LZerD starts from performing docking prediction using the provided protein-protein binding interface prediction as constraints, which is followed by the second round of docking with updated docking interface information to further improve docking conformation. Benchmark results on bound and unbound cases show that PI-LZerD consistently improves the docking prediction accuracy as compared with docking without using binding site prediction or using the binding site prediction as post-filtering.</p> <p>Conclusion</p> <p>We have developed PI-LZerD, a pairwise docking algorithm, which uses imperfect protein-protein binding interface prediction to improve docking accuracy. PI-LZerD consistently showed better prediction accuracy over alternative methods in the series of benchmark experiments including docking using actual docking interface site predictions as well as unbound docking cases.</p

Molecular dynamics of ribosomal elongation factors G and Tu

Translation on the ribosome is controlled by external factors. During polypeptide lengthening, elongation factors EF-Tu and EF-G consecutively interact with the bacterial ribosome. EF-Tu binds and delivers an aminoacyl-tRNA to the ribosomal A site and EF-G helps translocate the tRNAs between their binding sites after the peptide bond is formed. These processes occur at the expense of GTP. EF-Tu:tRNA and EF-G are of similar shape, share a common binding site, and undergo large conformational changes on interaction with the ribosome. To characterize the internal motion of these two elongation factors, we used 25 ns long all-atom molecular dynamics simulations. We observed enhanced mobility of EF-G domains III, IV, and V and of tRNA in the EF-Tu:tRNA complex. EF-Tu:GDP complex acquired a configuration different from that found in the crystal structure of EF-Tu with a GTP analogue, showing conformational changes in the switch I and II regions. The calculated electrostatic properties of elongation factors showed no global similarity even though matching electrostatic surface patches were found around the domain I that contacts the ribosome, and in the GDP/GTP binding region

Common Genetic Variants Contribute to Risk of Transposition of the Great Arteries.

RATIONALE: Dextro-transposition of the great arteries (D-TGA) is a severe congenital heart defect which affects approximately 1 in 4,000 live births. While there are several reports of D-TGA patients with rare variants in individual genes, the majority of D-TGA cases remain genetically elusive. Familial recurrence patterns and the observation that most cases with D-TGA are sporadic suggest a polygenic inheritance for the disorder, yet this remains unexplored. OBJECTIVE: We sought to study the role of common single nucleotide polymorphisms (SNPs) in risk for D-TGA. METHODS AND RESULTS: We conducted a genome-wide association study in an international set of 1,237 patients with D-TGA and identified a genome-wide significant susceptibility locus on chromosome 3p14.3, which was subsequently replicated in an independent case-control set (rs56219800, meta-analysis P=8.6x10 CONCLUSIONS: This work provides support for a polygenic architecture in D-TGA and identifies a susceptibility locus on chromosome 3p14.3 nea