Assessment of pavement deflection under vehicle loads using a 3D-DIC system in the field.

This study aims to introduce the use of 3D-digital image correlation (DIC) to the in situ testing of pavements and to support the development of techniques for a rapid evaluation of the conservation status of existing roads. Little research was found on this topic. The passage of a car wheel on an asphalt pavement was adopted as a case study. The DIC measurements were compared to those gathered by contact sensors. From a qualitative point of view, the DIC measurements captured the realistic shape of a deflection basin. From a quantitative point of view, the deflection values provided by the DIC system had a mean error of 0.015 mm and a standard deviation of 0.011 mm. At the moment of highest load, these errors had a mean value and standard deviation of - 0.016 mm and 0.021 mm, respectively. Thus, to improve the accuracy of the system, we propose modifying the camera support, speckle pattern, and control of natural light.

Usefulness of Bleeding After Acute Coronary Syndromes for Unmasking Silent Cancer.

There is a growing body of evidence on the incidence and negative prognostic impact of postdischarge hemorrhagic complications after an acute coronary syndrome (ACS). However, the risk of subsequent cancer after postdischarge bleeding in these patients is currently poorly known. The aim of this study was to assess the association of postdischarge bleeding with newly diagnosed cancers after an ACS. Data from a single-center registry of 3,644 ACS patients, who were discharged with dual antiplatelet therapy and treated with percutaneous coronary intervention, were used to investigate the association between postdischarge bleeding and diagnosis of cancer. During a median follow-up of 56.2 months, bleeding events were documented in 1,216 patients and newly diagnosed cancers in 227 patients. Postdischarge bleeding was associated with cancer diagnosis (adjusted hazard ratio [HR] 3.43, 95% confidence interval [CI] 2.62 to 4.50), but only spontaneous bleeding (adjusted HR 4.38, 95% CI 3.31 to 5.79). This association was stronger as the severity of the bleeding increased (HR 1.52, 4.88, 7.30, and 12.29, for BARC type 1, 2, 3a, and 3b bleeding, respectively). Positive predictive values for cancer diagnosis of postdischarge bleeding was 7.7%. Median time from bleeding to cancer was 4.6 months. In conclusion, spontaneous postdischarge bleeding in ACS patients is strongly associated with subsequent cancer diagnosis within the first 6 months. A prompt evaluation of bleeding could be useful for enabling an early detection of cancer in these patients.

A randomized comparison of novel bioresorbable polymer sirolimus-eluting stent and durable polymer everolimus-eluting stent in patients with acute coronary syndromes: The CENTURY II high risk ACS substudy.

BACKGROUND: To investigate clinical outcomes of percutaneous coronary intervention using a sirolimus-eluting stent with bioresorbable polymer, Ultimaster (BP-SES) compared with a permanent polymer everolimus-eluting stent, Xience (PP-EES) in patients with high risk (ST-segment elevation and non-ST-segment elevation myocardial infarction) acute coronary syndromes (ACS) enrolled in the CENTURY II trial. METHODS: CENTURY II is a prospective, multicenter, randomized, single blind, controlled trial comparing BP-SES and PP-EES, with primary endpoint of target lesion failure (TLF) at 9month post-stent implantation. Out of 1123 patients enrolled in CENTURY II trial, 264 high risk ACS patients were included in this subgroup analysis, and the clinical outcomes including target lesion failure (TLF), target vessel failure (TVF), cardiac death, myocardial infarction, and stent thrombosis were evaluated at 24months. RESULTS: The baseline clinical, angiographic and procedural characteristics were similar between two groups. At 24months, TLF occurred in 6.3% of patients receiving a BP-SES and 6.5% of patients receiving a PP-EES (P=0.95); TVF was 6.3% in patients receiving a BP-SES and 9.4% in patients receiving a PP-EES (P=0.36). There were no significant differences in cardiac death, myocardial infarction and stent thrombosis rate. CONCLUSIONS: BP-SES achieved similar safety and efficacy outcomes as PP-EES in this ACS subgroup of CENTURY II study, at 24-month follow-up. This finding is hypothesis-generating and needs to be confirmed in larger trials with longer follow-up.

Admixtures in Cement-Matrix Composites for Mechanical Reinforcement, Sustainability, and Smart Features.

For more than a century, several inclusions have been mixed with Portland cement-nowadays the most-consumed construction material worldwide-to improve both the strength and durability required for construction. The present paper describes the different families of inclusions that can be combined with cement matrix and reviews the achievements reported to date regarding mechanical performance, as well as two other innovative functionalities of growing importance: reducing the high carbon footprint of Portland cement, and obtaining new smart features. Nanomaterials stand out in the production of such advanced features, allowing the construction of smart or multi-functional structures by means of thermal- and strain-sensing, and photocatalytic properties. The first self-cleaning concretes (photocatalytic) have reached the markets. In this sense, it is expected that smart concretes will be commercialized to address specialized needs in construction and architecture. Conversely, other inclusions that enhance strength or reduce the environmental impact remain in the research stage, in spite of the promising results reported in these issues. Despite the fact that such functionalities are especially profitable in the case of massive cement consumption, the shift from the deeply established Portland cement to green cements still has to overcome economic, institutional, and technical barriers.

Nano-Inclusions Applied in Cement-Matrix Composites: A Review.

Research on cement-based materials is trying to exploit the synergies that nanomaterials can provide. This paper describes the findings reported in the last decade on the improvement of these materials regarding, on the one hand, their mechanical performance and, on the other hand, the new properties they provide. These features are mainly based on the electrical and chemical characteristics of nanomaterials, thus allowing cement-based elements to acquire "smart" functions. In this paper, we provide a quantitative approach to the reinforcements achieved to date. The fundamental concepts of nanoscience are introduced and the need of both sophisticated devices to identify nanostructures and techniques to disperse nanomaterials in the cement paste are also highlighted. Promising results have been obtained, but, in order to turn these advances into commercial products, technical, social and standardisation barriers should be overcome. From the results collected, it can be deduced that nanomaterials are able to reduce the consumption of cement because of their reinforcing effect, as well as to convert cement-based products into electric/thermal sensors or crack repairing materials. The main obstacle to foster the implementation of such applications worldwide is the high cost of their synthesis and dispersion techniques, especially for carbon nanotubes and graphene oxide.

Pharmacogenomics of anti-platelet therapy focused on peripheral blood cells of coronary arterial disease patients.

BACKGROUND: To investigate genes differentially expressed in peripheral blood cells (PBCs) from patients with coronary arterial disease (CAD) under double anti-platelet therapy. METHODS: Twenty-six CAD patients that were submitted to percutaneous coronary intervention (PCI) were selected to participate in this study. These patients took 100mg/day of acetylsalicylic acid (ASA) and 75mg/day of clopidogrel. Blood samples were collected before PCI to evaluate platelet reactivity using VerifyNow ASA and P2Y12 assays (Accumetrics). The patients were stratified into 4 quartiles based on ASA reaction units (ARUs) and P2Y12 reaction units (PRUs). Quartile 1 (Q1) patients were classified as responders and quartile 4 (Q4) patients as non-responders. Global mRNA expression from Q1 to Q4 was analyzed by microarray using the GeneChip Exon 1.0 ST array (Affymetrix) and was confirmed by RT-qPCR. RESULTS: Patients with ARU or PRU values within the first quartile (Q1, ARU<390 and PRU<151) were considered responders, while those who had ARU or PRU within the fourth quartile (Q4, ARU>467 and PRU>260) were considered nonresponders. The risk factors associated for CAD showed expected frequencies and no difference was found between Q1 and Q4. Microarray analysis identified 117 genes differentially expressed for ASA and 29 for clopidogrel between Q1 and Q4 groups (p<0.01, FC>1.2). CONCLUSION: The variation in response to ASA may be related with an increased expression of IGF1 and IGF1R, as well as a response to clopidogrel can be affected by pharmacokinetic change related to the reverse transport pathway by increased expression of ABCC3.

Increased clopidogrel response is associated with ABCC3 expression: a pilot study.

BACKGROUND: The aim of this study was investigate the relationship between ABCB1 and ABCC3 gene expressions in peripheral blood cells (PBC) and the response to clopidogrel in patients with coronary arterial disease (CAD). METHODS: Twenty-six male CAD patients (50-70 years) under treatment with clopidogrel (75 mg/day) for at least 5 days were selected. Blood samples were obtained to evaluate platelet reactivity and ABCB1 and ABCC3 mRNA expression. Platelet reactivity was measured in P2Y12 Reaction Units (PRU) using VerifyNow. RNA was extracted from PBC and mRNA levels were measured by qPCR, using GAPD as a reference gene. RESULTS: Platelet response to clopidogrel was categorized in to PRU quartiles. Individuals with PRU values within the first quartile (Q1, <151 units) were considered good responders, while those who had PRU within the fourth quartile (Q4, PRU>260) were considered non-responders. ABCC3 was 1.7 times more expressed in Q4 than in Q1 PRU group (p=0.048). Moreover, CAD patients with low ABCC3 expression (Qe1, <2.5×10(-3)) had higher probability to have a good response to clopidogrel (OR: 18.00, 95%CI: 1.90-169.99, p=0.001). Univariate linear regression analysis demonstrated that low ABCC3 mRNA expression contributed with a reduction of 73 PRU in relation to the patients with expression value higher than 2.5×10(-3) (p=0.027). Neither ABCB1 mRNA levels nor clinical variables studied influenced PRU values. CONCLUSIONS: Low ABCC3 mRNA expression in peripheral blood cells is associated with increased clopidogrel response, but further studies are needed to describe the functional relationship of clopidogrel with the ABCC3.