Effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy.

Recent clinical trials showed that short aspirin duration (1 or 3 months) in dual antiplatelet therapy (DAPT) followed by P2Y12 inhibitor monotherapy reduced the risk of bleeding and did not increase the ischemic risk compared to 12-month DAPT in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). However, it is unclear about the optimal duration of aspirin in P2Y12 inhibitor monotherapy. The purpose of this study was to evaluate the influence of aspirin treatment duration on clinical outcomes in a cohort of ACS patients with early aspirin interruption and received P2Y12 inhibitor monotherapy. From January 1, 2014 to December 31, 2018, we included 498 ACS patients (age 70.18 ± 12.84 years, 71.3% men) with aspirin stopped for various reasons before 6 months after PCI and received P2Y12 inhibitor monotherapy. The clinical outcomes between those with aspirin treatment ≤ 1 month and > 1 month were compared in 12-month follow up after PCI. Inverse probability of treatment weighting was used to balance the covariates between groups. The mean duration of aspirin treatment was 7.52 ± 8.10 days vs. 98.05 ± 56.70 days in the 2 groups (p<0.001). The primary composite endpoint of all-cause mortality, recurrent ACS or unplanned revascularization and stroke occurred in 12.6% and 14.4% in the 2 groups (adjusted HR 1.19, 95% CI 0.85-1.68). The safety outcome of BARC 3 or 5 bleeding was also similar (adjusted HR 0.69, 95% CI 0.34-1.40) between the 2 groups. In conclusion, patients with ≤ 1 month aspirin treatment had similar clinical outcomes to those with treatment > 1 month. Our results indicated that ≤ 1-month aspirin may be enough in P2Y12 inhibitor monotherapy strategy for ACS patients undergoing PCI.

Electrodeposited Copolymers Based on 9,9'-(5-Bromo-1,3-phenylene)biscarbazole and Dithiophene Derivatives for High-Performance Electrochromic Devices.

A 1,3-bis(carbazol-9-yl)benzene derivative (BPBC) was synthesized and its related homopolymer (PBPBC) and copolymers (P(BPBC-co-BT), P(BPBC-co-CDT), and P(BPBC-co-CDTK)) were prepared using electrochemical polymerization. Investigations of polymeric spectra showed that PBPBC film was grey, iron-grey, yellowish-grey, and greyish-green from the neutral to the oxidized state. P(BPBC-co-BT), P(BPBC-co-CDT), and P(BPBC-co-CDTK) films showed multicolor transitions from the reduced to the oxidized state. The transmittance change (ΔT) of PBPBC, P(BPBC-co-BT), P(BPBC-co-CDT), and P(BPBC-co-CDTK) films were 29.6% at 1040 nm, 44.4% at 1030 nm, 22.3% at 1050 nm, and 41.4% at 1070 nm. The coloration efficiency (η) of PBPBC and P(BPBC-co-CDTK) films were evaluated to be 140.3 cm2 C-1 at 1040 nm and 283.7 cm2 C-1 at 1070 nm, respectively. A P(BPBC-co-BT)/PEDOT electrochromic device (ECD) showed a large ΔT (36.2% at 625 nm) and a fast response time (less than 0.5 s), whereas a P(BPBC-co-CDTK)/PEDOT ECD revealed a large η (534.4 cm2 C-1 at 610 nm) and sufficient optical circuit memory.

Electrosynthesis of Electrochromic Polymer Membranes Based on 3,6-Di(2-thienyl)carbazole and Thiophene Derivatives.

Five carbazole-containing polymeric membranes (PDTC, P(DTC-co-BTP), P(DTC-co-BTP2), P(DTC-co-TF), and P(DTC-co-TF2)) were electrodeposited on transparent conductive electrodes. P(DTC-co-BTP2) shows a high ΔT (68.4%) at 855 nm. The multichromic properties of P(DTC-co-TF2) membrane range between dark yellow, yellowish-green, gunmetal gray, and dark gray in various reduced and oxidized states. Polymer-based organic electrochromic devices are assembled using 2,2'-bithiophene- and 2-(2-thienyl)furan-based copolymers as anodic membranes, and poly(3,4-ethylenedioxythiophene)-poly(styrene sulfonic acid) (PEDOT-PSS) as the cathodic membrane. P(DTC-co-TF)/PEDOT-PSS electrochromic device (ECD) displays a high transmittance change (ΔT%) (43.4%) at 627 nm as well as a rapid switching time (less than 0.6 s) from a colored to a bleached state. Moreover, P(DTC-co-TF2)/PEDOT-PSS ECD shows satisfactory optical memory (the transmittance change is less than 2.9% in the colored state) and high coloration efficiency (512.6 cm2 C-1) at 627 nm.

Impact of the Dual Antiplatelet Therapy Score on Clinical Outcomes in Acute Coronary Syndrome Patients Receiving P2Y12 Inhibitor Monotherapy.

Background: Dual antiplatelet therapy (DAPT) score is used to stratify ischemic and bleeding risk for antiplatelet therapy after percutaneous coronary intervention (PCI). This study assessed the association between the DAPT score and clinical outcomes in acute coronary syndrome (ACS) patients who were treated with P2Y12 inhibitor monotherapy. Methods: A total of 498 ACS patients, with early aspirin discontinuation for various reasons and who received P2Y12 inhibitor monotherapy after PCI, were enrolled during the period from January 1, 2014 to December 31, 2018. The efficacy and safety between those with low (<2) and high (≥2) DAPT scores were compared during a 12-month follow-up after PCI. Inverse probability of treatment weighting was used to balance the covariates between the two groups. The primary endpoint was a composite outcome of all-cause mortality, recurrent ACS or unplanned revascularization, and stroke within 12 months. The safety endpoint was major bleeding, defined as Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding. Results: The primary composite endpoint occurred in 11.56 and 14.38% of the low and high DAPT score groups, respectively. Although there was no significant difference in the primary composite endpoint between the two groups in the multivariate Cox proportional hazards models, the risk of recurrent ACS or unplanned revascularization was significantly higher in the high DAPT score group (adjusted hazard ratio [HR]: 1.900, 95% confidence interval [CI]: 1.095-3.295). The safety outcome for BARC 3 or 5 bleeding was similar between the two groups. Conclusions: Our results indicate that ACS patients receiving P2Y12 monotherapy with high DAPT score had an increased risk of recurrent ACS or unplanned revascularization.

Mapping coastal circulations using moving vehicle acoustic tomography.

With the increased availability of highly maneuverable unmanned surface/underwater vehicles, abundant ocean data can now be collected. This study uses tomographic techniques to extend the survey area covered by moving vehicles. An acoustic reciprocal transmission experiment was conducted using three tomographic sensors installed on an autonomous underwater vehicle, a fishing ship, and a buoy. The distributed sensing method is applied for currents estimation. The estimated currents near the ship show consistent results with the direct measurements. In particular, an anticyclonic circulation was revealed. Further, a general least-squares method is employed to improve the estimate of this vortical structure.

P2Y12 Inhibitor Monotherapy with Clopidogrel Versus Ticagrelor in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.

BACKGROUND: P2Y12 inhibitor monotherapy is an alternative antiplatelet strategy in patients undergoing percutaneous coronary intervention (PCI). However, the ideal P2Y12 inhibitor for monotherapy is unclear. METHODS AND RESULTS: We performed a multicenter, retrospective, observational study to compare the efficacy and safety of monotherapy with clopidogrel versus ticagrelor in patients with acute coronary syndrome (ACS) undergoing PCI. From 1 January 2014 to 31 December 2018, 610 patients with ACS who received P2Y12 monotherapy with either clopidogrel (n = 369) or ticagrelor (n = 241) after aspirin was discontinued prematurely were included. Inverse probability of treatment weighting was used to balance covariates between the groups. The primary endpoint was the composite of all-cause mortality, recurrent ACS or unplanned revascularization, and stroke within 12 months after discharge. Overall, 84 patients reached the primary endpoint, with 57 (15.5%) in the clopidogrel group and 27 (11.2%) in the ticagrelor group. Multivariate adjustment in Cox proportional-hazards models revealed a lower risk of the primary endpoint with ticagrelor than with clopidogrel (adjusted hazard ratio (aHR): 0.67, 95% confidence interval (CI): 0.49-0.93). Ticagrelor significantly reduced the risk of recurrent ACS or unplanned revascularization (aHR: 0.46, 95% CI: 0.28-0.75). No significant difference in all-cause mortality and major bleeding events was observed between the 2 groups. CONCLUSIONS: Among patients with ACS undergoing PCI who cannot complete course of dual antiplatelet therapy, a significantly lower risk of cardiovascular events was associated with ticagrelor monotherapy than with clopidogrel monotherapy. The major bleeding risk was similar in both the groups.

Bio-reduction and synchronous removal of hexavalent chromium from aqueous solutions using novel microbial cell/algal-derived biochar particles: Turning an environmental problem into an opportunity.

In China, Dolichospermum flos-aquae is one of the most prevalent bloom-forming cyanobacteria and thus a major challenge for the concerned catchment area. To solve this problem and turn it into an opportunity for heavy metal remediation, we investigated the potential of D. flos-aquae for production algal biochar, and constructed a microbe-algal biochar composite. The microbe-biochar composite (biochar immobilized Proteus mirabilis PC801) showed superior hexavalent chromium removal capacity. It produced 100% Cr(VI) (150 mg/L) removal efficiency, with 87.7% total Cr immobilized in/on the particles and only 12.3% Cr(III) left in solution. Furthermore, Scanning electron microscopy-energy dispersive spectroscopy and antioxidase activity results showed that Cr(VI) reduction mainly occurred outside the cells, and the biochar can effectively protect P. mirabilis YC801 from the direct toxicity of chromium, thereby promoting the removal efficiency. Overall, this study provides a promising approach by utilizing this harmful algae for the bio-remediation of Cr(VI)-contaminated groundwater in practical application.