SciCombinator

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Acute ST-segment elevation myocardial infarction (STEMI) typically arises from total occlusion of an epicardial coronary artery, most often due to atherosclerotic plaque rupture/erosion and subsequent thrombus formation. Granted this, important angiographic information for patients presenting with STEMI is not only about the status of infarct-related artery (IRA) but also about the atherosclerotic disease burden and disease severity of non-IRA vessels. Previous studies have reported that multivessel (MV) coronary artery disease (CAD) is found in approximately 50% of patients with STEMI undergoing primary percutaneous coronary intervention (PCI) [1,2]. Primary PCI is now considered the gold standard in the treatment for patients with STEMI; however, the optimal reperfusion strategy in patients with STEMI and MV disease (MVD) remains uncertain. In this review, we summarize the available evidence on treatment options for patients with STEMI and MVD, and highlight current guideline recommendations on this topic.

Concepts: Myocardial infarction, Atherosclerosis, Angina pectoris, Coronary artery disease, Cardiology, Atheroma, Artery, Coronary artery bypass surgery

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Worldwide, more than 7 million people experience acute myocardial infarction (AMI) every year (1), and although substantial reduction in mortality has been obtained in recent decades, one-year mortality rates are still in the range of 10%. Among patients who survive AMI, 20% suffer a second cardiovascular event in the first year and approximately 50% of major coronary events occur in those with a previous hospital discharge diagnosis of AMI (2). Despite the evidence that lifestyle changes and risk factors management strongly improve long-term prognosis, preventive care post-AMI remains sub-optimal. Cross-sectional data from the serially conducted EUROASPIRE surveys in patients with established ischemic heart disease (IHD) and people at high cardiovascular risk have demonstrated a high prevalence of unhealthy lifestyle, modifiable risk factors and inadequate use of drug therapies to achieve blood pressure and lipid goals (3). Secondary prevention programmes, defined as the level of preventive care focusing on early risk stratification, are highly recommended in all IHD patients, to restore quality of life, maintain or improve functional capacity and prevent recurrence.

Concepts: Myocardial infarction, Atherosclerosis, Hypertension, Heart, Stroke, Prevention, Ischaemic heart disease, Preventive medicine

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The intermolecular [2+2] photocycloaddition of typical cyclic α,β-unsaturated enones, such as 2-cyclohexenone, with olefins was performed in moderate to good yields (42-82%) and with high enantioselectivity (82%-96% ee). An unusual substitution pattern at the chiral oxazoborolidine-AlBr3Lewis acid complex that promotes the reaction was found to be crucial for the success of the reaction. The method was applied to the enantioselective synthesis of the monoterpene (-)-grandisol which could be accomplished in six steps and with an overall yield of 13% starting from 3-methyl-2-cyclo¬hexenone.

Concepts: Amine, Chemical reaction, Method acting, Stereochemistry, Enantiomer, Chirality, Yield, Tartaric acid

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Mid-infrared (mid-IR) coherent light is crucial for several applications in science as well as daily life, and its development especially in powerful augmentation is constrained by the availability of nonlinear optical (NLO) materials. The development of useful mid-IR NLO materials is limited by the requirements of a wide mid-IR transparent window, high laser damaged threshold (LDT), and strong NLO effect. It is common knowledge that oxides are not suitable mid-IR NLO materials, as their IR absorption cutoff wavelengths are usually less than 6 μm; however, their LDTs and NLO effects can be large. Herein, we focused on langasite oxides and built structure-composition-property maps that describe the NLO properties in these materials by combining computational property prediction and experimental characterization. Accordingly, rational molecular design was performed, and a new member of the langasite family, La3SnGa5O14 (LGSn), was synthesized, and single crystals were grown. The produced material exhibits the widest transparent region (0.27-11.0 μm) among available oxides, the largest LDT (846 MW/cm2) among materials that are transparent to 10 μm, and the strongest SHG effect among langasites. The discovery of LGSn facilitates the application of oxides as NLO crystals in the mid-IR spectral region beyond 10 μm. More generally, the developed strategy could be used to guide and accelerate the systematic discovery of functional materials through understanding the key structure-composition-property relationships using the predictive power of computational tools.

Concepts: Optics, Fundamental physics concepts, Light, Electromagnetic radiation, Optical fiber, Laser, Materials science, Infrared

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The blue-green mold Penicillium italicum is among the most problematic post-harvest plant infections limiting the integrity of citrus and many other crops during storage and transportation, but there is no sensor for its on-site or field detection. We hereby, for the first time, report the development of novel biomolecular sensor for assessing the presence of Penicillium italicum spores and hyphae using carbohydrate-lectin recognitions. Two approaches were developed: (i) lateral tests using stand-alone poly (amic) acid (PAA) membranes and glass surfaces and (ii) quantitative tests on 96-well polystyrene plates and paper electrodes. In both cases, the surfaces were functionalized with novel derivatized sugar based ligands while staining was performed with gold nanoparticles. Both approaches provided strong signals for 104 spores/mL of P.italicum isolated from experimentally infected lemons as the lowest-reliable concentration. The 96-well plate-based gave the most sensitive detection with a 4 x 102 spores/mL limit of detection, a linear dynamic range between 2.9 x103 - 6.02 x104 spores/mL (R2 0.9939) and standard deviation of less than 5% for five replicate measurements. The selectivity of the ligands was tested against Trichaptum biforme, Glomerulla cingulata (Colletotrichum gloeosporioides) and Aspergillus nidulans fungi species. The highest selectivity was obtained using the sugar-based gold-nanoparticles towards both the spores and hyphae of P.italicum. The advanced specificity was provided by the utilized sugar ligands employed in the synthesis of gold nanoparticles and was independent from size and shapes of the AuNPs. Accuracy of the sensor response showed dramatic dependence on the sample preparation. In the case of 5-10 min centrifugation at 600 rpm, the spores can be isolated free from hyphae and conidiophore, for which spiked recovery was up to 95% (std ±4). In contrast, for gravity-based precipitation of hyphae, the spiked recovery was 88% (std 11).

Concepts: Nanoparticle, Fungus, Measurement, Gold, Aspergillus, Ascomycota, Penicillium, Mold

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Some metal-organic frameworks (MOFs) incorporate nodes that are metal oxide clusters such as Zr6O8. Vacancies on the node surfaces, accidental or by design, act as catalytic sites. Here we report elucidation of the chemistry of Zr6O8 nodes in the MOFs UiO-66 and UiO-67, having used infrared and nuclear magnetic resonance spectroscopies to determine the ligands on the node surfaces originating from the solvents and modifiers used in the syntheses and having elucidated the catalytic properties of the nodes for ethanol dehydration, which takes place selectively to make diethyl ether but not ethylene at 473-523 K. Density functional theory calculations show that the key to the selective catalysis is the breaking of node-linker bonds (or the accidental adjacency of open/defect sites) that allows catalytically fruitful bonding of the reactant ethanol to neighboring sites on the nodes, facilitating the bimolecular ether formation through an SN2 mechanism.

Concepts: Oxygen, Ethanol, Catalysis, Nitrogen, Ether, Density functional theory, Solvent, Diethyl ether

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To report the results of a knowledge, attitude and practice (KAP) study related to diabetes mellitus (DM), hypertension and diabetic retinopathy (DR) of patient populations in India at different levels (Tertiary (T), Secondary (S) and Primary (P)) of a pyramidal model of eye health care.

Concepts: Nutrition, Myocardial infarction, Hypertension, Diabetes mellitus, Obesity, Diabetes, Retina, Diabetic retinopathy

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Magnetic nanomaterials (Fe3O4NMs) have become novel tools with multiple biological and medical applications because of their biocompatibility. However, adverse health effects of these NMs are of great interest to learn.

Concepts: Medicine, Oxidative stress, Carbon, Nanotechnology, Nanomaterials, Anatomy, Materials science, Ethology

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Despite treatment advances that have improved the health and life expectancy of HIV-positive people and contribute to the prevention of HIV transmission, HIV stigma is still frequently experienced by HIV-infected individuals and those close to them. This study investigated the types of HIV-related stigma experienced by HIV-negative adults in serodiscordant heterosexual relationships when their partner’s HIV-positive status was revealed to family and friends and their strategies to manage such stigma. In-depth interviews were conducted in New York City with 56 men and 44 women who were HIV negative and had been in a relationship for at least six months with an HIV-positive partner of the opposite sex. Those who had disclosed the HIV status of their partner to family or friends experienced four main types of stigmatizing behaviours: distancing (avoidance of the participant or his/her partner for fear of infection), depreciation of the partner (being told their partner is not worthy of them), violation of privacy (people spreading the information that the partner is HIV positive), or accusations (being told that it was wrong to be in a relationship with HIV-positive people or to try to conceive with them). Participants described four main ways of managing actual or anticipated stigma: secrecy (not disclosing the HIV status of their partner to anyone), avoidance (breaking ties with people who held stigmatizing views), seeking support from their partner or the HIV-positive community (e.g., HIV-related organizations or their partner’s family or friends), or education (informing family or friends about HIV treatment and prevention). Findings show that HIV-related “courtesy” stigma is frequently experienced by HIV-negative people in serodiscordant relationships but often can be managed. Offering support to individuals in serodiscordant relationships can improve the quality of life of HIV-positive people and their HIV-negative partners and potentially reduce HIV stigma.

Concepts: HIV, AIDS, HIV/AIDS, Viral load, Relationship, Infectious disease, Western blot, Interpersonal relationship

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Previous randomized controlled trials have reported a 6.1-6.9% incidence of clean intermittent catheterization (CIC) following treatment with onabotulinumtoxinA in non-neurogenic overactive bladder (OAB) patients who were inadequately managed by ≥1 anticholinergic. A multi-center retrospective chart review assessed the real-world rate of voiding dysfunction requiring catheterization.

Concepts: Epidemiology, Clinical trial, Medical statistics, Randomized controlled trial, ClinicalTrials.gov, Rates, Pharmaceutical industry, Clinical research