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Patchy nanoparticles (NPs) show many important applications, especially for constructing structurally complex colloidal materials, but existing synthetic strategies generate patchy NPs with limited types of symmetry. This article describes a versatile copolymer ligand-based strategy for the scalable synthesis of uniform Au-(SiO2 )x patchy NPs (x is the patch number and 1 ≤ x ≤ 5) with unusual symmetry at high yield. The hydrolysis and condensation of tetraethyl orthosilicate on block-random copolymer ligands induces the segregation of copolymers on gold NPs (AuNPs) and hence governs the structure and distribution of silica patches formed on the AuNPs. The resulting patchy NPs possess unique configurations where the silica patches are symmetrically arranged at one side of the core NP, resembling the geometry of polar small molecules. The number, size, and morphology of silica patches, as well as the spacing between the patches and the AuNP can be precisely tuned by tailoring copolymer architectures, grafting density of copolymers, and the size of AuNPs. Furthermore, it is demonstrated that the Au-(SiO2 )x patchy NPs can assemble into more complex superstructures through directional interaction between the exposed Au surfaces. This work offers new opportunities of designing next-generation complex patchy NPs for applications in such as biomedicines, self-assembly, and catalysis.

To demonstrate the feasibility of Octafen technique, a novel endovascular configuration for the treatment of thoracoabdominal aortic aneurysms (TAAA).

Two patients with complex TAAA and high surgical risk were treated with Octafen endograft configuration in a hybrid operating room with computed tomography (CT)-fluoroscopy image fusion guidance, using 3D-3D fusion techniques to facilitate procedural success. The procedure is a modification of the previously-described Octopus technique for endovascular repair of TAAA. The main advantage of this technique is the ability to use devices to repair a TAAA with the combination of off-the-shelf and noninvestigational custom-made devices. The devices used are readily available to most practicing vascular surgeons, which provides an alternative treatment in case of limited access to investigational devices, in time-sensitive cases, and in patients with limited functional capacity who cannot undergo open repair. In the modification described herein, we use a combinat-shelf and non-investigational, custom-made devices. The 'Octafen' technique provides a treatment alternative in case of limited access to investigational devices and can be adjusted according to patient anatomy.

Early readmissions of spontaneous bacterial peritonitis (SBP) are often associated with poor outcomes. SR-4835 We compared characteristics and outcomes for index and 30-day readmissions of SBP in the USA.

We analyzed the Nationwide Readmissions Database for 2018 to identify all adult (≥18years) 30-day readmissions of SBP in the USA. Hospitalization characteristics and outcomes for index and 30-day readmissions of SBP were compared. Independent predictors of 30-day readmissions were also identified.

In 2018, of the 5,797 index admissions for SBP, 30% (1726) were readmitted within 30day. At the time of readmission, the most common admitting diagnosis was alcoholic cirrhosis of the liver with ascites (11.8%) followed by sepsis due to an unspecified organism (9.2%). SBP as an admitting diagnosis was identified for only 8.3% of these 30-day readmissions. Compared with index admissions, 30-day readmissions of SBP had a lower mean age (56.1 vs 58.6years, P<0.001) without a statistically significant difference for gender. Furthermore, 30-day readmissions of SBP were associated with significantly higher odds of inpatient mortality (10% vs 4.9%, OR 2.15, 95% CI 1.66-2.79, P<0.001), and mean total hospital charge ($85,031 vs $56,000, mean difference 29,032, 95% CI 12,867-45,197, P<0.001) compared with index admissions. The presence of chronic pulmonary disease, liver failure, inpatient dialysis, and discharge against medical advice were identified as independent predictors for increased 30-day readmissions of SBP.

The 30-day readmission rate of SBP was 30% and these readmissions were associated with higher odds of inpatient mortality compared with index admissions.

The 30-day readmission rate of SBP was 30% and these readmissions were associated with higher odds of inpatient mortality compared with index admissions.BACKGROUND This study aimed to investigate the optimum time to reintroduce the original antiplatelet drugs after upper gastrointestinal hemorrhage in patients as secondary prevention for cardiovascular and cerebrovascular diseases. MATERIAL AND METHODS After the upper gastrointestinal bleeding stopped, patients were randomly divided according to the oral antiplatelet drugs administered. The aspirin group was further divided into 3-day and 7-day aspirin groups. The patients who took aspirin and clopidogrel were randomly divided into 3 groups 0-day aspirin+3-day clopidogrel; 0-day aspirin+7-day clopidogrel; and 3-day aspirin+7-day clopidogrel. The recovery time, rebleeding rate, incidence of cardiovascular and cerebrovascular events, and death were observed. RESULTS The 3-day aspirin group had more rebleeding, reduced risk of cardiovascular and cerebrovascular events, and a similar mortality rate compared to the other groups. In the aspirin+clopidogrel group, the 0-day aspirin+3-day clopidogrel group had the highest rebleeding rate and the lowest risk of cardiovascular and cerebrovascular events. The 3-day aspirin+7-day clopidogrel group had the highest risk of cardiovascular and cerebrovascular events and increased hospitalization time. The risk of rebleeding and cardiovascular and cerebrovascular events was lower in the 0-day aspirin+7-day clopidogrel group, and the overall mortality rate was the lowest in this group. CONCLUSIONS In patients receiving only aspirin, this drug should be reintroduced as soon as possible after peptic ulcer hemorrhage. Aspirin and clopidogrel are dual antiplatelet drugs used for the secondary prevention of cardiovascular diseases. In patients under dual-drug therapy, aspirin should not be stopped, while clopidogrel should be restarted in about 7 days.

The objective of this study was to analyze the impact of the abutment width on early marginal bone loss (MBL).

A balanced, randomized, double-blind clinical trial with two parallel experimental arms was conducted without a control group. The arms were "cylindrical" abutment and "concave" abutment. Eighty hexagonal internal connection implants, each with a diameter of 4 × 10 mm, were placed in healed mature bone. The main variable was the peri-implant tissue stability, which was measured as MBL at 8 weeks and 6 months.

The final sample consisted of 77 implants that were placed in 25 patients. 38 (49.4%) were placed using the cylindrical abutment, and the other 39 (50.6%) were placed using the concave abutment. The early global MBL of -0.6 ± 0.7 mm in the cylindrical abutment group was significantly higher than it was in the concave abutment group, in which the early global MBL was -0.4 ± 0.6 mm (p=.030). The estimated effect size (ES) was negative for the cylindrical abutment (ES=-1.3730, CI -2.5919 to -0.1327; t-value=-2.4893; p=.0139), therefore implying a loss of mean bone level, and it was positive for the concave abutment (ES=2.8231; CI 1.4379 to 4.2083; t-value=4.0957; p=.0002), therefore implying an increase in the average bone level.

The concave abutments presented significantly less early MBL at 6 months post-loading than classical cylindrical abutments did.

The concave abutments presented significantly less early MBL at 6 months post-loading than classical cylindrical abutments did.Effective pyroptosis induction is a promising approach to potentiate cancer immunotherapy. However, the actual efficacy of the present pyroptosis inducers can be weakened by successive biological barriers. Here, a cascaded pH-activated supramolecular nanoprodrug (PDNP) with a stepwise size shrinkage property is developed as a pyroptosis inducer to boost antitumor immune response. PDNPs comprise multiple poly(ethylene glycol) (PEG) and doxorubicin (DOX) drug-polymer hybrid repeating blocks conjugated by ultra-pH-sensitive benzoic imine (bzi) and hydrazone (hyd) bonds. The PEG units endow its "stealth" property and ensure sufficient tumor accumulation. A sharp switch in particle size and detachment of PEG shielding can be triggered by the acidic extracellular pH to achieve deep intratumor penetration. Following endocytosis, second-stage size switching can be initiated by more acidic endolysosomes, and PDNPs disassociate into ultrasmall cargo to ensure accurate intracellular delivery. The cascaded pH activation of PDNPs can effectively elicit gasdermin E (GSDME)-mediated pyroptosis to enhance the immunological response. In combination with anti-PD-1 antibody, PDNPs can amplify tumor suppression and extend the survival of mice, which suggests a powerful immune adjuvant and pave the way for high-efficiency immune checkpoint blockade therapy.Synergistic electronic modulations is an effective strategy to develop efficient and stable electrocatalysts for the electrochemical hydrogen production via water splitting. Herein, tremella-like Ni3 S2 @RuO2 and Ni3 S2 @NiFeOOH heterostructures catalysts are constructed on Ni foams (NF) by coupling RuO2 and NiFeOOH on Ni3 S2 nanoflake arrays. The resulting Ni3 S2 @RuO2 /NF electrode exhibits top-level hydrogen evolution reaction electrocatalysis with an extremely low overpotential of 12 mV at 10 mA cm-2 and a Tafel slope of 30.7 mV dec-1 , as well as the as-obtained Ni3 S2 @NiFeOOH/NF electrode with tunable binding energy for OH* intermediates shows remarkable oxygen evolution reaction electrocatalysis with an overpotential of 227 mV at 10 mA cm-2 . The electrolyzer employing Ni3 S2 @RuO2 /NF electrode for cathodic H2 production and Ni3 S2 @NiFeOOH/NF for anodic O2 production merely needs a low voltage of 1.47 V to drive 10 mA cm-2 with excellent durability. The combined theoretical calculation and X-ray photoelectron spectroscopy investigation reveal that heterogeneous configuration can induce electron transfer from Ni3 S2 to RuO2 through NiRu/SRu bonds, and thus tailor the d-band center and optimize the activated H2 O/H* Gibbs free energies for enhanced hydrogen evolution reaction on Ni3 S2 @RuO2 . This study may shed new light on the construction of heterostructures as highest-performing electrocatalysts and offer unique insight into the theory mechanism.The extraordinary optoelectronic properties and continued commercialization of GaN enable it a promising component for neuromorphic visual system (NVS). However, typical GaN-based optoelectronic devices demonstrated to data only show temporary and unidirectional photoresponse in ultraviolet region, which is an insurmountable obstacle for construction of NVS in practical applications. Herein, an ultrasensitive visual sensor with phototransistor architecture consisting of AlGaN/GaN high-electron-mobility-transistor (HEMT) and two-dimensional Ruddlesden-Popper organic-inorganic halide perovskite (2D OIHP) is reported. Utilizing the significant variation in activation energy for ion transport in 2D OIHP (from 1.3 eV under dark to 0.4 eV under illumination), the sensor can efficiently perceive and storage optical information in ultraviolet-visible region. Meanwhile, the photo-enhanced field-effect mechanism in the depletion-mode HEMT enables gate-tunable negative and positive photoresponse, where some typical optoelectronic synaptic functions including inhibitory and excitatory postsynaptic current as well as paired-pulse facilitation are demonstrated.

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