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Despite the lack of high-level evidence, laparoscopic distal pancreatectomy (LDP) is frequently performed in patients with pancreatic ductal adenocarcinoma (PDAC) owing to advancements in surgical techniques. The aim of this study was to investigate the long-term oncologic outcomes of LDP in patients with PDAC via propensity score matching (PSM) analysis using data from a large-scale national database.A total of 1202 patients who were treated for PDAC via distal pancreatectomy across 16 hospitals were included in the Korean Tumor Registry System-Biliary Pancreas. The 5-year overall (5YOSR) and disease-free (5YDFSR) survival rates were compared between LDP and open DP (ODP).ODP and LDP were performed in 846 and 356 patients, respectively. The ODP group included more aggressive surgeries with higher pathologic stage, R0 resection rate, and number of retrieved lymph nodes. After PSM, the 5YOSRs for ODP and LDP were 37.3% and 41.4% (p = 0.150), while the 5YDFSRs were 23.4% and 27.2% (p = 0.332), respectively. Prognostic factors for 5YOSR included R status, T stage, N stage, differentiation, and lymphovascular invasion.LDP was performed in a selected group of patients with PDAC. Within this group, long-term oncologic outcomes were comparable to those observed following ODP.

Because of paucity of published data, we evaluated the 2-year major clinical outcomes between early invasive (EI) and delayed invasive (DI) strategies according to the stage of chronic kidney disease (CKD) in patients with non-ST-segment elevation myocardial infarction (NSTEMI), who underwent a successful newer-generation drug-eluting stent (DES) implantation.A total of 8241 NSTEMI patients were recruited from the Korea Acute Myocardial Infarction Registry (KAMIR). Based on baseline estimated glomerular filtration rate (eGFR; ≥90, 60-89, 30-59, and30 mL/min/1.73 mAfter multivariable-adjusted and propensity score-adjusted analyses, the cumulative incidence of MACE (group A, p = 0.139 and p = 0.103, respectively; group B, p = 0.968 and p = 0.608, respectively; group C, p = 0.111 and p = 0.196, respectively; group D, p = 0.882 and p = 0.571, respectively), all-cause death, re-MI, and any repeat revascularization was similar between the EI and DI groups in the 4 different renal function groups.In the era of newer-generation DES, EI and DI strategies showed comparable major clinical outcomes in patients with NSTEMI and CKD during a 2-year follow-up period. However, to confirm these results, further randomized, large-scale, long-term follow-up studies are needed.

Objectives The purpose of this study was to test whether the success rate of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) increased with pre-procedural coronary computed tomography angiography (CTA). Background Coronary CTA provides valuable information before and during CTO-PCI. However, there are no randomized data that explore whether coronary CTA increases its success rate. Methods In this multicenter, randomized trial, a total of 400 patients with CTO were randomized to receive PCI with pre-procedural coronary CTA (coronary CTA–guided group; n = 200) or without coronary CTA (angiography-guided group; n = 200) between January 2014 and September 2019. The primary endpoint was the successful recanalization rate, a final TIMI (Thrombolysis In Myocardial Infarction) grade ≥2, and ≤30% residual stenosis on the final angiogram. Results A total of 10 operators performed PCI. Successful recanalization was achieved in 187 patients (93.5%) in the coronary CTA–guided group and in 168 patients (84.0%) in the angiography-guided group (absolute difference, 9.5% [95% confidence interval: 3.4% to 15.6%]; p = 0.003). When comparing the success rates according to the Multicenter CTO Registry of Japan score (J-CTO), the coronary CTA guidance was favored over the angiography-guidance in the subset of J-CTO ≥2 versus in the subset of J-CTO Conclusions Pre-procedural coronary CTA-guidance for CTO resulted in higher success rates with numerically fewer immediate periprocedural complications such as coronary perforations or periprocedural myocardial infarction than angiography guidance. Higher success rates were more prominently observed in patients with CTO who had a high J-CTO score than those who did not. (Role of CT Scan for the Successful Recanalization of Chronic Total Occlusion; a Randomized Comparison Between 3D CT-guided PCI vs. Conventional Treatment [CT-CTO Trial]; NCT02037698 )

Objectives The aim of this study was to determine whether 1 month of dual-antiplatelet therapy (DAPT) followed by aspirin monotherapy after polymer-free drug-coated stent (PF-DCS) implantation is noninferior to 6 to 12 months of DAPT after biodegradable-polymer drug-eluting stent (BP-DES) implantation. Background It is necessary to determine the optimal minimal duration of DAPT followed by aspirin monotherapy after percutaneous coronary intervention (PCI). Methods In this trial, 3,020 patients with coronary artery disease considered for PCI for noncomplex lesions were randomized to 1-month DAPT after PF-DCS (n = 1,507) or 6- to 12-month DAPT after BP-DES (n = 1,513). The primary endpoint was the 1-year composite of cardiac death, nonfatal myocardial infarction, target vessel revascularization, stroke, or major bleeding (noninferiority hypothesis margin of 3%). Results The primary endpoint occurred in 88 patients (5.9%) in the 1-month DAPT after PF-DCS group and 98 patients (6.5%) in the 6- to 12-month DAPT after BP-DES group (absolute difference −0.7%; upper limit of 1-sided 97.5% confidence interval: 1.33%; P Conclusions Among patients who underwent PCI for noncomplex lesions, 1-month DAPT followed by aspirin monotherapy after PF-DCS implantation was noninferior to 6- to 12-month DAPT after BP-DES implantation for the 1-year composite of cardiovascular events or major bleeding. The present findings need to be interpreted in the setting of different types of stents according to antiplatelet strategy. (A Randomized Controlled Comparison Between One Versus More Than Six Months of Dual Antiplatelet Therapy After Biolimus A9-Eluting Stent Implantation; NCT02513810 )

Background Optimal antiplatelet monotherapy during the chronic maintenance period in patients who undergo coronary stenting is unknown. We aimed to compare head to head the efficacy and safety of aspirin and clopidogrel monotherapy in this population. Methods We did an investigator-initiated, prospective, randomised, open-label, multicentre trial at 37 study sites in South Korea. We enrolled patients aged at least 20 years who maintained dual antiplatelet therapy without clinical events for 6-18 months after percutaneous coronary intervention with drug-eluting stents (DES). We excluded patients with any ischaemic and major bleeding complications. Patients were randomly assigned (1:1) to receive a monotherapy agent of clopidogrel 75 mg once daily or aspirin 100 mg once daily for 24 months. The primary endpoint was a composite of all-cause death, non-fatal myocardial infarction, stroke, readmission due to acute coronary syndrome, and Bleeding Academic Research Consortium (BARC) bleeding type 3 or greater, in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT02044250. Findings Between March 26, 2014, and May 29, 2018, we enrolled 5530 patients. 5438 (98·3%) patients were randomly assigned to either the clopidogrel group (2710 [49·8%]) or to the aspirin group (2728 [50·2%]). Ascertainment of the primary endpoint was completed in 5338 (98·2%) patients. During 24-month follow-up, the primary outcome occurred in 152 (5·7%) patients in the clopidogrel group and 207 (7·7%) in the aspirin group (hazard ratio 0·73 [95% CI 0·59-0·90]; p=0·0035). Interpretation Clopidogrel monotherapy, compared with aspirin monotherapy during the chronic maintenance period after percutaneous coronary intervention with DES significantly reduced the risk of the composite of all-cause death, non-fatal myocardial infarction, stroke, readmission due to acute coronary syndrome, and BARC bleeding type 3 or greater. In patients requiring indefinite antiplatelet monotherapy after percutaneous coronary intervention, clopidogrel monotherapy was superior to aspirin monotherapy in preventing future adverse clinical events. Funding ChongKunDang, SamJin, HanMi, DaeWoong, and the South Korea Ministry of Health and Welfare.

Objectives The aim of this study was to assess whether the effects of ticagrelor monotherapy after 3-month dual-antiplatelet therapy (DAPT) are consistent among patients presenting with ST-segment elevation myocardial infarction (STEMI), non–ST-segment elevation myocardial infarction, and unstable angina treated with drug-eluting stents. Background Ticagrelor monotherapy after short-term DAPT has not been investigated in patients with STEMI. Methods This was a pre-specified, stratified, subgroup analysis of the STEMI cohort from the TICO (Ticagrelor Monotherapy After 3 Months in the Patients Treated With New Generation Sirolimus Stent for Acute Coronary Syndrome) trial, which constituted 36% of the total population. The primary outcome was a composite of major bleeding and major adverse cardiac and cerebrovascular events (MACCE; death, myocardial infarction, stent thrombosis, stroke, or target vessel revascularization). The secondary outcomes were major bleeding and MACCE. Results The incidence of the primary outcome was 4.4% in patients with STEMI (n = 1,103), 6.0% in those with non–ST-segment elevation myocardial infarction (n = 1,027), and 4.1% in those with unstable angina (n = 926), without statistical significance (p = 0.09). Compared with ticagrelor-based 12-month DAPT, ticagrelor monotherapy after 3-month DAPT showed consistent effects on the primary outcome across clinical presentations (p for interaction [pint] = 0.64). Furthermore, the effect of ticagrelor monotherapy on the reduction of major bleeding was consistent across clinical presentations (pint = 0.36). The effect of ticagrelor monotherapy on MACCE was also consistent in patients with STEMI, without evidence of a higher risk for MACCE (pint = 0.14). Conclusions This pre-specified subgroup analysis revealed no heterogeneity in the effects of ticagrelor monotherapy after 3-month DAPT, compared with 12-month DAPT, for the primary outcome, major bleeding, and MACCE across clinical presentations including STEMI, though larger studies are needed to demonstrate these findings with adequate power. (Ticagrelor Monotherapy After 3 Months in the Patients Treated With New Generation Sirolimus Stent for Acute Coronary Syndrome [TICO Study]; NCT02494895 )

Background Cholangiocarcinoma (CCA) is a malignant cancer of the biliary tract with a poor prognosis. Herein, we investigated possible mechanism of extrahepatic CCA (eCCA) by dysregulated iron metabolism and post-translational modifications (PTMs). Further, we evaluated potential biomarkers in the bile fluid for diagnosis of eCCA and differentiation between eCCA and benign biliary disease. Methods From August 2018 to April 2019, we obtained bile fluids from 46 patients; 28 patients with eCCA (eCCA group) and 18 patients with common bile duct stone (Control group) via percutaneous transhepatic biliary drainage. We examined the levels of reduced glutathione (GSH), peroxide, ferrous iron [Fe+2], glutathione peroxidase (GPX) and farnesyl transferase/geranylgeranyl transferase type-1 subunit alpha (FNTA) concentration in bile fluids to clarify the mechanism of ferroptosis and prenylation. Results The remarkable difference of PTMs was that FNTA which means prenylated cysteine as regulator was significantly decreased in eCCA than that of control. In addition, level of GSH, peroxide, GPX and ferrous iron [Fe+2] were significantly depleted in eCCA than control. These results demonstrate that PTM, dysregulated iron metabolism and GPX-regulated ferroptosis with GSH depletion through cysteine modification in bile are possible mechanisms of eCCA. Liquid Chromatography (LC)-Mass Spectrometry (MS) analysis, several oncogenic pathways including MYC target, apoptosis, fatty acid metabolism, P53 and mTORC1 were enriched in eCCA. Conclusions In conclusion, redox-dependent modification of cysteine and ferroptosis in bile fluids are possible mechanisms of eCCA. Several protein and oncogenic pathways related to PTM which are seen in eCCA tissues were also enriched in bile fluids. It suggests that bile fluid represents the oncogenic characteristics of eCCA tissues. Therefore, bile fluids have a role of a biomarker for diagnosis in eCCA, especially, differentiation of eCCA from benign biliary stricture.

Background and aims The long-term comparative results between culprit-only percutaneous coronary intervention (C–PCI) and multivessel PCI (M-PCI) or those between complete revascularization (CR) and incomplete revascularization (IR) in patients with non-ST-elevation myocardial infarction (NSTEMI) and multivessel disease (MVD) after successful newer-generation drug-eluting stent (DES) implantation are limited. Therefore, we compared the 2-year clinical outcomes in such patients. Methods A total of 4588 patients with NSTEMI and MVD (C–PCI, n = 2055; M-PCI, n = 2533; CR, n = 2029; IR, n = 504) were evaluated. The primary outcome was major adverse cardiac events (MACEs) defined as all-cause death, recurrent myocardial infarction MI, and any repeat coronary revascularization. The secondary outcome was stent thrombosis (ST). Results The cumulative incidences of the primary and secondary outcomes were similar in the three comparison groups (C–PCI vs. M-PCI, CR vs. IR, or CR vs. C–PCI). However, the cumulative incidence of non-target vessel revascularization (non-TVR) was higher in the C–PCI group than in the M-PCI group (adjusted hazard ratio [aHR]: 2.011; 95% confidence interval [CI]: 1.942–3.985; p = 0.012), higher in the IR group than in the CR group (aHR: 2.051; 95% CI: 1.216–4.183; p = 0.043), and higher in the C–PCI group than in the CR group (aHR: 2.099; 95% CI: 1.237–3.564; p = 0.006). Conclusions Regarding the higher cumulative incidence of non-TVR, M-PCI and CR were preferred compared to C–PCI or IR in patients with NSTEMI and MVD. However, further randomized studies are required to confirm these findings.

Background Intensive statin therapy reduces cardiovascular events in acute coronary syndrome. The data concerning the long-term clinical impacts of statin therapy between ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) after drug-eluting stent implantation are limited. We compared the 2-year clinical outcomes between these 2 groups after statin therapy. Materials and Methods A total of 30,616 Korean patients with acute myocardial infarction (AMI) were enrolled. Among them, 13,686 patients were classified as group A (STEMI statin user), 3,824 patients were as group B (STEMI statin nonuser), 10,398 patients were as group C (NSTEMI statin user), and 2,708 patients were as group D (NSTEMI statin nonuser). The major clinical endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction (re-MI), and any repeat revascularization during a 2-year follow-up period. Results After adjustment, the cumulative risks of MACE (adjusted hazard ratio [aHR] = 1.112 [1.002-1.235]; P = 0.047), all-cause death (aHR = 1.271 [1.054-1.532]; P = 0.012), and target vessel revascularization (TVR, aHR = 1.262 [1.049-1.518]; P = 0.014) in group C were significantly higher than group A. The cumulative risks of MACE, all-cause death, and cardiac death of the statin nonuser group (groups B and D) were significantly higher compared with statin user group (groups A and C). Conclusions Statin therapy was more effective in reducing the cumulative risks of MACE, all-cause death, and TVR in the STEMI group than NSTEMI group in Korean patients with AMI after successful drug-eluting stent implantation.

In this paper, we demonstrate a simple and effective method to control the visibility of embedded silicon solar cells in building-integrated photovoltaic (BIPV) windows by surface structure modification and metal-oxide back coating. The surface structure modification by etching the front glass in BIPV modules and the use of a thin niobium pentoxide (Nb2O5) film as a back coating enable the silicon solar cells to be hidden from view without a serious loss in the power efficiency. By employing the etched front glass and Nb2O5 back coating, silicon solar cells embedded in the BIPV module exhibited power conversion efficiency of 15.23% and fill factor of 65.05%. We also investigate the origin of the improved photovoltaic performance of the solar cells in the BIPV modules. The surface modification of the front cover glass of the BIPV windows enhances the light absorption in the solar cells, which results in the improved photovoltaic performance degraded by a metal-oxide back coating. We believe that the proposed surface modification which induces light trapping and anti-reflection into the cover glass of the BIPV modules with a metal-oxide back coating film is a promising and practical solution for the successful integration of BIPV windows with high efficiency and invisibility.

Objectives The goal of this study was to evaluate whether the beneficial effect of use of intravascular ultrasound (IVUS) is sustained for long-term follow-up. Background The use of IVUS promoted favorable 1-year clinical outcome in the IVUS-XPL (Impact of Intravascular Ultrasound Guidance on the Outcomes of Xience Prime Stents in Long Lesions) trial. It is not known, however, whether this effect is sustained for long-term follow-up. Methods The IVUS-XPL trial randomized 1,400 patients with long coronary lesions (implanted stent length ≥28 mm) to receive IVUS-guided (n = 700) or angiography-guided (n = 700) everolimus-eluting stent implantation. Five-year clinical outcomes were investigated in patients who completed the original trial. The primary outcome was the composite of major adverse cardiac events, including cardiac death, target lesion–related myocardial infarction, or ischemia-driven target lesion revascularization at 5 years, analyzed by intention-to-treat. Results Five-year follow-up was completed in 1,183 patients (85%). Major adverse cardiac events at 5 years occurred in 36 patients (5.6%) receiving IVUS guidance and in 70 patients (10.7%) receiving angiographic guidance (hazard ratio: 0.50; 95% confidence interval: 0.34 to 0.75; p = 0.001). The difference was driven mainly by a lower risk for target lesion revascularization (31 [4.8%] vs. 55 [8.4%]; hazard ratio: 0.54; 95% confidence interval: 0.33 to 0.89; p = 0.007). By landmark analysis, major adverse cardiac events between 1 and 5 years occurred in 17 patients (2.8%) receiving IVUS guidance and in 31 patients (5.2%) receiving angiographic guidance (hazard ratio: 0.53; 95% confidence interval: 0.29 to 0.95; p = 0.031). Conclusions Compared with angiography-guided stent implantation, IVUS-guided stent implantation resulted in a significantly lower rate of major adverse cardiac events up to 5 years. Sustained 5-year clinical benefits resulted from both within 1 year and from 1 to 5 years post-implantation. (Impact of Intravascular Ultrasound Guidance on the Outcomes of Xience Prime Stents in Long Lesions [IVUS-XPL Study]: Retrospective and Prospective Follow-Up Study; NCT03866486)

Background and aims There are limited data comparing clinical outcomes among new-generation drug-eluting stents (DES) in ST-segment elevation myocardial infarction (STEMI) patients with multivessel coronary artery disease (MVD) who underwent primary percutaneous coronary intervention (PCI) with culprit-only or multivessel PCI. We investigated 1-year clinical outcomes between biodegradable-polymer (BP)-coated biolimus-eluting stent (BES) and durable-polymer (DP)-coated DES in STEMI patients with MVD who underwent two different reperfusion strategies. Methods A total of 4255 patients were enrolled and divided into two groups, a culprit-only (n = 2571, BP- [n = 264] or DP-DES [n = 2307]) or a multivessel PCI group (n = 1684, BP- [n = 145] or DP-DES [n = 1539]). The primary endpoint was major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction (re-MI), and total repeat revascularization. The secondary endpoint was the incidence of definite or probable stent thrombosis (ST). Results BP-BES and DP-DES showed a similar 1-year adjusted hazard ratio (HR) for MACE (culprit-only, adjusted hazard ratio [HR], 1.114; p = 0.740; multivessel, HR, 0.564; p = 0.167) and ST (culprit-only, HR, 1.110, p = 0.891; multivessel, HR, 0.375; p = 0.402). The adjusted HR for all-cause death, re-MI, and repeat revascularization were similar between the two groups. In the total population, the culprit-only PCI group showed a higher incidence of total repeat revascularization than the multivessel PCI group. Conclusions BP-BES and DP-DES showed comparable safety and efficacy in STEMI patients with MVD who underwent primary PCI with two different reperfusion strategies during a 1-year follow-up period.

Defects both microscale and nanoscale are play an important role in CdZnTe (CZT) device performance. Typical micro-scale defects such as Te inclusions were removed via a two-step annealing process, and their concentration was analyzed via IR transmission microscopy. In addition, transmission electron microscopy (TEM) measurement was employed to investigate the evolution of nano-scale defects after the annealing process. Dislocation and stacking faults were commonly observed defects in as-grown and annealed CZT. The line shape defects, which are possibly related to the stress field around dislocations, disappeared during the in-situ the annealing at 200–220 ° C. A Frisch-grid CZT detector made via the two-step annealing process exhibited improved energy resolution and low backscattering counts in Cs-137 gamma spectra.

We compared the clinical impact of renin-angiotensin system inhibitors (RASI) on long-term clinical outcomes between ST-segment elevation (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) after successful percutaneous coronary intervention (PCI) with drug eluting stents (DES) because of the paucity of published data.A total of 24,960 acute myocardial infarction (AMI) patients who underwent PCI with DES and were prescribed the RASI were enrolled and divided into two groups, the STEMI group (n = 14,061) and the NSTEMI group (n = 10,899). The clinical endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death, cardiac death (CD), recurrent myocardial infarction (re-MI), total coronary revascularization (target lesion revascularization [TLR], target vessel revascularization [TVR], non-TVR) during 2 years.After propensity score-matched (PSM) analysis, two PSM groups (6762 pairs, n = 13,524, C-statistic = 0.682) were generated. All-cause death (hazard ratio [HR], 1.386; 95% confidence interval [CI], 1.114-1.725; p = 0.003) and CD (HR, 1.358; 95% CI, 1.041-1.770; p = 0.024) rates were significantly higher in NSTEMI patients. However, the incidence of MACE, re-MI, total revascularization, TLR, TVR, non-TVR was not significantly different between the two groups. In addition, old age (≥65years), decreased left ventricular ejection fraction (50%), hypertension, creatine kinase isoenzyme level, cardiogenic shock, cardiopulmonary resuscitation on admission, and PCI within 24 h were common significant independent risk factors of all-cause death and CD.The mortality reduction capability of RASI was more prominent in the STEMI patients compared with the NSTEMI patients.

In this paper, we demonstrate highly conductive and stretchable fiber interconnections for electronic textiles (e-textiles) using dry-spun carbon nanotube (CNT) fibers modified with ionic liquid (IL)/poly (vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP) copolymer composite. By adopting direct infiltration of CNT fibers with a mixture of 1-butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide and PVDF-HFP, mechanical properties such as stretchability, maximum load and strain were significantly improved while minimizing the reduction in electrical conductivity. Such IL/PVDF modified CNT fibers (hybrid CNT fibers) exhibited electrical conductivity up to ∼1300 S/cm, with maximum load and strain values of 0.84 N and 35.7%, respectively. Using hybrid-CNT fibers, we demonstrated highly stretchable and electrically stable fiber interconnections for e-textiles by optimizing the interconnection pattern design. Particularly, by adopting a serpentine pattern, stretchability up to ∼70% and resistance variation of ∼2.7% at a tensile strain of 40% were achieved.

The data presented in this article are related to “Odd-even phonon transport effects in strained carbon atomic chains bridging graphene nanoribbon electrodes” (Kim et al., 2019). To provide the information that can be utilized in reproducing our results, we provide the fully optimized graphene nanoribbon (GNR)–carbon chain (CC)–GNR junction atomic configurations at different strain values, the computational setting for quantum phonon transport calculations, and several computational data that were not included in the main manuscript. Data on graphene–CC–graphene junctions are additionally presented.

Here, we report the persistent photoconductance (PPC) and transient photo-response characteristics of photochemically activated and thermally annealed indium‑gallium‑zinc-oxide (IGZO) thin-film transistors (TFTs). From various analyses on the time-variant photo-current change in IGZO TFTs, it was found that photochemically activated IGZO TFTs exhibited significantly weak PPC behavior and rapid photo-decaying characteristics compared to thermally annealed IGZO TFTs. It is claimed that such behaviors of photochemically activated IGZO TFTs are due to the low activation energy for the neutralization of ionized oxygen vacancies, which can be beneficial in achieving highly photo-stable electronic devices. Furthermore, we report the influence of pulsed gate bias on the photo-decaying characteristics of photochemically activated and thermally annealed IGZO TFTs.

Solution-processed oxide gate dielectrics play an important in thin-film transistors (TFTs), determining their operation voltage, device performance and power consumption. Up to now, various solution-processed oxide gate dielectrics such as aluminum oxide (Al2O3) have been surveyed, however, they generally exhibit relatively high leakage current, low dielectric constant, and hysteresis which are unfavorable for stable device operation. Here, we demonstrate solution-processed lanthanum (La)-doped Al2O3 (LAO) gate dielectrics which exhibit low leakage current density, high dielectric constant, and relatively small frequency-dependent capacitance variation. In order to find the optimal doping concentration of lanthanum in Al2O3 film, various electrical, morphological, and spectroscopic analyses were carried out. We found that the addition of lanthanum in Al2O3 film effectively reduced the defective metal hydroxide bonding states within the film and significantly enhanced its dielectric characteristics. At an optimal doping concentration of lanthanum (20 at.%), gate dielectrics showing leakage current density, dielectric constant, and breakdown field of ~10−8 A/cm2 (at 2 MV/cm), 10.5, and >5 MV/cm were obtained. Using the LAO film as a gate dielectric, solution-processed indium-zinc-oxide TFTs having a field-effect mobility of 11.9 cm2/V-s, subthreshold slope of 0.38 V/dec, and on/off ratio of 104–105 were demonstrated.

Resumen Introduccion y objetivos La vigente guia de practica clinica para el tratamiento de la hipercolesterolemia recomienda mantener la terapia intensiva con estatinas de los pacientes tratados con implante de stent farmacoactivo (SFA). Sin embargo, el tratamiento intensivo con estatinas, una vez estabilizado el paciente, con frecuencia no se lleva a cabo en la practica clinica tras la revascularizacion con SFA. Actualmente se desconoce el impacto de mantener esa terapia intensiva con estatinas en estos pacientes estables. Se estudia la reduccion de eventos adversos en pacientes clinicamente estables en monoterapia con acido acetilsalicilico tras el implante de un SFA segun la terapia de alta o baja intensidad con estatinas. Metodos Se aleatorizo a pacientes estables a los 12 meses del implante de un SFA y en monoterapia con acido acetilsalicilico a recibir terapia de alta intensidad con estatinas (atorvastatina 40 mg; n = 1.000) o terapia de baja intensidad (pravastatina 20 mg; n = 1.000). El objetivo primario fueron los eventos clinicos adversos a los 12 meses de seguimiento (objetivo compuesto de muerte, infarto de miocardio, revascularizacion, trombosis del stent, accidente cerebrovascular, insuficiencia renal, necesidad de intervencion arterial periferica y nuevo ingreso hospitalario por eventos cardiacos). Resultados El objetivo primario a los 12 meses de seguimiento se produjo en 25 pacientes (2,5%) en tratamiento de alta intensidad con estatinas y en 40 (4,1%) en tratamiento de baja intensidad (HR = 0,58; IC95%, 0,36-0,92; p = 0,018). Esta diferencia se debio principalmente a la menor incidencia de muerte cardiaca (0 frente al 0,4%; p = 0,025) y de infarto de miocardio no relacionado con el vaso diana (el 0,1 frente al 0,7%; p = 0,033) en el grupo de tratamiento de alta intensidad con estatinas. Conclusiones Entre los pacientes clinicamente estables en monoterapia con acido acetilsalicilico, el tratamiento de alta intensidad con estatinas redujo la incidencia de eventos comparado con el tratamiento de baja intensidad. Registro de ensayos clinicos: URL: http://www.clinicaltrials.gov . Identificador unico: NCT01557075 .

Long-term clinical outcome data according to severity of coronary artery spasm (CAS) as assessed by an intracoronary acetylcholine provocation test are limited in series of Asian patients.To investigate 5-year clinical outcomes in patients with CAS according to CAS severity.In total, 5873 consecutive patients with insignificant coronary artery disease (70% fixed stenosis) who underwent an acetylcholine provocation test were enrolled and divided into four groups according to CAS severity during the acetylcholine provocation test: negative, borderline positive, moderately positive and severely positive. CAS severity was assessed by quantitative coronary angiography. We investigated 5-year clinical outcomes according to CAS severity.Over a follow-up period of up to 5 years, before adjustment, the severely-positive CAS group showed a significantly higher incidence of major adverse cardiac events (MACE; composite of death, myocardial infarction and de novo revascularization) (hazard ratio [HR]: 1.834, 95% confidence interval [CI]: 1.047-3.211; P=0.033), total death (HR: 3.124, 95% CI: 1.047-9.322; P=0.041), myocardial infarction (HR: 3.190, 95% CI: 1.069-9.519; P=0.037) and recurrent angina (HR: 1.762, 95% CI: 1.363-2.278; P0.001) compared with the negative group. However, after adjustment for baseline confounders, only the incidence of recurrent angina (HR: 1.323, 95% CI: 1.014-1.726; P=0.039) was significantly higher in the severely-positive CAS group compared with the negative group.The severity of CAS in the positive group was not associated with an increased incidence of MACE after adjustment for covariates compared with the negative group, but the severely-positive CAS group was associated with a higher incidence of recurrent angina compared with the negative group.

Model predictions of oil transport and fate for the 2010 Deepwater Horizon oil spill (Gulf of Mexico) were compared to field observations and absolute and relative concentrations of oil compounds in samples from 900 to 1400 m depth11 km from the well. Chemical partitioning analyses using quantitative indices support a bimodal droplet size distribution model for oil released during subsea dispersant applications in June with 74% of the mass in1 mm droplets that surfaced near the spill site within a few hours, and 1-8% as0.13 mm microdroplets that remained below 900 m. Analyses focused on 900-1400 m depth11 km from the well indicate there was substantial biodegradation of dissolved components, some biodegradation in microdroplets, recirculation of weathered microdroplets into the wellhead area, and marine oil snow settling from above 900 m carrying more-weathered particulate oil into the deep plume.

Aim We compared the 2-year clinical outcomes between prediabetes and type 2 diabetes mellitus (T2DM) in patients with acute myocardial infarction (AMI) and chronic kidney disease (CKD) after the successful implantation of new-generation drug-eluting stents. Methods A total of 11,961 AMI patients were classified into group A (estimated glomerular filtration rate [eGFR] Results In group A, the MACE (p = 0.016 and p = 0.004, respectively) and all-cause death (p = 0.044, and p = 0.031, respectively) rates; in groups B, the MACE, all-cause death, and cardiac death rates, were significantly higher in the prediabetes and T2DM groups than in the normoglycemia group. The re-MI and any repeat revascularization rates were significantly higher in the T2DM group than in the normoglycemia group. The MACE, all-cause death, and cardiac death rates in group A were significantly higher than those in all three glycemic subgroups of group B. Both in group A and B, the major clinical outcomes were not significantly different between the prediabetes and T2DM groups. Conclusions AMI patients, both with prediabetes and T2DM, showed a higher mortality rate than those with normoglycemia regardless of the degree of eGFR.

We demonstrate a practical and robust encapsulation for environment-stable solar window modules based on multi-crystalline silicon solar cells with ultra-violet-curable optically clear resin (OCR) films. Compared to encapsulation with polyvinyl butyral (PVB) films, OCR films significantly improved the operational stability in solar window modules following a harsh damp heat test, at 85 °C of temperature and 85% of relative humidity for 1 k h. Such advance can be realized by suppressed chemical reactions with water molecules in OCR films. We further investigate the optical characteristics of PVB and OCR encapsulation films using ultraviolet/vis. spectrophotometer and Fourier-transform infrared spectroscopy measurements to support the claim. We believe that this is the first module-level demonstration (400 mm × 400 mm) of solar windows encapsulated with OCR films fabricated below 60 °C by using UV curing technology, which exhibit a power conversion efficiency of ∼10%, even after undergoing the damp heat tests.

In this paper, we investigated the strontium doping effects on the electrical and physical characteristics of solution-processed aluminum oxide dielectric layer and its application to low-voltage-operated indium-gallium-zinc-oxide (IGZO) thin-film transistors (TFTs). With an optimized doping concentration of strontium (5 at%) in aluminum oxide (Al 2 O 3 ), an oxide gate dielectric layer having a dielectric constant of ~7 and low leakage current characteristics (~4 × 10 −7 A/cm 2 at 3 MV/cm) could be achieved by a solution process, which are comparably better than those of pristine Al 2 O 3 film. The enhanced dielectric properties from strontium doping can be attributed to the change in the physical properties of Al 2 O 3 film incorporated with strontium, providing charge relaxation of defect states in Al 2 O 3 film. Also, since the strontium is highly reactive with oxygen, the strontium substitution through a doping leads to more strongly bound structure in an Al 2 O 3 film without considerable lattice distortion. Using the strontium-doped aluminum oxide film as a gate dielectric layer, having a thickness less than 10 nm, solution-processed IGZO TFTs operating at ≤ 1 V were demonstrated showing a field-effect mobility of 1.74 ± 1.10 cm 2 /V s and an on-current level of ~10 −5 A.

In this paper, we report high-mobility InO x /GaO x bilayer channel thin-film transistors (TFTs) fabricated using the persistent high-surface-energy characteristic of photochemically activated metal-oxide films. The photochemically-activated metal-oxide films exhibited persistent high surface-energy characteristics compared to a thermally annealed film, which enabled the facile vertical stacking of oxide films using a solution-based process. By using the photochemical activation process as an annealing method and by employing an InO x /GaO x bilayer channel structure, high-mobility oxide TFTs with saturation field-effect mobilities as high as 15.7 cm 2 /V-s were obtained with an average value of 11.2 ± 1.9 cm 2 /V-s. Various spectroscopic and surface analyses were performed to elucidate the persistent high surface-energy behavior and the dynamic changes in surface states.

Based on oil fate modeling of the Deepwater Horizon spill through August 2010, during June and July 2010, ~89% of the oil surfaced, ~5% entered (by dissolving or as microdroplets) the deep plume (900 m), and ~6% dissolved and biodegraded between 900 m and 40 m. Subsea dispersant application reduced surfacing oil by ~7% and evaporation of volatiles by ~26%. By July 2011, of the total oil, ~41% evaporated, ~15% was ashore and in nearshore (10 m) sediments, ~3% was removed by responders, ~38.4% was in the water column (partially degraded; 29% shallower and 9.4% deeper than 40 m), and ~2.6% sedimented in waters10 m (including 1.5% after August 2010). Volatile and soluble fractions that did not evaporate biodegraded by the end of August 2010, leaving residual oil to disperse and potentially settle. Model estimates were validated by comparison to field observations of floating oil and atmospheric emissions.

Recently, with the increased importance of low-power human-based wearable technology incorporating multiple sensory systems, room-temperature operating sensory devices are of significant interest. In this work, we demonstrate a versatile approach to realize room-temperature operable and fast recovery amorphous oxide semiconductor (AOS)-based gas sensors using multi-wavelength ultraviolet (UV) illumination. Particularly, illumination of UV light with different wavelengths enabled an amorphous indium-gallium-zinc oxide (a-IGZO) thin film transistor (FET)-based gas sensor to monitor the sensing behaviours of nitrogen dioxide (NO2) at various concentrations down to sub-ppm level. Our systematic investigation exhibited that time period taken for reacting and detaching the NO2 gas from the surface of AOS could be significantly controlled down to 32 s and several minutes, respectively, without any thermal energy. The key point of the variable properties of NO2 sensing performances in the a-IGZO FET is the generation of diverse electron-hole-pairs owing to the difference of the photonic energy applied to the sensor. Our work introduced in this research may provide a simple and efficient way for enhancing gas-sensing properties of AOS FET gas sensors by enabling programmable multi-spectral UV illumination approaches.

In this paper, we investigated the effects of crystalline structure of indium-gallium-zinc-oxide (IGZO) thin films on the electrical and photo-stability of metal-oxide thin-film transistors (TFTs). It was found that the TFTs with c-axis aligned crystalline (CAAC) IGZO channels exhibited enhanced stability under various combinations of electrical, temperature, and light-stressed conditions compared to those with amorphous (a) and nanocrystalline (nc) IGZO channels. From various electrical and spectroscopic studies, it is suggested that the low deep-level defects in CAAC-IGZO channels allowed high electrical performance and enhanced stability. Meanwhile, the a- and nc-IGZO TFTs showed relatively poor stability owing to the higher levels of deep-level defects in the channel layers. To explain the origin of the enhanced light-stability in CAAC-IGZO TFTs, we investigated the transient photo-response characteristics and it was found that the low activation energy for recombination and/or neutralization of photo-generated carriers was responsible for the enhanced stability.

In order to evaluate water quality and biological productivity, observation data sets were collected and analyzed in Yeongsan River Estuary, Korea. We also set up a numerical model to resolve hydrodynamics and fate of water quality variables in the system. Results show that most of nutrients loading are trapped in the lake and higher concentrations of nutrients and organic matters (OM) are present only inside of the artificial sea dike. There exist episodial discharges at the dam, which coincide mostly with rainfall events during summer monsoon periods. During this discharge event, lower salinity and higher suspended solids, nutrients, and OM are observed in surface layer of the estuarine section. Hydrodynamic model results show that circulation in the estuarine section is governed by freshwater discharge from the lake, resulting in an enhanced two-layer estuarine circulation being dominated, during and after the freshwater is discharged. Such two-layer estuarine circulation combined with higher concentration of nutrients in the surface layer results in that outfluxes of nutrients in the surface layer dominate over the influxes in the bottom layer during summer high precipitation periods. Meanwhile, numerical dye experiment results show that the discharged water with elevated nutrients levels have a short residence time (∼5-10 days) in the estuarine section. Due to this fast flushing rate, excessive nutrient loadings are not used to produce biological matters in the estuarine section. This limited biological productivity, characterized by seaward side of the artificial sea dike, makes Yeongsan estuarine system excluded from acting as an active carbon sink.

The Yellow Sea is a shallow marginal sea with a large tidal range. In this study, ten areas located along the western coast of the Korean Peninsula are investigated with respect to remotely sensed water quality indicators derived from NASA MODIS aboard of the satellite Aqua. We found that there was a strong seasonal trend with spatial heterogeneity. In specific, a strong six-month phase-lag was found between chlorophyll-a and total suspended solid owing to their inversed seasonality, which could be explained by different dynamics and environmental settings. Chlorophyll-a concentration seemed to be dominantly influenced by temperature, while total suspended solid was largely governed by local tidal forcing and bottom topography. This study demonstrated the potential and applicability of satellite products in coastal management, and highlighted find that remote-sensing would be a promising tool in resolving orthogonality of large spatio-temporal scale variabilities when combining with proper time series analyses.

Vehicular traffic congestion in a vehicle-to-vehicle (V2V) communication environment can lead to congestion effects for information flow propagation. Such congestion effects can impact whether a specific information packet of interest can reach a desired location, and if so, in a timely manner to influence the traffic system performance. Motivated by the usefulness and timeliness of information propagation, this paper aims to characterize the information flow propagation wave (IFPW) for an information packet in a congested V2V communication environment under an information relay control strategy. This strategy seeks to exclude information that is dated in the communication buffer under a first-in, first-out queue discipline, from being relayed if the information flow regime is congested. It trades off the need to enable the dissemination of every information packet as far as possible, against the congestion effects that accrue because of the presence of multiple information packets. A macroscopic two-layer model is proposed to characterize the IFPW. The upper layer is formulated as integro-differential equations to characterize the information dissemination in space and time under this control strategy. The lower layer adopts the Lighthill-Whitham-Richards model to capture the traffic flow dynamics. Based on the upper layer model, a necessary condition is derived which quantifies the expected time length that needs to be reserved for broadcasting the information packet of interest so as to ensure the formation of an IFPW under a given density of V2V-equipped vehicles. When the necessary condition is satisfied under homogeneous conditions, it is shown that the information packet can be propagated at an asymptotic speed whose value can be derived analytically. Besides, under the proposed control strategy, only a proportion of vehicles (labeled asymptotic density of informed vehicles) can receive the specific information packet, which can be estimated by solving a nonlinear equation. The asymptotic IFPW speed, the asymptotic density of informed vehicles, and the necessary condition for the IFPW, help in evaluating the timeliness of information propagation and the influence of traffic dynamics on information propagation. In addition, the proposed model can be used to numerically estimate the IFPW speed for heterogeneous conditions, which can aid in the design of traffic management strategies built upon the timely propagation of information through V2V communication.

Nuclear mRNA export is highly regulated to ensure accurate cellular gene expression. Viral inhibition of cellular mRNA export can enhance viral access to the cellular translation machinery and prevent anti-viral protein production but is generally thought to be nonselective. We report that ORF10 of Kaposi's sarcoma associated herpesvirus (KSHV), a nuclear DNA virus, inhibits mRNA export in a transcript-selective manner to control cellular gene expression. Nuclear export inhibition by ORF10 requires an interaction with an RNA export factor, Rae1. Genome-wide analysis reveals a subset of cellular mRNAs whose nuclear export is blocked by ORF10 with the 3' untranslated regions (3' UTRs) of ORF10-targeted transcripts conferring sensitivity to export inhibition. The Rae1-ORF10 interaction is important for the virus to express viral genes and produce infectious virions. These results suggest that a nuclear DNA virus can selectively interfere with RNA export to restrict host gene expression for optimal replication.

Optoelectronic neuromorphic systems mimicking the structure and the signal processing of biological neural systems have gained significant interest due to their potential advantages such as high computing speed, high bandwidth, parallel processing, and low power requirements. Here, we demonstrate an optoelectronic synapse array consisting of solution-processed indium-gallium-zinc-oxide (IGZO) synapse devices emulating complex neural functions such as the spatiotemporal synaptic integration for neuromorphic implementation. Particularly, we adopted a vertically stacked metal-insulator-semiconductor-metal structure for IGZO synapse device to enable efficient light-induced conductance update and a low-voltage operation typically below 3 V. Using light as the stimulation, versatile synaptic functions including short-term memory/long-term memory, symmetric spike-timing dependent plasticity, and spike-number dependent plasticity were mimicked. In addition, we obtained a high recognition accuracy of handwritten digit images up to 89.4% by implementing ADAM training algorithm. Furthermore, using a crossbar structure 3 × 3 IGZO synapse array, the emulation of spatiotemporal summation was successfully carried out which is believed to be responsible for the neural encoding and the auditory recognition processes occur in the brain.

Transition metal compounds are known to be tricky for ab initio calculations mainly because of the strongly localized nature of transition metal d electrons. Nonetheless, the bulk of current theoretical studies of MXenes (transition metal carbide or nitride) relies on the density functional theory using a semilocal PBE functional, whose notorious self-interaction error grossly misrepresents electronic and magnetic properties of many well-known transition metal compounds. Although several studies have adopted Hubbard-U corrections to MXenes, the lack of systematic guidelines on how to determine the U parameters has led to a cornucopia of different results. To shed some light on the reliability of different methods (different functionals or different U parameters), we performed ab initio calculations for 22 carbide MXenes (M2CT2 with M= Sc, Y, La, Ti, Zr, Hf, V, Nb, Ta, Mo, W, and T= O, F) using density functional theory and four different methods: PBE, SCAN, HSE06, and PBE+U. In addition to trivial improvement of electronic structures of MXenes by SCAN, HSE06, and PBE+U, we found new ground-state structures for two MXenes (Hf2CF2 and Ta2CF2) and magnetic states for three MXenes (V2CO2, V2CF2, and Mo2CF2), which have not previously been reported. In addition, we found that SCAN, HSE06, and PBE+U dramatically improve the dynamical stability of V2CO2 and Mo2CF2 compared with PBE. This paper offers an overview of a broad range of MXenes with a systematic verification of various methods.

Recently, textile-based pressure sensors have gained considerable interest in the field of wearable electronics due to their wide range of applicability and good scalability. Despite recent progress, however, urgent challenges remain to develop a fully integrated textile sensor array with highly sensitive multi-sensing capability and low-power consumption. Here, we demonstrate a highly-sensitive capacitive ionotronic (CIT) pressure sensor array using high-k ion-gel (IG) film for implementation of textile-based electronic systems. With a composition and thickness optimized IG film, CIT pressure sensors with high sensitivity up to 308 nF kPa−1 and relatively good stability was successfully obtained. In addition, based on mechanical simulations using finite element method, it was found that the pressure-dependent contact-area variation between multifilament fiber electrodes and the IG film played the dominant role in capacitance change rather than the thickness change of the IG film. Furthermore, a 3 × 3 CIT pressure sensor system is implemented on a large-area textile substance with multi-point detection capability, demonstrating a textile-based pressure monitoring system integrated with a pressure variable multi-color light emitting diode array.

Recently, one of the blades of an impeller installed in the water-jet propulsion shaft of a particular naval vessel was fractured. Macro and microscopic investigation of the fracture surface indicated that the fracture was caused by mechanical fatigue. Therefore, root cause analysis is performed related to the vibration fatigue. Measurement of the accelerations on the thrust bearing housing showed that very high vibration occurred at the high-speed range over 600 rpm, and that the frequency of vibration did not vary according to the variation in rpm. Since dynamic thrust load is applied on the impeller blade, it can be assumed that the dynamic thrust load is represented as a nonlinear function of the ship speed and the rotation speed of the impeller. When the equation of motion of the shaft is derived with this assumption, it can be known that the shaft system can be unstable at certain condition where the self-exciting vibration occurs. In this research, numerical analysis and experiments are conducted to verify the assumption that the root cause of the impeller’s fracture is self-exciting vibration from the increasing flow-induced thrust load of the impeller.

Low-temperature-processable gate dielectrics with high dielectric constants, low leakage current, and good electrical/mechanical stabilities are largely pursued in diverse electronics including flexible transistors, wearable sensors, integrated logic circuits, and various optoelectronic devices. Here, we report low-temperature photochemically activated gate dielectrics based on a lanthanum oxide-aluminum oxide (La2O3–Al2O3 or LAO) alloy system for a utilization in flexible metal-oxide thin-film transistors (TFTs). With proper alloying of La2O3 and Al2O3 at an optimal ratio, synergetic effects could be achieved from both gate dielectric materials, high dielectric constant and excellent insulating properties. With a La:Al ratio of 2:8, LAO gate dielectrics with high dielectric constant (k = 10.72), low surface roughness (0.517 nm), low leakage current density (1.7 × 10−10 A cm−2 @2 MV cm−1), and high breakdown field (∼4.8 MV cm−1) were achieved. By utilizing the photo-annealed LAO as a gate dielectric, low operating voltage (≤5 V) solution-processed indium-gallium-zinc-oxide (IGZO) TFTs having saturation mobility of 8.5 ± 3.25 cm2 V−1s−1, linear mobility of 10.8 ± 2.03 cm2 V−1s−1, subthreshold slope of 0.228 V dec−1, and on/off ratio of ∼105 are demonstrated. Furthermore, the fabricated IGZO TFTs exhibited negligible hysteresis characteristics (

Objectives The aim of this study was to investigate whether a 6-month dual-antiplatelet therapy (DAPT) duration was comparable with a 12-month duration in patients who underwent everolimus-eluting stent implantation. Background Well-designed studies that determine optimal DAPT strategies after everolimus-eluting stent implantation are limited. Methods A total of 1,400 patients (implanted mean total stent length >45 mm) were randomly assigned to receive 6-month (n = 699) or 12-month (n = 701) DAPT between October 2010 and July 2014 at 20 centers in Korea. The primary endpoint was the composite of cardiac death, myocardial infarction, stroke, or TIMI (Thrombolysis in Myocardial Infarction) major bleeding at 1 year, analyzed using an intention-to-treat approach. Results The primary endpoint occurred in 15 patients (2.2%) in the 6-month DAPT group and 14 patients (2.1%) in the 12-month DAPT group (hazard ratio [HR]: 1.07; p = 0.854). Definite or probable stent thrombosis occurred in 2 patients (0.3%) in the 6-month DAPT group and in 2 patients (0.3%) in the 12-month DAPT group (HR: 1.00; p = 0.999). There were no significant between-group differences in the primary endpoint in 686 patients with acute coronary syndrome (2.4% in both groups; HR: 1.00; p = 0.994) and in 506 patients with diabetes mellitus (2.2% [6-month] vs. 3.3% [12-month]; HR: 0.64; p = 0.428). Conclusions Compared with 12-month DAPT, 6-month DAPT did not increase the composite events of cardiac death, myocardial infarction, stroke, or TIMI major bleeding at 1 year in patients who underwent everolimus-eluting stent implantation. (Impact of Intravascular Ultrasound Guidance on Outcomes of XIENCE PRIME Stents in Long Lesions [IVUS-XPL Study]; NCT01308281)