Temporal trends in use of antisecretory agents among patients administered clopidogrel-based dual antiplatelet therapy after percutaneous coronary intervention.

BACKGROUND: Antisecretory drugs are commonly prescribed with clopidogrel-based dual antiplatelet therapy (DAPT) to prevent gastrointestinal bleeding in high-risk patients after percutaneous coronary intervention (PCI). However, omeprazole and esomeprazole (inhibiting proton pump inhibitors [PPIs]) may increase cardiovascular event rates on co-administration with clopidogrel. This study aimed to examine trends in the use of antisecretory agents in patients administered clopidogrel-based DAPT and the concomitant use of clopidogrel and inhibiting PPIs. METHODS: We used National Inpatient Sample data compiled by the Health Insurance Review & Assessment Service from 2009 to 2020. Further, we identified patients who were prescribed clopidogrel-based DAPT after PCI and investigated the concomitant use of antisecretory agents with clopidogrel. To verify the annual trend of drug utilization, we used the Cochran-Armitage trend test. RESULTS: From 2009 to 2020, the percentage of H2 receptor antagonist users decreased steadily (from 82.5% in 2009 to 25.3% in 2020); instead, the percentage of PPI users increased (from 23.7% in 2009 to 82.0% in 2020). The use of inhibiting PPI also increased (from 4.2% in 2009 to 30.7% in 2020). Potassium competitive acid blockers (P-CABs) were rarely used before 2019; however, in 2020, it accounted for 7.8% of the antisecretory users. CONCLUSIONS: Our study demonstrates that the use of inhibiting PPIs increased steadily in patients administered clopidogrel-based DAPT therapy. This is a major concern since the concomitant use of inhibiting PPIs with clopidogrel could increase the risk of cardiovascular events.

Dopant Evolution in Electrocatalysts after Hydrogen Oxidation Reaction in an Alkaline Environment.

Introduction of interstitial dopants has opened a new pathway to optimize nanoparticle catalytic activity for, e.g., hydrogen evolution/oxidation and other reactions. Here, we discuss the stability of a property-enhancing dopant, B, introduced through the controlled synthesis of an electrocatalyst Pd aerogel. We observe significant removal of B after the hydrogen oxidation reaction. Ab initio calculations show that the high stability of subsurface B in Pd is substantially reduced when H is adsorbed/absorbed on the surface, favoring its departure from the host nanostructure. The destabilization of subsurface B is more pronounced, as more H occupies surface sites and empty interstitial sites. We hence demonstrate that the H2 fuel itself favors the microstructural degradation of the electrocatalyst and an associated drop in activity.

Biocompatibility and mineralization potential of new calcium silicate cements.

Background/purpose: As calcium silicate cements (CSCs) have been successfully used in various types of vital pulp therapy, many new CSC products have been developed. The aim of this study was to evaluate the biocompatibilities and mineralization potential of new CSC. The experimental materials were NeoMTA Plus and EndoSequence Root Repair Material-Fast Set Putty (ERRM-FS) which were compared to ProRoot MTA. Materials and methods: In vitro, the effects of the new CSC on stem cells were evaluated. Each CSC was prepared for cell viability testing, alkaline phosphatase (ALP) assay, and calcium ion release assay. In vivo, the exposed pulp model was used for the partial pulpotomy procedure. Thirty-six teeth were treated with three materials: ProRoot MTA, NeoMTA Plus, or ERRM-FS. After four weeks, the teeth were extracted and processed for histologic analysis. Dentin bridge formation, pulp inflammation, and odontoblastic cell layer were evaluated and the area of newly formed calcific barrier of each group was measured. Results: Three CSCs demonstrated similar cell viability on stem cells and the levels of ALP and calcium release were not significantly different between tested materials. ProRoot MTA and ERRM-FS showed better tissue healing process than NeoMTA Plus after partial pulpotomy, in terms of quality of calcific barrier and pulp inflammation. The outcomes from measuring newly formed calcific area demonstrated no significant differences between the materials. Conclusion: NeoMTA Plus and ERRM-FS displayed similar biocompatibilities and mineralization potential compared to ProRoot MTA. Therefore, these new CSCs can be used as desirable alternatives to ProRoot MTA.

Utilization of triple antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention.

BACKGROUND: Triple antithrombotic therapy (TAT), a combination of an oral anticoagulant and dual antiplatelet therapy (DAPT), is a key treatment for prevention of ischemic events in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). However, TAT is not extensively used because of the risk of bleeding. This study aimed to determine the utilization and influencing factors of TAT using real-world data in the non-vitamin K antagonist oral anticoagulants (NOACs) era. METHODS: We analyzed National Inpatient Sample data compiled by the Health Insurance Review & Assessment Service (HIRA-NIS) from 2011 to 2020. Patients with AF who underwent PCI with stent implantation and with an increased stroke risk were selected as candidates for TAT therapy. Demographic and clinical factors associated with TAT use were investigated using the chi-squared test and the Student t-test, and influencing factors were identified using multiple logistic regression. RESULTS: The TAT utilization rate steadily increased from 30.3% in 2011 to 65.4% in 2020 (Cochran-Armitage trend test: p < 0.001) with an average of 45.9%. Positive influencing factors for TAT use were identified as congestive heart failure, history of previous stroke/transient ischemic attack/thromboembolism, valvular heart disease, and year. Negative influencing factors included insurance type (medical aid or Patriots & Veterans Insurance), type of medical institution (general hospitals or primary medical institutions), and comorbidities such as renal disease, liver disease, and history of the previous hemorrhage. CONCLUSIONS: The utilization of TAT following PCI among high-stroke risk AF patients steadily increased from 2011 to 2020, reaching 65.4% by the end of the study period. However, in 2020, a significant proportion of 29.4% of patients still received DAPT, indicating that many AF patients undergoing PCI did not receive adequate antithrombotic therapy.

Leaf Mustard (Brassica juncea) Germplasm Resources Showed Diverse Characteristics in Agro-Morphological Traits and Glucosinolate Levels.

Leaf mustard, characterized by its purple/red/green leaves with a green/white midrib, is known for its thick, tender, and spicy leaves with a unique taste and flavor. There were only a few studies reported on leaf mustard for its morphological and biochemical traits from Korea. A total of 355 leaf mustard accessions stored at the GenBank of the National Agrobiodiversity Center were evaluated for 25 agro-morphological traits and seven intact glucosinolates (GSLs). The accessions showed a wide variation in terms of most of the traits. The quantitative agro-morphological traits varied from 16.0 (leaf length) to 48.7% (petiole width) of the coefficient of variation (CV). The highest variation was observed in glucoiberin (299.5%, CV), while the total GSL showed a CV of 66.1%. Sinigrin, followed by gluconapin and gluconasturtiin, was the most abundant GSL, accounting for as high as 75% of the total GSLs, while glucobrassicanapin and glucoiberin were the least abundant, contributing 0.7% and 0.1% on average, respectively. Sinigrin had a positive significant correlation with all GSLs but gluconasturtiin, while glucobarbarin and gluconasturtiin were highly positively correlated to each other, but least correlated with other GSLs. The leaf length was negatively correlated with sinigrin and glucoiberin. The width of the petiole showed a positive correlation with gluconapin, glucobrassicanapin, and glucobrassicin, while the length of the petiole had a negative correlation with sinigrin, glucobrassicanapin, glucoiberin, glucobrassicin, and the total GSLs. A higher width of the midrib was associated with higher contents of gluconapin, glucobrassicanapin, and glucobrassicin. A PCA analysis based on the agro-morphological traits showed that the first and second principal components accounted for 65.2% of the overall variability. Accessions that form a head tend to exhibit a longer leaf length, a larger plant weight, a thicker midrib, and higher widths of the midrib, petiole, and leaf. The GSLs showed inconsistent inter-and intra-leaf variation. Accessions that identified for various traits in their performance, such as, for example, Yeosu66 and IT259487 (highest total glucosinolates) and IT228984 (highest plant weight), would be promising lines for developing new varieties.

Epitaxial Core-Shell Oxide Nanoparticles: First-Principles Evidence for Increased Activity and Stability of Rutile Catalysts for Acidic Oxygen Evolution.

Due to their high activity and favorable stability in acidic electrolytes, Ir and Ru oxides are primary catalysts for the oxygen evolution reaction (OER) in proton-exchange membrane (PEM) electrolyzers. For a future large-scale application, core-shell nanoparticles are an appealing route to minimize the demand for these precious oxides. Here, we employ first-principles density-functional theory (DFT) and ab initio thermodynamics to assess the feasibility of encapsulating a cheap rutile-structured TiO2 core with coherent, monolayer-thin IrO2 or RuO2 films. Resulting from a strong directional dependence of adhesion and strain, a wetting tendency is only obtained for some low-index facets under typical gas-phase synthesis conditions. Thermodynamic stability in particular of lattice-matched RuO2 films is instead indicated for more oxidizing conditions. Intriguingly, the calculations also predict an enhanced activity and stability of such epitaxial RuO2 /TiO2 core-shell particles under OER operation.

Distinctive cytokine profiles of stem cells from human exfoliated deciduous teeth and dental pulp stem cells.

BACKGROUND/PURPOSE: SHED and DPSC have stem cell regenerative potential, but comparative research on their cytokine profile is rare. This study aimed to investigate and compare cytokine profiles secreted from stem cells from human exfoliated deciduous teeth (SHED) and dental pulp stem cells (DPSCs). MATERIALS AND METHODS: SHED-conditioned medium (CM) and DPSC-CM were extracted using seven primary and permanent teeth each. Cytokine membrane array was performed for each CM to quantify and compare the secretomes of 120 cytokines. Enzyme-linked immunosorbent assay, immunocytochemistry, and immunohistochemistry analysis were performed to demonstrate cytokine membrane array analysis. RESULTS: Significant differences were observed in the expression levels of 68 cytokines-27 and 41 cytokines were 1.3-fold more strongly expressed in SHED-CM and DPSC-CM, respectively. Cytokines involved in immunomodulation, odontogenesis and osteogenesis were more strongly expressed in SHED-CM. Cytokines involved in angiogenesis were detected more strongly in DPSCs-CM. SHED and DPSCs have distinctive cytokine profiles and characteristics in terms of their stem cell regenerative potential. CONCLUSION: These observations suggest that SHED may have a better cytokine profile related to inflammatory, proliferative, osteogenic, and odontogenic potential.

Data-efficient iterative training of Gaussian approximation potentials: Application to surface structure determination of rutile IrO2 and RuO2.

Machine-learning interatomic potentials, such as Gaussian Approximation Potentials (GAPs), constitute a powerful class of surrogate models to computationally involved first-principles calculations. At a similar predictive quality but significantly reduced cost, they could leverage otherwise barely tractable extensive sampling as in global surface structure determination (SSD). This efficiency is jeopardized though, if an a priori unknown structural and chemical search space as in SSD requires an excessive number of first-principles data for the GAP training. To this end, we present a general and data-efficient iterative training protocol that blends the creation of new training data with the actual surface exploration process. Demonstrating this protocol with the SSD of low-index facets of rutile IrO2 and RuO2, the involved simulated annealing on the basis of the refining GAP identifies a number of unknown terminations even in the restricted sub-space of (1 × 1) surface unit cells. Particularly in an O-poor environment, some of these, then metal-rich terminations, are thermodynamically most stable and are reminiscent of complexions as discussed for complex ceramic materials.

IrO_{2} Surface Complexions Identified through Machine Learning and Surface Investigations.

A Gaussian approximation potential was trained using density-functional theory data to enable a global geometry optimization of low-index rutile IrO_{2} facets through simulated annealing. Ab initio thermodynamics identifies (101) and (111) (1×1) terminations competitive with (110) in reducing environments. Experiments on single crystals find that (101) facets dominate and exhibit the theoretically predicted (1×1) periodicity and x-ray photoelectron spectroscopy core-level shifts. The obtained structures are analogous to the complexions discussed in the context of ceramic battery materials.

In search of non-conventional surface oxidic motifs of Cu on Au(111).

Growing ultrathin oxide layers on metal surfaces presents a new class of low-dimensional nanomaterials with exceptional chemical and physical properties. These "new oxides" can be used in many niche technologies and applications such as nanoscale electronics and heterogeneous nanocatalysis. In this work, we study the formation of surface oxidic structures and motifs of Cu, supported on the Au(111) substrate, using first-principles density-functional theory calculations in conjunction with an ab initio atomistic thermodynamics model. In particular, we systematically examine and analyze the detailed atomic structure and surface energetics of various oxidic motifs of Cu on Au(111), in particular, p2, p2s, p2(6q6) and the newly suggested metastable p2(6q6) + O3, in comparison to both the binary O/Cu(111) and O/Au(111) systems. Depending on the oxygen atmosphere and the type of surface defects introduced in the oxidic layer, various non-conventional, non-hexagonal surface oxidic motifs of Cu could be obtained. Our theoretical results agree with recent scanning tunneling microscopy (STM) experiments and we propose that metastable non-hexagonal surface motifs may pave a way to pursue further studies of these interesting complex surface oxidic layers on various metal supports.

Characteristics of SiO2/Si3N4/SiO2 stacked-gate dielectrics obtained via atomic-layer deposition.

An interpoly-stacked dielectric film with a SiO2/Si3N4/SiO2/Si (ONO) structure was prepared via the atomic-layer deposition method. The multilayer structure of the ONO film with triple interfaces was investigated via medium-energy ion scattering (MEIS). A few defects in the interface layer of the ONO structure were detected. From the X-ray photoelectron spectroscopy (XPS) results, it was presumed that the interface layer with defects in the MEIS result is due to the formation of an oxynitride layer on the unstable and rougher Si3N4 layer via. By measuring the I-V characteristics, the leakage current density and breakdown field of the ONO film were determined to be 3.4 x 10(-9) A/cm2 and 10.86 MV/cm, respectively. By estimation the C-V curve, the flat band (V(FB)) of the ONO film shifted to a negative voltage (-1.14 V), the dielectric constant (K(ONO)) of the ONO film was 5.79, and the effective interface-trapped charge density of the ONO film was about 4.96 x 10(11)/cm2.

Toxic tetrapyrrole accumulation in protoporphyrinogen IX oxidase-overexpressing transgenic rice plants.

We generated transgenic rice plants (Oryza sativa cv. Dongjin) over-expressing human protoporphyrinogen IX oxidase (PPO) with the aim to increase mitochondrial PPO activity and confer herbicide resistance (Lee et al., Pestic Biochem Physiol 80:65-74, 2004). The transgenic plants showed during further leaf development the formation of severe necrotic spots and growth retardation. Several experiments were performed to examine the reasons for the formation of necrotic leaf lesions. Human PPO is normally located in mitochondria. An in vitro organellar import experiment revealed translocation of human PPO into pea chloroplasts, but not into mitochondria. Using a specific antibody raised against human PPO confirmed its plastidic localisation. The heme and chlorophyll contents were lower in necrotic leaves than wild-type leaves. Interestingly, mature and necrotic leaves of 12-week-old transgenic plants contained up to 14- and 24-fold more protoporphyrin IX, respectively, than mature wild-type leaves. Enhanced levels of Mg-Protoporphyrin IX, Mg-Protoporphyrin IX monomethyl ester and protochlorophyllide were concurrently observed in transgenic plants relative to wild type. Accumulated porphyrins and Mg-porphyrins likely act as photosensitizers and cause high formation of the reactive oxygen species. These high levels of tetrapyrrole intermediates correlated with increased rates of 5-aminolevulinic acid synthesis in transgenic plants. Tetrapyrrole-induced photooxidation was confirmed by increased lipid peroxidation and subsequent cell death. The transgenic phenotype is the consequence of a highly modified tetrapyrrole metabolism due to additional expression of human PPO. A possible regulatory role of PPO in graminaceous seedlings is discussed.