Bilateral versus Single Internal-Thoracic-Artery Grafts at 10 Years.

BACKGROUND: Multiple arterial grafts may result in longer survival than single arterial grafts after coronary-artery bypass grafting (CABG) surgery. We evaluated the use of bilateral internal-thoracic-artery grafts for CABG. METHODS: We randomly assigned patients scheduled for CABG to undergo bilateral or single internal-thoracic-artery grafting. Additional arterial or vein grafts were used as indicated. The primary outcome was death from any cause at 10 years. The composite of death from any cause, myocardial infarction, or stroke was a secondary outcome. RESULTS: A total of 1548 patients were randomly assigned to undergo bilateral internal-thoracic-artery grafting (the bilateral-graft group) and 1554 to undergo single internal-thoracic-artery grafting (the single-graft group). In the bilateral-graft group, 13.9% of the patients received only a single internal-thoracic-artery graft, and in the single-graft group, 21.8% of the patients also received a radial-artery graft. Vital status was not known for 2.3% of the patients at 10 years. In the intention-to-treat analysis at 10 years, there were 315 deaths (20.3% of the patients) in the bilateral-graft group and 329 deaths (21.2%) in the single-graft group (hazard ratio, 0.96; 95% confidence interval [CI], 0.82 to 1.12; P=0.62). Regarding the composite outcome of death, myocardial infarction, or stroke, there were 385 patients (24.9%) with an event in the bilateral-graft group and 425 patients (27.3%) with an event in the single-graft group (hazard ratio, 0.90; 95% CI, 0.79 to 1.03). CONCLUSIONS: Among patients who were scheduled for CABG and had been randomly assigned to undergo bilateral or single internal-thoracic-artery grafting, there was no significant between-group difference in the rate of death from any cause at 10 years in the intention-to-treat analysis. Further studies are needed to determine whether multiple arterial grafts provide better outcomes than a single internal-thoracic-artery graft. (Funded by the British Heath Foundation and others; Current Controlled Trials number, ISRCTN46552265 .).

A sutureless valve with sutures.

The use of sutureless valves in infective endocarditis has been previously reported. Singh et al. have reported a single-center successful surgical treated pulmonary endocarditis in two cases with a sutureless bioprosthesis.

Square-wave adsorptive anodic stripping voltammetric determination of norfloxacin using a glassy carbon electrode modified with carbon black and CdTe quantum dots in a chitosan film.

A glassy carbon electrode was modified with carbon black and CdTe quantum dots in a chitosan film to obtained a sensor for norfloxacin (NOR) in the presence of dopamine, caffeine, and uric acid. The morphological, structural and electrochemical characteristics of the nanostructured material were evaluated using spectrophotometry, X-ray diffraction, transmission electronic microscopy and voltammetry. The high electrochemical activity, fast electron transfer rate and high surface area enhanced the oxidation peak currents and shifted the peak potentials of NOR for more negative values (typically at 0.95 V vs. Ag/AgCl). Electrochemical determination of NOR was carried out using square-wave adsorptive anodic stripping voltammetry (SWAdASV). Response is linear in the 0.2 to 7.4 µmol L-1 NOR concentration range, and the detection limit is as low as 6.6 nmol L-1. The method was successfully applied to the determination of norfloxacin in pharmaceutical formulation, synthetic urine and spiked serum. Graphical abstract Schematic presentation of a voltammetric method using a glassy carbon electrode modified with carbon black and CdTe quantum dots in a chitosan film for the determination of norfloxacin in serum and urine samples.

Thermal and shape topological robustness of heat switchers using nematic liquid crystals.

One interesting way to control heat is to use devices designed by transformation thermics, where artificial media are used. However, once manufactured (either repelling or concentrating heat, for example), besides being mono-purpose, such devices are designed according to a specific geometric boundary conditions. Another problem is the temperature dependence of the materials employed, since their properties are sometimes considered temperature-invariant. In this paper, we show that a previously proposed bi-objective heat switcher (Phys. Rev. E 89, 020501(R) (2014)) is in fact robust against temperature and geometric deformations, due to the topological properties of the molecular nematic orientation. Using a geometrical approach for heat propagation, by performing finite element simulations, we show that a device made by concentric cylinders with thermotropic nematic liquid crystal between them, sustains its functionality even with their molecular thermal conductivities depending on the temperature, achieving a 60% increase and a 44% decrease in the heat flux for each mode. Utilizing topological arguments we show that deformations on the surface of the outer cylinder do not break the operating mode (repeller or concentrator). We present a comparison between our geometrical approach and the transformation thermodynamics to give an additional explanation for the obtained results. We hope the presented device is useful for heat control under mechanical and thermal influence of the external environment.

Bromopyrrole Alkaloid Inhibitors of the Proteasome Isolated from a Dictyonella sp. Marine Sponge Collected at the Amazon River Mouth.

The new pyrrole-imidazole and pyrrole-guanidine alkaloids 4-debromooroidin (1), 4-debromougibohlin (2), 5-debromougibohlin (3), and 5-bromopalau'amine (4), along with the known hymenidin (5) and (+)-monobromoisophakellin (6), have been isolated from a Dictyonella sp. marine sponge, collected at the Amazon River mouth. The bromine-substitution pattern observed for compounds 1, 2 and 4 is unusual among bromopyrrole alkaloids isolated from marine sponges. The 20S proteasome inhibitory activities of compounds 1-6 have been recorded, with 5-bromopalau'amine (4) being the most active in this series.

Functionalized pink Al2O3:Mn pigments applied in prosthetic dentistry.

STATEMENT OF PROBLEM: The color of dental poly(methyl methacrylate) (PMMA) is conventionally rendered by organic and inorganic pigments, which are usually not bonded to the polymer network. Functionalized ceramic pigments can be used to color PMMA, allowing improved chemical interaction with the resin matrix. PURPOSE: The purpose of this in vitro study was to synthesize, functionalize, and characterize pink manganese-doped alumina ceramic pigments. The hypothesis tested was that functionalized ceramic pigments would render pink coloration to a translucent PMMA without jeopardizing its mechanical properties. MATERIAL AND METHODS: Pink alumina powders doped with 1 or 2 mol% of manganese (Al2O3:Mn) were prepared by means of a polymeric precursor method. Pigment (Pig.) particles were functionalized with a silica coating method followed by silanation before preparation of PMMA-based composite resins (5 wt% pigment). The color of composite resins (Pig.1% and Pig.2%) and PMMA controls (Pink and translucent [Trans]) was evaluated (CIELab color coordinates), and their mechanical properties were tested (3-point bending). RESULTS: The microstructure of the pigment particles showed approximately 55-nm nanocrystals of manganese-doped α-alumina clustered into irregular porous particles up to 60 µm. The composite resins and pink PMMA showed similar color parameters (CIE a* pink=20.1, Pig.1%=14.6, Pig.2%=16.0, Trans=0.19, P<.001; CIE b* Pink=17.0, Pig.1%=18.6, Pig.2%=19.0, Trans=2.52, P<.001). No statistical differences were observed in mechanical properties among groups (σf pink=98.4, Pig.1%=98.1, Pig.2%=98.8, trans=89.1, P=.136). CONCLUSIONS: The addition of the functionalized pink ceramic pigments to a translucent PMMA yielded similar coloration to that of the regular pink PMMA used in dentistry and did not jeopardize its mechanical properties.

Geometric effects in the electronic transport of deformed nanotubes.

Quasi-two-dimensional systems may exibit curvature, which adds three-dimensional influence to their internal properties. As shown by da Costa (1981 Phys. Rev. A 23 1982-7), charged particles moving on a curved surface experience a curvature-dependent potential which greatly influence their dynamics. In this paper, we study the electronic ballistic transport in deformed nanotubes. The one-electron Schrödinger equation with open boundary conditions is solved numerically with a flexible MAPLE code made available as supplementary data. We find that the curvature of the deformations indeed has strong effects on the electron dynamics, suggesting its use in the design of nanotube-based electronic devices.

Retrieving the saddle-splay elastic constant K24 of nematic liquid crystals from an algebraic approach.

The physics of light interference experiments is well established for nematic liquid crystals. Using well-known techniques, it is possible to obtain important quantities, such as the differential scattering cross section and the saddl-splay elastic constant K24. However, the usual methods to retrieve the latter involve adjusting of computational parameters through visual comparisons between the experimental light interference pattern or a (2) H-NMR spectral pattern produced by an escaped-radial disclination, and their computational simulation counterparts. To avoid such comparisons, we develop an algebraic method for obtaining of saddle-splay elastic constant K24. Considering an escaped-radial disclination inside a capillary tube with radius R0 of tens of micrometers, we use a metric approach to study the propagation of the light (in the scalar wave approximation), near the surface of the tube and to determine the light interference pattern due to the defect. The latter is responsible for the existence of a well-defined interference peak associated to a unique angle [Formula: see text] . Since this angle depends on factors such as refractive indexes, curvature elastic constants, anchoring regime, surface anchoring strength and radius R0, the measurement of [Formula: see text] from the interference experiments involving two different radii allows us to algebraically retrieve K24. Our method allowed us to give the first reported estimation of K24 for the lyotropic chromonic liquid crystal Sunset Yellow FCF: K 24 = 2.1 pN.

Graphene nanosheets and quantum dots: a smart material for electrochemical applications.

A novel material for the electrochemical determination of endocrine disruptors using a composite based on graphene oxide modified with cadmium telluride quantum dots has been evaluated. The morphology, structure and electrochemical performance of the composite electrodes were characterised by transmission electron microscopy, dynamic light scattering, UV-visible absorption spectra, fluorescence spectra, Raman spectra and cyclic voltammetry. The dynamic light scattering, transmission electronic microscopy and spectrophotometric measurements all showed good distribution of the quantum dots with a small particle size. The electrochemical measurements demonstrated the high performance of the composite response in the presence of a light source. Differential pulse voltammetry allowed the development of a method to determine 17ß-estradiol levels in the range from 0.2 to 4.0 µmol L(-1) with a detection limit of 2.8 nmol L(-1) (0.76 µg L(-1)).

Taxonomy of Placospongia Gray, 1867 from Northern and Northeastern Brazil, with description of two new species (Porifera: Demospongiae: Clionaida).

The demosponge genus Placospongia includes 13 valid species, of which six occur in the Brazilian Exclusive Economic Zone. In the present study, we describe two new species of Placospongia from Northern (off the Amazon River mouth) and Northeastern Brazilian continental shelf and oceanic islands (i.e., Fernando de Noronha Archipelago), viz., Placospongia beatrizae sp. nov. and Placospongia amphinolastra sp. nov., and redescribe the holotype of Placospongia cristata Boury-Esnault, 1973, a poorly known species. In addition, we revise the Brazilian records of the allegedly cosmopolitan species P. carinata, P. melobesioides and P. intermedia, and provide new records of P. colombiensis and P. ruetzleri from Brazil. We demonstrate that P. carinata sensu Coelho & Mello-Leito and P. intermedia sensu Muricy & Moraes and Jimenez et al. belong in fact to P. ruetzleri, and that P. melobesioides sensu Mothes et al. and Gonzlez-Faras is a new species, described here as Placospongia beatrizae sp. nov. With the description of the two new species and synonymyzation of previous records, six species of Placospongia are currently known in Brazilian waters, two of which are endemic. A key to Placospongia species is also provided.

Avalanche-assisted transient optical phenomenon in aggregated toluidine blue dye.

Pulse-modulated CW laser heat deposition modulates the darkness or the transparency of an aggregated medium in the high signal optical regimen. A recently reported work found that transient optical responses of molecular aggregates can be different depending on whether the sample is excited with a laser wavelength tuned within the absorption band of the monomer or within the absorption band of the aggregates. The different transient responses were attributed to different dynamic processes during the laser-induced disassembling of the molecular aggregates and may have implications in the field of organic electronics and optical devices, such as optical logical gates, optical power limiters and all-optical switching. In this paper laser beams with wavelengths of 663 nm and 532 nm were used to produce sudden changes in the thermodynamic equilibrium of the aggregation states of the ortho-toluidine blue dye, which allowed to observe the occurrence of the avalanche - mediated transient phenomenon in the laser-induced disassembling of ortho-toluidine blue (TBO) aggregates. A double exponential model was adjusted to the registered transient data. The obtained values for the fast components of the transient time responses of ortho-toluidine blue dye, for the studied concentrations, ranged from âˆ¼ 6.5 to 9.5 ms at 532 nm, and from âˆ¼ 43 to 48 ms at 663 nm. A single beam experiment was employed to evaluate the performance of the ortho-toluidine blue dye in a beam power-damping device, driven by the simultaneous and cooperative actions of the laser induced disassembling of aggregated dye units and the thermal lensing effect. It was found that the phenomenon of laser-induced dye disassembling of TBO, acting cooperatively with the thermal lensing effect, damps the laser beam power faster than the thermal lensing phenomenon alone. In addition, the results showed that the speed of the laser beam power-damping is dye dependent.

Challenges of Congenital Heart Surgery in Brazil: It is Time to Designate Pediatric Congenital Heart Surgery Subspecialty.

Congenital heart disease (CHD) affects eight to ten out of every 1,000 births, resulting in approximately 23,057 new cases in Brazil in 2022. About one in four children with CHD requires surgery or other procedures in the first year of life, and it is expected that approximately 81% of these children with CHD will survive until at least 35 years of age. Professionals choosing to specialize in CHD surgery face numerous challenges, not only related to mastering surgical techniques and the complexity of the diseases but also to the lack of recognition by medical societies as a separate subspecialty. Furthermore, families face difficulties when access to services capable of providing treatment for these children. To address these challenges, it is essential to have specialized hospitals, qualified professionals, updated technologies, sustainable industry, appropriate financing, quality assessment systems, and knowledge generation. The path to excellence involves specialization across all involved parties. As we reflect on the importance of Pediatric Cardiovascular Surgery and Congenital Heart Diseases establishing themselves as a subspecialty of Cardiovascular Surgery, it is essential to look beyond our borders to countries like the United States of America and United Kingdom, where this evolution is already a reality. This autonomy has led to significant advancements in research, education, and patient care outcomes, establishing a care model. By following this path in Brazil, we not only align our practice with the highest international standards but also demonstrate our maturity and the ability to meet the specific needs of patients with CHD and those with acquired childhood heart disease.

Four new species of Plakinidae (Porifera: Homoscleromorpha) from Brazil.

Seven species of Plakinidae are currently known from Brazil, belonging to genera Plakina (P. trilopha), Plakinastrella (P. microspiculfera, P. onkodes), and Plakortis (P. angulospiculatus, P. halichondrioides, P. insularis, and P microrhabdifera). In this study we describe four new species of the genera Plakinastrella and Plakortis, increasing the number of plakinid species in Brazil to eleven. Plakortis petrupaulensis sp. nov. is encrusting, light brown; the skeleton is disorganized with few traces of reticulation; lacunae are absent; the spicules are diods and tuberculate microrhabds; spheres are common and triods are absent. Plakortis spinalis sp. nov. is encrusting, gray, cartilaginous, has a reticulated ectosomal skeleton, and is distinguished by the spines in some of the diods and triods; microrhabds are also tuberculate and smooth spheres are common. Plakortis potiguarensis sp. nov. is encrusting, brown with gray tinges, and cartilaginous; the skeleton is disorganized and scarce, composed of thin, irregular diods, triods and relatively large microrhabds. Plakinastrella globularis sp. nov. has a globular shape and dark blue color in vivo; the ectosomal skeleton has a double tangential reticulation and the choanosomal skeleton is reticulated. The spicules are diods, triods, calthrops and microrhabds; spheres are common. Two of the new species have characters previously unknown in their respective genera: the spined diods and triods of Plakortis spinalis sp. nov. and the blue color and microrhabds of Plakinastrella globularis sp. nov. The presence of microrhabds in Plakinastrella suggests a close relationship of this genus with Plakortis.

Simultaneous Determination of Uric Acid and Caffeine by Flow Injection Using Multiple-Pulse Amperometry.

The present study reports the development and application of a flow injection analysis (FIA) system for the simultaneous determination of uric acid (UA) and caffeine (CAF) using cathodically pretreated boron-doped diamond electrode (CPT-BDD) and multiple-pulse amperometry (MPA). The electrochemical profiles of UA and CAF were analyzed via cyclic voltammetry in the potential range of 0.20-1.7 V using 0.10 mol L-1 H2SO4 solution as supporting electrolyte. Under optimized conditions, two oxidation peaks at potentials of 0.80 V (UA) and 1.4 V (CAF) were observed; the application of these potentials using multiple-pulse amperometry yielded concentration linear ranges of 5.0 × 10-8-2.2 × 10-5 mol L-1 (UA) and 5.0 × 10-8-1.9 × 10-5 mol L-1 (CAF) and limits of detection of 1.1 × 10-8 and 1.3 × 10-8 mol L-1 for UA and CAF, respectively. The proposed method exhibited good repeatability and stability, and no interference was detected in the electrochemical signals of UA and CAF in the presence of glucose, NaCl, KH2PO4, CaCl2, urea, Pb, Ni, and Cd. The application of the FIA-MPA method for the analysis of environmental samples resulted in recovery rates ranging between 98 and 104%. The results obtained showed that the BDD sensor exhibited a good analytical performance when applied for CAF and UA determination, especially when compared to other sensors reported in the literature.

Voltammetric Sensing of Nifedipine Using a Glassy Carbon Electrode Modified with Carbon Nanofibers and Gold Nanoparticles.

Nifedipine, a widely utilized medication, plays a crucial role in managing blood pressure in humans. Due to its global prevalence and extensive usage, close monitoring is necessary to address this widespread concern effectively. Therefore, the development of an electrochemical sensor based on a glassy carbon electrode modified with carbon nanofibers and gold nanoparticles in a Nafion® film was performed, resulting in an active electrode surface for oxidation of the nifedipine molecule. This was applied, together with a voltammetric methodology, for the analysis of nifedipine in biological and environmental samples, presenting a linear concentration range from 0.020 to 2.5 × 10-6 µmol L-1 with a limit of detection 2.8 nmol L-1. In addition, it presented a good recovery analysis in the complexity of the samples, a low deviation in the presence of interfering potentials, and good repeatability between measurements.

Manned submersible dives reveal a singular assemblage of Hexactinellida (Porifera) off the Amazon River mouth, Northern Brazil.

The outer shelf and upper slope region under the influence of the Amazon River mouth harbors an extensive reef system with a rich sponge fauna, but no hexactinellids were recorded in the area so far. In this work, manned submersibles were used to describe for the first time three species of Hexactinellida off the Amazon River mouth: Hyalonema (Cyliconemaoida) alucia sp. nov., Dactylocalyx pumiceus and Claviscopulia facunda. We found two morphotypes of Dactylocalyx pumiceus, suggesting that it may be a complex of cryptic species. The populations of the three species off Par State were sparse, but a large aggregation of D. pumiceus was found off Maranho State from 145 to 230 m depth. These findings indicate that hexactinellid grounds may be more common along the Northern Brazilian continental outer shelf and slope than previously thought.

Voltammetric Determination of 3-Methylmorphine Using Glassy Carbon Electrode Modified with rGO and Bismuth Film.

This work reports the development and application of a simple, rapid and low-cost voltammetric method for the determination of 3-methylmorphine at nanomolar levels in clinical and environmental samples. The proposed method involves the combined application of a glassy carbon electrode modified with reduced graphene oxide, chitosan and bismuth film (Bi-rGO-CTS/GCE) via square-wave voltammetry using 0.04 mol L-1 Britton-Robinson buffer solution (pH 4.0). The application of the technique yielded low limit of detection of 24 × 10-9 mol L-1 and linear concentration range of 2.5 × 10-7 to 8.2 × 10-6 mol L-1. The Bi-rGO-CTS/GCE sensor was successfully applied for the detection of 3-methylmorphine in the presence of other compounds, including paracetamol and caffeine. The results obtained also showed that the application of the sensor for 3-methylmorphine detection did not experience any significant interference in the presence of silicon dioxide, povidone, cellulose, magnesium stearate, urea, ascorbic acid, humic acid and croscarmellose. The applicability of the Bi-rGO-CTS/GCE sensor for the detection of 3-methylmorphine was evaluated using synthetic urine, serum, and river water samples through addition and recovery tests, and the results obtained were found to be similar to those obtained for the high-performance liquid chromatography method (HPLC)-used as a reference method. The findings of this study show that the proposed voltammetric method is a simple, fast and highly efficient alternative technique for the detection of 3-methylmorphine in both biological and environmental samples.

Determination of ofloxacin in the presence of dopamine, paracetamol, and caffeine using a glassy carbon electrode based on carbon nanomaterials and gold nanoparticles.

A new electrode was prepared based on functionalized graphene and gold nanoparticles dispersed in a chitosan film. Such an electrochemical sensor determines ofloxacin in the presence of dopamine, paracetamol, and caffeine. Characterization (morphological and electrochemical) was done using scanning electron microscopy, electrochemical impedance spectroscopy, and cyclic voltammetry. The sensor design improved the analytical signal, the electrochemical activity, and the electron transfer rate. Ofloxacin was determined by square-wave voltammetry, with a linear concentration range of 0.10-4.9 µmol L-1 (r = 0.999, LOD = 12 nmol L-1). The proposed sensor showed good repeatability and selectivity and was applied successfully to the determination of ofloxacin in pharmaceutical formulations, synthetic urine, and water river samples. The proposed method proved to be excellent; therefore, it is an alternative method for the determination of ofloxacin.

Enhancing the electrochemical sensitivity of hydroquinone using a hydrophobic deep eutectic solvent-based carbon paste electrode.

The present study reports the synthesis and characterization of hydrophobic deep eutectic solvents (HDES) based on fatty acids and tetrabutylammonium bromide (TBAB) or 1-octanol using Fourier transform infrared spectroscopy, and the analysis of the physicochemical properties (viscosity, density, electrical conductivity, and water content) of these solvents. A carbon paste electrode modified with 6.0% (m/m) decanoic acid and TBAB-based HDES was characterized by cyclic voltammetry, electrochemical impedance spectroscopy, and scanning electron microscopy. The oxidation peak currents of the proposed electrode were enhanced by its high electrochemical activity, fast electron transfer rate, and high surface area, while a remarkable decrease was observed in the peak potential separation. The electrochemical determination of hydroquinone (H2Q) was carried out using square-wave adsorptive anodic stripping voltammetry (SWAdASV). The electrode response was found to be linear in the H2Q concentration range of 2.5 × 10-6-3.0 × 10-3 mol L-1, with the limit of detection (LOD) of 7.7 × 10-7 mol L-1. The method was successfully applied for H2Q determination in dermatological creams.

Biosynthesis of silver nanoparticles from Syzygium cumini leaves and their potential effects on odontogenic pathogens and biofilms.

This study analyzed the antimicrobial and antibiofilm action and cytotoxicity of extract (HEScL) and silver nanoparticles (AgNPs-HEScL) from Syzygium cumini leaves. GC-MS, UV-Vis, EDX, FEG/SEM, DLS and zeta potential assays were used to characterize the extract or nanoparticles. Antimicrobial, antibiofilm and cytotoxicity analyses were carried out by in vitro methods: agar diffusion, microdilution and normal oral keratinocytes spontaneously immortalized (NOK-SI) cell culture. MICs of planktonic cells ranged from 31.2-250 (AgNPs-HEScL) to 1,296.8-10,375 µg/ml (HEScL) for Actinomyces naeslundii, Fusobacterium nucleatum, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus mutans, Streptococcus oralis, Veillonella dispar, and Candida albicans. AgNPs-HEScL showed antibiofilm effects (125-8,000 µg/ml) toward Candida albicans, Streptococcus mutans and Streptococcus oralis, and Staphylococcus aureus and Staphylococcus epidermidis. The NOK-SI exhibited no cytotoxicity when treated with 32.8 and 680.3 µg/ml of AgNPs-HEScL and HEScL, respectively, for 5 min. The data suggest potential antimicrobial and antibiofilm action of HEScL, and more specifically, AgNPs-HEScL, involving pathogens of medical and dental interest (dose-, time- and species-dependent). The cytotoxicity of HEScL and AgNPs-HEScL detected in NOK-SI was dose- and time-dependent. This study presents toxicological information about the lyophilized ethanolic extract of S. cumini leaves, including their metallic nanoparticles, and adds scientific values to incipient studies found in the literature.