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Hydrogels containing antimicrobial materials have emerged as attractive platforms for wound treatment in the past decade due to their favorable bio-mimicking properties, excellent modulation of bacterial infection, and ability to minimize bacterial resistance. Herein, a hybrid combination of polyvinyl alcohol (PVA), hyperbranched poly L-lysine (L), tannic acid decorated AgNPs (AgTA NPs), loaded with Allantoin (Alla) is used to fabricate PLAg-Alla hydrogel dressing via the freeze-thaw method without use of any chemical cross-linker. The PLAg-Alla hydrogel possesses a great structure, is biodegradable, and safe, and exhibits high antibacterial potential, all required for efficient wound healing. The incorporation of AgTA and poly L-lysine (L) within the hydrogel contributes to the enhancement of antibacterial ability, as well as effectively promoting the wound healing. This hybrid hydrogel possessed favorable physicochemical features, robust antibacterial properties, and accelerated wound healing in vivo as promising dressing for the clinical application.
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The Navitor transcatheter heart valve (THV) is the latest iteration of the Portico self-expanding valve system. Early prospective studies have shown promising outcomes, however, there is a lack of complementary 'real-world' data. This study aimed to assess early safety and efficacy outcomes of the Navitor THV using registry data from 6 high-volume United Kingdom transcatheter aortic valve replacement (TAVR) centers. Demographic, procedural, and in-hospital outcome data were retrieved from 6 United Kingdom centers. The primary safety end point was 30-day mortality. Primary efficacy end points were procedural success, mean aortic gradient, and ≥moderate paravalvular leak. Secondary end points included rates of new permanent pacemaker implantation, stroke, and vascular injury. A total of 574 patients (mean age 83.4 years; 54.5% female) underwent Navitor TAVR between January 2020 and May 2023. The 30-day mortality in this patient cohort was 1.6%. Procedural success was 98.1%, mean echo-derived gradient post-TAVR was 7.7 ± 4.8 mm Hg (95% confidence interval [CI] 7.2 to 8.3, p <0.001) and 5.1% of patients had ≥moderate paravalvular leak (sample proportion estimate [pÌ] = 0.051, 95% CI [0.035, 0.073], p <0.001). New permanent pacemaker implantation to discharge was required in 11% (pÌ = 0.119, 95% CI 0.088 to 0.158, p <0.001), stroke occurred in 1.2% of patients (pÌ = 0.017, 95% CI 0.006 to 0.036, p <0.001) and significant vascular injury in 1.6% (pÌ = 0.014, 95% CI 0.005 to 0.032, p <0.001). In conclusion, early procedural outcomes with Navitor TAVR compare favorably to new-generation THVs. Procedural success was high with a low incidence of complications.
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Estenosis de la Válvula Aórtica , Prótesis Valvulares Cardíacas , Sistema de Registros , Reemplazo de la Válvula Aórtica Transcatéter , Humanos , Reemplazo de la Válvula Aórtica Transcatéter/métodos , Femenino , Masculino , Reino Unido/epidemiología , Anciano de 80 o más Años , Estenosis de la Válvula Aórtica/cirugía , Diseño de Prótesis , Anciano , Complicaciones Posoperatorias/epidemiología , Resultado del Tratamiento , Válvula Aórtica/cirugíaRESUMEN
The external quantum efficiency (EQE) of a perovskite-based light-emitting diode (PELED) is a key indicator, comprising the internal quantum efficiency (IQE) and light extraction efficiency (LEE). Currently, enhancing EQE faces a major challenge in optimizing LEE. This study introduces an innovative structure to boost LEE, exploring various influencing parameters. The transition from a planar to a domical architecture leverages factors like the waveguiding effect, resulting in a remarkable tenfold increase in LEE, from 6 to 59%. Additionally, investigations into factors affecting LEE, such as altering dipole orientation, material-substrate contact angle, and layer thickness, reveal the potential for further improvement. The optimized structure attains an impressive LEE value of 74%.
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The light absorption process is a key factor in improving the performance of perovskite solar cells (PSCs). Using arrays of metal nanostructures on semiconductors such as perovskite (CH3NH3PbI3), the amount of light absorption in these layers is significantly increased. Metal nanostructures have been considered for their ability to excite plasmons (collective oscillations of free electrons). Noble metal nanoparticles placed inside solar cells, by increasing the scattering of the incident light, effectively increase the optical absorption inside PSCs; this in turn increases the electric current generated in the photovoltaic device. In this work, by calculating the cross-sectional area of dispersion and absorption on gold (Au) nanoparticles, the effects of the position of nanoparticles in the active layer (AL) and their morphology on the increase of absorption within the PSC are investigated. The optimal position of the plasmonic nanoparticle was obtained in the middle of the AL using a three-dimensional simulation method. Then, three different morphologies of nano-sphere, nano-star and nano-cubes were investigated, where the short-circuit currents (Jsc) for these three nanostructures were obtained equal to 19.01, 18.66 and 20.03 mA/cm2, respectively. In our study, the best morphology of the nanostructure according to the Jsc value was related to the nano-cube, in which the device power conversion efficiency was equal to 16.20%, which is about 15% better than the PSC with the planar architecture.
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In this research study, the effects of different parameters on the electron transfer rate from three quantum dots (QDs), CdSe, CdS, and CdTe, on three metal oxides (MOs), TiO2, SnO2, and SnO2, in quantum-dot-sensitized solar cells (QDSSCs) with porous structures in the presence of four types of blocking layers, ZnS, ZnO, TiO2, and Al2O3, are modeled and simulated using the Marcus theory and tunneling between two spheres for the first time. Here, the studied parameters include the change in the type and thickness of the blocking layer, the diameter of the QD, and the temperature effect. To model the effect of the blocking layer on the QD, the effective sphere method is used, and by applying it into the Marcus theory equation and the tunneling method, the electron transfer rate is calculated and analyzed. The obtained results in a wide range of temperatures of 250-400 °K demonstrate that, based on the composition of the MO-QD, the increase in the temperature could reduce or increase the electron transfer rate, and the change in the QD diameter could exacerbate the effects of the temperature. In addition, the results show which type and thickness of the blocking layer can achieve the highest electron transfer rate. In order to test the accuracy of the simulation method, we calculate the electron transfer rate in the presence of a blocking layer for a reported sample of a QDSSC manufacturing work, which was obtained with an error of ~3%. The results can be used to better interpret the experimental observations and to assist with the design and selection of the appropriate combination of MO-QD in the presence of a blocking layer effect.
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So far, remarkable achievements have been obtained by optimizing the device architecture and modeling of solar cells is a precious and very effective way to comprehend a better description of the physical mechanisms in solar cells. As a result, this study has inspected two-dimensional simulation of perovskite solar cells (PSCs) to achieve a precise model. The solution which has been employed is based on the finite element method (FEM). First, the periodically light trapping (LT) structure has been replaced with a planar structure. Due to that, the power conversion efficiency (PCE) of PSC was obtained at 14.85%. Then, the effect of adding an SiO2 layer to the LT structure as an anti-reflector layer was investigated. Moreover, increasing the PCE of these types of solar cells, a new structure including a layer of CH3NH3SnI3 as an absorber layer was added to the structure of PSCs in this study, which resulted in 25.63 mA/cm2 short circuit current (Jsc), 0.96 V open circuit voltage (Voc), and 20.48% PCE.
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Mitral interventions remain technically challenging owing to the anatomical complexity and heterogeneity of mitral pathologies. As such, multi-disciplinary pre-procedural planning assisted by advanced cardiac imaging is pivotal to successful outcomes. Modern imaging techniques offer accurate 3D renderings of cardiac anatomy; however, users are required to derive a spatial understanding of complex mitral pathologies from a 2D projection thus generating an 'imaging gap' which limits procedural planning. Physical mitral modelling using 3D printing has the potential to bridge this gap and is increasingly being employed in conjunction with other transformative technologies to assess feasibility of intervention, direct prosthesis choice and avoid complications. Such platforms have also shown value in training and patient education. Despite important limitations, the pace of innovation and synergistic integration with other technologies is likely to ensure that 3D printing assumes a central role in the journey towards delivering personalised care for patients undergoing mitral valve interventions.
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The first diastereo- and enantiodivergent asymmetric synthesis of new bis-spirocyclopropyloxindole scaffolds has been accomplished from the readily available isatin as a single starting material. Four rel-(1R,2R,3R), rel-(1S,2S,3R), rel-(1R,2R,3S), and rel-(1S,2S,3S) configurations of desired products were constructed in excellent enantiopurity via a simple switch in substrates using the chiral auxiliary-controlled method. The absolute configuration of cycloadducts with three contiguous quaternary/tertiary stereogenic centers was confirmed through X-ray diffraction analysis. A facile synthesis of versatile precursor 3-chlorooxindoles was also introduced.
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In the present study, a library of important enantiopure dispirooxindole [indolizidine, pyrrolizidine, and pyrrolidine] derivatives with three or four contiguous and two quaternary stereogenic centers using different amino acids (pipecolic acid, sarcosine, proline and hydroxyproline) were synthesized in high yields (up to 96%) through a regio- and diastereoselective (up to 99 : 1) multicomponent 1,3-dipolar cycloaddition strategy. Based on the results, the alteration of amino acids led to a change in the regioselectivity and unusual regioisomers (pyrrolizidine versus indolizidine/pyrrolidine) were obtained to construct a novel enantiopure 1,3-dispirooxindole skeleton. The stereochemical outcome of the cycloaddition was determined by single crystal X-ray diffraction analysis and the self-disproportionation of enantiomers (SDE) test confirmed the enantiomeric purity of the desired products. The mechanism and differences in the regioselectivity of the 1,3-dipolar cycloaddition reactions between the stable azomethane ylides obtained from ninhydrin, pipecolinic acid, and proline with (E)-2-oxoindolin-3-ylideneacetyl sultam were theoretically studied through DFT calculations at the M06-2X/6-31G(d,p) level in methanol.
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BACKGROUND: Post-infarction ventricular septal defect (PIVSD) carries a very poor prognosis. Surgical repair offers reasonable outcomes in patients who survive the initial healing period. Percutaneous device implantation remains a potentially effective earlier alternative. METHODS AND RESULTS: From March 2018 to May 2022, 11 trans-arterial PIVSD closures were attempted in 9 patients from two centers (aged 67.2 ± 11.1 years; 77.8% male). Two patients had a second procedure. Myocardial infarction was anterior in four patients (44.5%) and inferior in five cases (55.5%). Devices were successfully implanted in all patients. There were no major immediate procedural complications. Immediate shunt grade postprocedure was significant (11.1%), minimal (77.8%), or none (11.1%). Median length of stay after the procedure was 14.8 days. Five patients (55%) survived to discharge and were followed up for a median of 605 days, during which time no additional patients died. CONCLUSION: Single arterial access for percutaneous closure of PIVSD is a good option for these extremely high-risk patients, in the era of effective large-bore arterial access closure. Mortality remains high, but patients who survive to discharge do well in the longer term.
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Infarto de la Pared Anterior del Miocardio , Procedimientos Quirúrgicos Cardíacos , Defectos del Tabique Interventricular , Infarto del Miocardio , Dispositivo Oclusor Septal , Humanos , Masculino , Femenino , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Resultado del Tratamiento , Cateterismo Cardíaco/efectos adversos , Cateterismo Cardíaco/métodos , Defectos del Tabique Interventricular/cirugía , Infarto del Miocardio/complicaciones , Infarto del Miocardio/diagnóstico por imagen , Infarto del Miocardio/terapia , Infarto de la Pared Anterior del Miocardio/complicaciones , Dispositivo Oclusor Septal/efectos adversosRESUMEN
Background & Objective: Parkinson's disease (PD) is a progressive neurodegenerative disorder in which the cause is attributed to the alpha-synuclein (α-Syn) accumulation due to the decreased rate of autophagy. Due to the many advantages, mesenchymal stem cells (MSCs), such as the secretion of neurotrophic factors, have been proposed for PD cell therapy. The present study, in continuation of the previous study, aimed to investigate the therapeutic effect of human-derived Conjunctival MSCs (CJ-MSCs) on the clearance of α-Syn by the microRNA-149(miR-149)/Akt/mTOR/ pathway. Methods: Stereotaxic 6-hydroxy dopamine (6-OHDA) was injected directly into the medial forebrain bundle (MFB) to induce Parkinson's disease. An apomorphine-induced rotation test was used to confirm the model establishment. CJ-MSCs were encapsulated in alginate microgel using a microfluidic system. The green fluorescent protein (GFP) labeled CJ-MSCs were encapsulated, and free cells were transplanted into the rats' right striatum. Behavioral and molecular analyses evaluated the potency of CJ-MSCs (encapsulated and free cells) in PD rats. Real-Time Quantitative Reverse Transcription PCR (qRT-PCR) was performed to investigate the expression of the miR-149-5p, Akt, mTOR, and α-Syn. Results: Our obtained results indicated that transplantation of CJ-MSCs leads to a decrease in the number of rotations while raising the balance and motor abilities. The gene expression evaluation showed a significant reduction in Akt, mTOR, and α-Syn mRNA levels and a significant increase in the level of miR-149-5p compared to the control group. Conclusion: It seems that CJ-MSCs can promote the degradation of intracellular α-Syn by miR-149-5p/Akt/mTOR pathway and improve rats' motor functions.
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INTRODUCTION: In mitral valve replacement (MVR), sudden increases in afterload and disruption of the annular-chordal-papillary-left-ventricular wall causes left ventricular (LV) dysfunction in the early postoperative period. Preservation of the posterior mitral leaflet apparatus (MVR-P) has a favorable outcome on LV function. However, there is paucity of data on the impact of complete preservation of the sub-valvular apparatus (MVR-C). OBJECTIVE: We investigated the impact of MVR-P and MVR-C on baseline and 3-months postoperative LV ejection fraction (EF) and global longitudinal strain (GLS). METHODS: We retrospectively analyzed a cohort of 29 MVR-P and 19 MVR-C patients with complete echocardiography data at our unit, who were operated between 2008 and 2017. Between-group changes in LVEF and GLS were compared using independent sample T-test. RESULTS: Median age was 59 years (IQR 50-69 years). Baseline LVEF was 58% (51%- 60%). Baseline GLS was -18.4 (-21.2 to -15.5). There were no significant between-group differences between all baseline demographics and echocardiographic markers. There was significantly higher absolute postoperative LVEF in MVR-C patients (p = 0.029). There was also significant worsening in LVEF (p = 0.0121) and GLS (p < 0.0001) after MVR-P and not MVR-C, suggesting no reduction in LV function post-MVR-C but a reduction post-MVR-P. There was significantly less postoperative worsening of GLS per patient in MVR-C group as compared to the MVR-P group (p = 0.023), indicating better preservation of LV function. There was also a smaller decline in LVEF per patient in the MVR-C as compared to the MVR-P group, although not statistically significant (p = 0.23). CONCLUSION: MVR with complete preservation of the sub-valvular apparatus shows a favorable impact on the longitudinal function of the heart at 3 months. Further studies with larger patient numbers are indicated to investigate the long-term results of this surgical approach.
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Implantación de Prótesis de Válvulas Cardíacas , Insuficiencia de la Válvula Mitral , Disfunción Ventricular Izquierda , Humanos , Persona de Mediana Edad , Válvula Mitral/diagnóstico por imagen , Válvula Mitral/cirugía , Función Ventricular Izquierda , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Insuficiencia de la Válvula Mitral/cirugía , Insuficiencia de la Válvula Mitral/complicaciones , Estudios Retrospectivos , Volumen Sistólico , Disfunción Ventricular Izquierda/etiología , Implantación de Prótesis de Válvulas Cardíacas/métodosRESUMEN
Background: Brain ischemia often leads to the chloride gradient alternations, which affects volume regulation and neuronal survival. Increase in NKCC1 expression and reduction in KCC2 level under ischemic condition results in inflammation and neuronal death. In this study, we investigated the effect of mimic miRNA and coenzyme Q10 (CoQ10) on the expression of cation-chloride cotransporters (CCCs) (NKCC1 and KCC2) after cerebral ischemia. Methods: In this study, cerebral ischemia was modeled using the middle cerebral artery occlusion method. Rats were randomly divided into six groups: sham, model, negative control, vehicle, and the first and second treatments. In the Sham group, ischemia was not induced, and no treatment was performed. In the Model group, ischemia induction was performed, and other groups, in addition to ischemia induction, received Scramble miRNA, Ethanol, mimic miRNA-149-5p and CoQ10, respectively. Each group was divided into three subgroups to assess the volume of the tissue damage and neurological deficits scores (NDS) in subgroup 1, brain water content in subgroup 2, level of miRNA-149-5p and CCC expressions in subgroup 3. Results: Our data suggested that the use of mimic miRNA and Q10 increased the level of miRNA-149 and KCC2 expression and decreased NDS, NKCC1 expression, brain water content, and infract volume. Conclusion: Findings of this study suggest that the mimic miRNA and Q10 may have neuroprotective effects through reducing infract volume and brain water content and modulating the expression of CCCs after brain ischemia.
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Isquemia Encefálica , MicroARNs , Simportadores , Animales , Ratas , Cationes/metabolismo , Cloruros/metabolismo , Infarto de la Arteria Cerebral Media , MicroARNs/genética , MicroARNs/metabolismo , Simportadores/genética , Simportadores/metabolismo , Regulación hacia Arriba/genética , Agua/metabolismoRESUMEN
Cerebral ischemia is a common neurodegenerative disease in which damage to the blood-brain barrier (BBB) is the main consequence. In cerebral ischemia, the level of miR-149-5p and tight junction proteins are decreased, while the level of Calpine is increased, finally leading to increased BBB permeability. This study investigated the effect of miR-149-5p mimic on the expression of Calpain, Occludin, and ZO-1 and the consequences of cerebral ischemia. Cerebral ischemia model was performed via middle cerebral artery occlusion (MCAO) method on female Wistar rats. Four groups of Wistar rats were studied: Sham, cerebral ischemia without treatment, Scramble miR, and miR-149-5p mimic treatment. Then, neurological defects and BBB permeability (via Evans blue staining), cerebral edema (cerebrospinal fluid percentage), and ZO-1, Occludin, and Calapin expression (by quantitative real time- PCR) were investigated. qRT-PCR results showed miR-149-5p expression decreases after cerebral ischemia induction. In addition, Occludin and ZO-1 expression significantly increased in miR-149-5p group. In contrast, Calapin expression, BBB permeability, brain water content and neurological defects were significantly decreased. It seems that the increased level of miR-149-5p exerts its protective effect on cerebral ischemia due to increasing of tight junction proteins.
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BACKGROUND AND AIM: Parkinson's disease (PD) is a progressive neurodegenerative disorder caused by the destruction of the dopaminergic neurons in the nigrostriatal pathway, leading to motor-behavioral complications. Cell therapy has been proposed as a promising approach for PD treatment using various cellular sources. Despite a few disadvantages mesenchymal stem cells (MSCs) represent, they have more auspicious effects for PD cell therapy. The present study aimed to evaluate a new source of MSCs isolated from human Conjunctiva (CJ-MSCs) impact on PD complications for the first time. MATERIALS AND METHODS: Parkinson's was induced by stereotactic injection of 6-hydroxydopamine (6-OHDA) into the right medial forebrain bundle (MFB). An apomorphine-induced rotation test was used to confirm the model establishment. After PD model confirmation, green fluorescent protein (GFP) labeled CJ-MSCs and induced CJ-MSCs (microfluidic encapsulated and non-capsulated) were transplanted into the rats' right striatum. Then Rotation, Rotarod, and Open-field tests were performed to evaluate the behavioral assessment. Additionally, the immunohistochemistry technique was used for identifying tyrosine hydroxylase (TH). RESULTS: According to the obtained data, the cell transplantation caused a reduction in the rats' rotation number and improved locomotion compared to the control group. The previous results were also more pronounced in induced and microfluidic encapsulated cells compared to other cells. Rats recipient CJ-MSCs also have represented more TH-expressed GFP-labeled cell numbers in the striatum than the control group. CONCLUSION: It can be concluded that CJ-MSCs therapy can have protective effects against PD complications and nerve induction of cells due to their ability to express dopamine. On the other hand, CJ-MSCs microencapsulating leads to enhance even more protective effect of CJ-MSCs. However, confirmation of this hypothesis requires further studies and investigation of these cells' possible mechanisms of action.
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Conjuntiva/trasplante , Trasplante de Células Madre Mesenquimatosas , Células Madre Mesenquimatosas/citología , Enfermedad de Parkinson/terapia , Animales , Conjuntiva/citología , Cuerpo Estriado/patología , Cuerpo Estriado/trasplante , Modelos Animales de Enfermedad , Humanos , Técnicas Analíticas Microfluídicas , Oxidopamina/farmacología , Enfermedad de Parkinson/patología , RatasRESUMEN
Parkinson's disease (PD) is a complex neurodegenerative disease in which the understanding of the underlying molecular mechanisms can be constructive in the diagnosis and treatment. Matrix metalloproteinase (MMPs) elevation and damage to the blood-brain barrier (BBB) are critical mechanisms involved in the PD separation. Studies have revealed that changes in miR-149-5p and CoQ10 are associated with BBB damage, and CoQ10 can affect the levels of some miRs. Hence, in the present study, we aimed to evaluate CoQ10 and miR-149-5p mimic on miR-149-5p, MMPs and TH expression, and behavioral functions of the PD models. PD was induced by injection of 6-OHDA into the rats' Medial Forbrain Bundle (MFB). The behavioral tests, including the Rotation test, Rotarod test, and Open field test, have been directed two weeks after PD induction. Next, the MiR-149-5p mimic (miR-mimic) and CoQ10 have been administered to rats. The same behavioral tests have been evaluated two weeks after administration to investigate the effect of miR-149-5p mimic and CoQ10. The rats were followed extra four weeks, and the behavioral tests have performed again. Finally, the expression of MMPs and miR-149-5p genes was measured using RT-qPCR, and tyrosine hydroxylase (TH) was assessed through immunohistochemistry analysis. According to the obtained results, the level of miR-149-5p has decreased, followed by PD induction in rats. RT-qPCR analysis has represented upregulation and downregulation of miR-149-5p and MMP-2,9, respectively, after miR-mimic and CoQ10 treatment. The treated rats have also represented improved motor function and increased TH + cells in the striatum according to the behavioral tests and immunohistochemistry assay. Taking together miR-149 and CoQ10 has shown to have an impressive potential to prevent damage to dopaminergic neurons caused by 6-OHDA injection through reducing MMP-2,9, increased TH expression, and improved motor function.
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MicroARNs , Enfermedades Neurodegenerativas , Fármacos Neuroprotectores , Enfermedad de Parkinson , Animales , Modelos Animales de Enfermedad , Metaloproteinasas de la Matriz/genética , MicroARNs/genética , MicroARNs/metabolismo , Fármacos Neuroprotectores/farmacología , Fármacos Neuroprotectores/uso terapéutico , Oxidopamina , Enfermedad de Parkinson/tratamiento farmacológico , Ratas , Ubiquinona/análogos & derivadosRESUMEN
The increase in some factors following cerebral ischemia, especially Matrix metalloproteinase (MMPs) and inflammatory factors lead to blood-brain barrier (BBB) damages, edema and neuronal death. Previous studies have shown that these molecules are miRNA-149-5p (miR-149) and Coenzyme (Co) Q10 targets. Therefore, in this study, the effect of mimic of miRNA-149-5p (mimic miR) and CoQ10 on the expression of metalloproteinase 1 and 2 and inflammatory cytokines following injury caused by cerebral ischemia is investigated. Cerebral ischemia was modeled by Middle Cerebral Artery Occlusion (MCAO). Male Wistar rats were randomly divided into 6 groups: sham (without surgery and treatment), control (MCAO), negative control (NC): MCAO + scrambled miR, vehicle: MCAO + Ethanole, first treatment: MCAO + mimic miR, second treatment: MCAO + Q10. Each group was divided into 6 subgroups to evaluate neurological defects, the volume of tissue damage using 2,3,5-triphenyl tetrazolium chloride (TTC) staining, blood-brain barrier permeability using cerebral Evans Blue (EB) staining, edema by measuring the percentage of brain water, MMP-2,9 mRNA and miR-149-5p levels using Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) and the levels of IL-6 and TNF-α proteins using ELISA. The data obtained from this study showed that the use of mimic miR and Q10 increased the level of miR-149, decreased the extent of neurological defects and tissue damage, increased BBB integrity, decreased brain water percentage and also decreased the level of inflammatory cytokines and MMPs. It seems that the use mimic of miRNA-149-5p and Q10 can have a protective effect on the brain by reducing MMPs and inflammatory factors following cerebral ischemia and this could lead to a new treatment strategy to reduce the complications of cerebral ischemia.
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Edema Encefálico/tratamiento farmacológico , Isquemia Encefálica/tratamiento farmacológico , Citocinas/metabolismo , Metaloproteasas/metabolismo , MicroARNs/metabolismo , Fármacos Neuroprotectores/farmacología , Ubiquinona/análogos & derivados , Animales , Barrera Hematoencefálica/efectos de los fármacos , Barrera Hematoencefálica/metabolismo , Encéfalo/diagnóstico por imagen , Encéfalo/metabolismo , Edema Encefálico/genética , Edema Encefálico/metabolismo , Isquemia Encefálica/genética , Isquemia Encefálica/metabolismo , Modelos Animales de Enfermedad , Masculino , MicroARNs/genética , Fármacos Neuroprotectores/uso terapéutico , Ratas , Ratas Wistar , Ubiquinona/farmacología , Ubiquinona/uso terapéuticoRESUMEN
OBJECTIVES: Congestion can worsen outcomes after transcatheter aortic valve implantation (TAVI), but can be difficult to quantify non-invasively. We hypothesised that preprocedural plasma volume status (PVS), estimated using a validated formula that enumerates percentage change from ideal PV, would provide prognostic utility post-TAVI. METHODS: This retrospective cohort study identified patients who underwent TAVI (2007-2017) from a prospectively collected database. Actual ([1-haematocrit] × [a + (b × weight (Kg))] and ideal (c × weight (Kg)) PV were quantified from equations where a, b and c are sex-dependent constants. Calculated PVS was then derived (100% x [(actual - ideal PV)/ideal PV]). RESULTS: In 564 patients (mean age 82±7 years, 49% male), mean PVS was -2.7±10.2%, with PV expansion (PVS >0%) evident in 39%. Only logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) independently predicted a PVS >0% (OR 1.85, p=0.002). On Cox analyses, a PVS >0% was associated with greater mortality at 3 (HR 2.29, 95% CI 1.11 to 4.74, p=0.03) and 12 months (HR 2.00, 95% CI 1.23 to 3.26, p=0.006) after TAVI, independently of, and incremental to, the EuroSCORE and New York Heart Association class. A PVS >0% was also independently associated with more days in intensive care (coefficient: 0.41, 95% CI 0.04 to 0.78, p=0.03) and in hospital (coefficient: 1.95, 95% CI 0.48 to 3.41, p=0.009). CONCLUSION: Higher PVS values, calculated simply from weight and haematocrit, are associated with greater mortality and longer hospitalisation post-TAVI. PVS could help refine risk stratification and further investigations into the utility of PVS-guided management in TAVI patients is warranted.
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Estenosis de la Válvula Aórtica/cirugía , Volumen Plasmático/fisiología , Medición de Riesgo/métodos , Reemplazo de la Válvula Aórtica Transcatéter/métodos , Anciano de 80 o más Años , Válvula Aórtica/cirugía , Estenosis de la Válvula Aórtica/sangre , Estenosis de la Válvula Aórtica/mortalidad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Factores de TiempoRESUMEN
In this paper, a nanostructured perovskite solar cell (PSC) on a textured silicon substrate is examined, and its performance is analyzed. First, its configuration and the simulated unit cell are discussed, and its fabrication method is explained. In this proposed structure, poly-dimethylsiloxane (PDMS) is used instead of glass. It is shown that the use of PDMS dramatically reduces the reflection from the cell surface. Furthermore, the light absorption is found to be greatly increased due to the light trapping and plasmonic enhancement of the electric field in the active layer. Then, three different structures, are compared with the main proposed structure in terms of absorption, considering the imperfect fabrication conditions and the characteristics of the built PSC. The findings show that in the worst fabrication conditions considered structure (FCCS), short-circuit current density (Jsc) is 22.28 mA/cm2, which is 27% higher than that of the planar structure with a value of 17.51 mA/cm2. As a result, the efficiencies of these FCCSs are significant as well. In the main proposed structure, the power conversion efficiency (PCE) is observed to be improved by 32%, from 13.86% for the planar structure to 18.29%.