Optimizing Droplet-Based Electricity Generator via a Low Sticky Hydrophobic Droplet-Impacted Surface.

Droplet-based electricity generators (DEGs) are increasingly recognized for their potential in converting renewable energy sources. This study explores the interplay of surface hydrophobicity and stickiness in improving DEG efficiency. It find that the high-performance C-WaxDEGs leverage both these properties. Specifically, DEGs incorporating polydimethylsiloxane (PDMS) with carnauba wax (C-wax) exhibit increased output as surface stickiness decreases. Through experimental comparisons, PDMS with 1wt.% C-wax demonstrated a significant power output increase from 0.07 to 1.2 W m- 2, which attribute to the minimized adhesion between water molecules and the polymer surface, achieved by embedding C-wax into PDMS surface to form microstructures. This improvement in DEG performance is notable even among samples with similar surface potentials and contact angles, suggesting that C-wax's primary contribution is in reducing surface stickiness rather than altering other surface properties. The further investigations into the C-WaxDEG variant with 1wt.% C-wax PDMS uncover its potential as a sensor for water quality parameters such as temperature, pH, and heavy metal ion concentration. These findings open avenues for the integration of C-WaxDEGs into flexible electronic devices aimed at environmental monitoring.

Highly Conductive PEDOT:PSS: Ag Nanowire-Based Nanofibers for Transparent Flexible Electronics.

Highly conductive, transparent, and easily available materials are needed in a wide range of devices, such as sensors, solar cells, and touch screens, as alternatives to expensive and unsustainable materials such as indium tin oxide. Herein, electrospinning was employed to develop fibers of PEDOT:PSS/silver nanowire (AgNW) composites on various substrates, including poly(caprolactone) (PCL), cotton fabric, and Kapton. The influence of AgNWs, as well as the applied voltage of electrospinning on the conductivity of fibers, was thoroughly investigated. The developed fibers showed a sheet resistance of 7 Ω/sq, a conductivity of 354 S/cm, and a transmittance value of 77%, providing excellent optoelectrical properties. Further, the effect of bending on the fibers' electrical properties was analyzed. The sheet resistance of fibers on the PCL substrate increased slightly from 7 to 8 Ω/sq, after 1000 bending cycles. Subsequently, as a proof of concept, the nanofibers were evaluated as electrode material in a triboelectric nanogenerator (TENG)-based energy harvester, and they were observed to enhance the performance of the TENG device (78.83 V and 7 µA output voltage and current, respectively), as compared to the same device using copper electrodes. These experiments highlight the untapped potential of conductive electrospun fibers for flexible and transparent electronics.

Comparative effectiveness and safety of prasugrel and ticagrelor in patients of acute coronary syndrome undergoing percutaneous transluminal coronary angioplasty: A propensity score-matched analysis.

Evidence on comparative effectiveness and safety of prasugrel and ticagrelor post-percutaneous transluminal coronary angioplasty is scarce in Indian population. In a 1:1 propensity score-matched cohort with 71 individuals in each group, the incidence of a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, or coronary revascularization was not significantly different in prasugrel and ticagrelor group (7.04% vs 9.86%; absolute difference, 2.8%; HR, 0.65; 95% CI, 0.21-2.1; p = 0.49). There was no significant difference in bleeding (5.63% vs 9.86%; absolute difference, -4.20%; 95% CI, -13.0%-4.5%) and dyspnea (7.04% vs 12.7%; absolute difference, -5.60%; 95% CI, -15.4%-4.1%).

Crystalline Porous Material-Based Nanogenerators: Recent Progress, Applications, Challenges, and Opportunities.

Nanogenerator (NG) is a potential technology that allows to build self-powered systems, sensors, flexible and portable electronics in the current Internet of Things (IoT) generation. Nanogenerators include piezoelectric nanogenerators (PENGs) and triboelectric nanogenerators (TENGs), convert different forms of mechanical motion into useful electrical signals. They have evolved and expanded their applications in various fields since their discovery in 2006 and 2012. Material selection is crucial for designing efficient NGs, with high conversion efficiencies. In the recent past, crystalline porous mat erials (metal-organic frameworks (MOFs) and covalent organic frameworks (COFs)) have been widely reported as potential candidates for nanogenerators, owing to their special properties of large surface area, porosity tailoring, ease of surface, post-synthesis modification, and chemical stability. The present organized review provides a complete overview of all the crystalline porous materials (CPMs)-based nanogenerator devices reported in the literature, including synthesis, characterization, device fabrication, and potential applications. Additionally, this review article discusses current challenges, future directions, and perspectives in the field of CPMs-NGs.

Usefulness of the PRECISE-DAPT score at differentiating between ticagrelor and prasugrel for dual antiplatelet therapy initiation.

As a part of dual antiplatelet therapy (DAPT), prasugrel or ticagrelor is prescribed along with aspirin to patients of acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). We aimed to assess if the PRECISE-DAPT score, which provides prediction of bleeding during DAPT, could be used to choose between prasugrel and ticagrelor for DAPT initiation. 181 patients out of which 71 received prasugrel and 110 received ticagrelor were enrolled in this prospective cohort study. PRECISE-DAPT score was calculated for everyone and was used to dichotomize patients into two subgroups (score <25 and ≥25). After balancing potential confounders in baseline characteristics of the subgroups using propensity scores, comparison of a composite outcome of 4-point major adverse cardiovascular events (4P-MACE) (i.e., cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, or coronary revascularization due to stent thrombosis) and bleeding (any type as defined by the Bleeding Academic Research Consortium) within 1-year post-PCI was performed among the subgroups using Cox proportional hazards regression. Prasugrel was associated with lower and comparatively higher 4P-MACE events in subgroups with score ≥25 (HR: 0.17; 95% CI, 0.04-0.77) and score <25 (HR: 3.58; 95% CI, 0.62-20.70) respectively. For bleeding outcome, prasugrel trended towards more clinical benefit for scores ≥25 (HR: 0.44; 95% CI, 0.10-1.93) than <25 (HR: 0.93; 95% CI, 0.13-6.58). Therefore, prasugrel was associated with better clinical effectiveness and trended towards a lower bleeding risk compared to ticagrelor within 1-year post-PCI for those with a high PRECISE-DAPT score (≥25). This finding requires validation through larger studies.

Validation of UK-BCIS CHIP Score to Predict 1-Year Outcomes in a Contemporary United States Population.

BACKGROUND: A complex high-risk indicated percutaneous coronary intervention (CHIP) score was recently developed from the British Cardiovascular Intervention Society (BCIS) database to define CHIP cases and their risk of in-hospital major adverse cardiac or cerebrovascular events (MACCE). OBJECTIVES: The authors sought to apply this score to a contemporary U.S. population for the prediction of adverse events at 1 year following percutaneous coronary intervention (PCI). METHODS: Consecutive patients undergoing PCI at a large tertiary care center between 2011 and 2020 were considered for inclusion. Patients were categorized into 4 groups based on their BCIS-CHIP score (0, 1-2, 3-4, ≥5). In each category, we assessed the 1-year risk of MACCE, a composite of all-cause death, myocardial infarction, and stroke. Secondary outcomes were the individual components of MACCE, and major bleeding at 1 year. RESULTS: Among 20,799 patients included, MACCE at 1 year occurred in 1.7% patients with score 0 (reference), 3.0% with score 1 or 2 (HR: 1.72; 95% CI: 1.32-2.24), 6.1% with score 3 or 4 (HR: 3.60; 95% CI: 2.78-4.66), and 12.0% with score ≥5 (HR: 7.40; 95% CI: 5.75-9.51). Each point increase of the BCIS-CHIP score conferred a 28.0% increase of MACCE risk. The BCIS-CHIP score demonstrated good discrimination for the prediction of 1-year MACCE (C-index 0.70). The risk of secondary outcomes also progressively increased with higher score values. CONCLUSIONS: In a large PCI registry, the BCIS-CHIP score had a good predictive value for MACCE at 1 year. The utilization of this score can facilitate an accurate risk stratification of patients undergoing PCI.

Recent Advances in Triboelectric Nanogenerators: From Technological Progress to Commercial Applications.

Serious climate changes and energy-related environmental problems are currently critical issues in the world. In order to reduce carbon emissions and save our environment, renewable energy harvesting technologies will serve as a key solution in the near future. Among them, triboelectric nanogenerators (TENGs), which is one of the most promising mechanical energy harvesters by means of contact electrification phenomenon, are explosively developing due to abundant wasting mechanical energy sources and a number of superior advantages in a wide availability and selection of materials, relatively simple device configurations, and low-cost processing. Significant experimental and theoretical efforts have been achieved toward understanding fundamental behaviors and a wide range of demonstrations since its report in 2012. As a result, considerable technological advancement has been exhibited and it advances the timeline of achievement in the proposed roadmap. Now, the technology has reached the stage of prototype development with verification of performance beyond the lab scale environment toward its commercialization. In this review, distinguished authors in the world worked together to summarize the state of the art in theory, materials, devices, systems, circuits, and applications in TENG fields. The great research achievements of researchers in this field around the world over the past decade are expected to play a major role in coming to fruition of unexpectedly accelerated technological advances over the next decade.

Triboelectric Nanogenerators as Power Sources for Chemical Sensors and Biosensors.

The recent advances of portable sensors in flexible and wearable form factors are drawing increasing attention worldwide owing to their requirement applications ranging from health monitoring to environment monitoring. While portability is critical for these applications, real-time data gathering also requires a reliable power supply-which is largely met with batteries. Besides the need for regular charging, the use of toxic chemicals in batteries makes it difficult to rely on them, and as a result different types of energy harvesters have been explored in recent years. Among these, triboelectric nanogenerators (TENGs) provide a promising platform for harnessing ambient energy and converting it into usable electric signals. The ease of fabrication and possibility to develop TENGs with a diverse range of easily available materials also make them attractive. This review focuses on the TENG technology and its efficient use as a power source for various types of chemical sensors and biosensors. The paper describes the underlying mechanism, various modes of working of TENGs, and representative examples of their utilization as power sources for sensing a multitude of analytes. The challenges associated with their adoption for commercial solutions are also discussed to stimulate further advances and innovations.

High-Performance Triboelectric Nanogenerators Based on Commercial Textiles: Electrospun Nylon 66 Nanofibers on Silk and PVDF on Polyester.

A high-performance textile triboelectric nanogenerator is developed based on the common commercial fabrics silk and polyester (PET). Electrospun nylon 66 nanofibers were used to boost the tribo-positive performance of silk, and a poly(vinylidene difluoride) (PVDF) coating was deployed to increase the tribo-negativity of PET. The modifications confer a very significant boost in performance: output voltage and short-circuit current density increased ∼17 times (5.85 to 100 V) and ∼16 times (1.6 to 24.5 mA/m2), respectively, compared with the Silk/PET baseline. The maximum power density was 280 mW/m2 at a 4 MΩ resistance. The performance boost likely results from enhancing the tribo-positivity (and tribo-negativity) of the contact layers and from increased contact area facilitated by the electrospun nanofibers. Excellent stability and durability were demonstrated: the nylon nanofibers and PVDF coating provide high output, while the silk and PET substrate fabrics confer strength and flexibility. Rapid capacitor charging rates of 0.045 V/s (2 µF), 0.031 V/s (10 µF), and 0.011 V/s (22 µF) were demonstrated. Advantages include high output, a fully textile structure with excellent flexibility, and construction based on cost-effective commercial fabrics. The device is ideal as a power source for wearable electronic devices, and the approach can easily be deployed for other textiles.

Self-Powered Active Sensing Based on Triboelectric Generators.

The demand for portable and wearable chemical or biosensors and their expeditious development in recent years has created a scientific challenge in terms of their continuous powering. As a result, mechanical energy harvesters such as piezoelectric and triboelectric generators (TEGs) have been explored recently either as sensors or harvesters to store charge in small, but long-life, energy-storage devices to power the sensors. The use of energy harvesters as sensors is particularly interesting, as with such multifunctional operations it is possible to reduce the number devices needed in a system, which also helps overcome the integration complexities. In this regard, TEGs are promising, particularly for energy autonomous chemical and biological sensors, as they can be developed with a wide variety of materials, and their mechanical energy to electricity conversion can be modulated by various analytes. This review focuses on this interesting dimension of TEGs and presents various self-powered active chemical and biological sensors. A brief discussion about the development of TEG-based physical, magnetic, and optical sensors is also included. The influence of environmental factors, various figures of merit, and the significance of TEG design are explained in context with the active sensing. Finally, the key applications, challenges, and future perspective of chemical and biological detection via TEGs are discussed with a view to drive further advances in the field of self-powered sensors.

Exploring the Subclinical Atherosclerotic Load in Patients With Rheumatoid Arthritis: A Cross-Sectional Study.

BACKGROUND: Atherosclerosis is the major etiopathogenic factor that decides cardiovascular mortality and morbidity. While inflammation is the putative mechanism for atherosclerosis in various experimental studies, chronic inflammatory state (e.g. in rheumatoid arthritis [RA]) is often neglected as a contributing factor for the development of atherosclerosis. RA patients have two to four times more risk of fatal or non-fatal cardiovascular events, which is not explained by traditional risk factors alone. For example, low-density lipoprotein (LDL) cholesterol levels may not convey the true atherosclerotic risk in RA patients - "the lipid paradox". Thus, for better risk stratification of future cardiovascular events in RA, the traditional parameters like diabetes, hypertension, and dyslipidemia may not suffice. Newer parameters like carotid intimal-medial thickness (CIMT), coronary calcification scores, and C-reactive protein (CRP) may be needed. This study determined subclinical atherosclerotic load in groups of RA and non-RA patients with comparable Framingham risk scores using CIMT values. MATERIALS AND METHODS:  In this hospital-based cross-sectional study, the RA study group had 64 patients with RA (disease duration > 1 year) and 64 controls were patients with at least one traditional risk factor of cardiovascular disease (e.g., hypertension, cigarette smoking, dyslipidemia, and diabetes mellitus). They were all analyzed for CIMT. The aim was to compare if there was a difference in CIMT scores between groups of RA and non-RA patients, with comparable Framingham score cardiovascular risk categories. RESULTS: CIMT was significantly higher in the study population compared to controls, indicating increased subclinical atherosclerotic load in the former. Mean CIMT was higher in all age groups in RA patients when compared to the control population (statistically significant in age groups 40-49 years 0.66 ± 0.07 mm vs 0.64 ± 0.06 mm, P < 0.026 and 50-59 years 0.8 ± 0.05 mm vs 0.76 ± 0.05 mm, P < 0.047). CIMT was significantly higher in the intermediate-risk groups (based on the Framingham risk score) in the RA study population when compared with the same risk categories of the control population. Atherogenic indices such as LDL/high-density lipoprotein (HDL) ratio, atherogenic index, and CIMT were significantly higher in the RA patients with more than five years of disease duration than those with a duration of fewer than five years. CONCLUSION: Subclinical atherosclerotic load is higher in RA versus controls. The mean CIMT was higher in all age groups in RA compared to the controls. CIMT was significantly higher in the intermediate-risk subgroup (by Framingham risk score) when compared between RA and controls. RA subgroup comparisons based on seropositivity/seronegativity, high/normal CRP, and disease activity (low, intermediate, and high) for CIMT were not found to have statistically significant differences. RA group had lower HDL cholesterol and comparable LDL cholesterol values compared to controls.

COVID-19 and thrombotic complications-the role of anticoagulants, antiplatelets and thrombolytics.

Coronavirus disease 2019 (COVID-19) is a global pandemic the world is dealing with currently. Clinical evidences suggest that the patients are predisposed to both venous and arterial thrombotic complications. This is because of severe inflammatory responses, injury to endothelium and activation of platelets leading to increased coagulation. Additionally, individuals who are already receiving antithrombotic drug therapy for various cardiovascular diseases and complications might contract the disease in which case, attention should be given to the choice and duration of the therapy besides close monitoring of biochemical blood parameters. Herein, we review the incidences of thrombotic complications and their outcomes in COVID-19 patients as reported till date, while understanding the prophylactic and therapeutic roles of anticoagulants, antiplatelets and thrombolytics in the management of this severe viral respiratory illness.

Metal-Amino Acid Nanofibers based Triboelectric Nanogenerator for Self-Powered Thioacetamide Sensor.

The biomolecules offer different metal-binding sites to form a coordination polymer with structural diversity. The coordination directed one-dimensional metal-biomolecule nanofibers (Cu-Asp NFs) designed using copper as metal ion and aspartate as a ligand for triboelectric nanogenerator (TENG) is reported here. The different characterization techniques reveal the detailed characteristics of the synthesized Cu-Asp NFs. The robust coating of the Cu-Asp NFs is achieved using a simple tape cast coater. The bending and water dipping studies suggest the stability of the coated material. The relative polarity test and Kelvin probe force microscopy (KPFM) reveal the position of Cu-Asp in the triboelectric series. The Cu-Asp NFs and Teflon are used as the active material for the fabrication of freestanding mode (NF-TENG) and contact-separation mode (cNF-TENG) TENG. The NF-TENG generates an output of 200 V and 6 µA. The simple ion deposition technique enhances the voltage, current, and transferred charge of cNF-TENG by 2.5, 8, and 3 times. The use of the material for the single electrode sliding mode device further confirms the coated material's stability and robustness. A selective self-powered thioacetamide sensor is developed with the cNF-TENG, which exhibits a sensitivity of 0.76 v mM-1. Finally, NF-TENG is demonstrated for powering up numerous portable electronics.

Biodegradable metal-organic framework MIL-88A for triboelectric nanogenerator.

Metal-organic frameworks (MOFs) are multifunctional materials with a unique advantage of high porosity and surface area and size tunability and can be modified without altering the topology. The interesting and desirable properties of MOFs led to their exploration for the triboelectric nanogenerator. Herein, a biodegradable MOF MIL-88A for TENG (MIL-TENG) is reported. MIL-88A can be easily synthesized by coordinating iron chloride and fumaric acid in water, thus offering eco-friendly synthesis. Various materials are selected as opposite layers to MIL-88A to analyze triboelectric behavior and performance. The MIL-TENG exhibits an output trend of TENGEC < TENGKapton < TENGFEP. The MIL-88A and FEP generated an output voltage of 80 V and an output current of 2.2 µA. The surface potential measurement and electrical output trend suggest the positive triboelectric behavior of MIL-88A concerning FEP and Kapton. The utilization of biomechanical motions and numerous low-rating electronics powered via a capacitor are demonstrated.

Curative resection for adenocarcinoma of the gastro-esophageal junction following neo-adjuvant chemotherapy-thoraco-abdominal vs. trans-abdominal approach.

PURPOSE: This study compares the short- and long-term outcomes between the left thoraco-abdominal and trans-abdominal approaches for radical resection of adenocarcinoma of the gastro-esophageal junction (GEJ) (Siewert types II and III) following neo-adjuvant chemotherapy. METHODS: A retrospective analysis of a prospectively maintained database of patients from May 2008 to December 2016. Demographic variables, perioperative outcomes, and survival were compared between two approaches. RESULTS: Of the 792 patients, who underwent total/proximal gastrectomy during the specified time interval, 162 had Siewert's type II/III lesions, of which 147 received neoadjuvant chemotherapy and were included in the study. Ninety-two and 55 patients underwent definitive surgery through trans-abdominal and left thoraco-abdominal approach respectively. On baseline endoscopy, 81.8% of patients in the left thoraco-abdominal group had lower esophageal mucosal infiltration as compared to 41.3% in the trans-abdominal group (p < 0.001). Both groups were comparable in terms of duration of surgery, blood loss, complications, severity of complications (Clavien-Dindo grade), duration of hospital stay, R0 resection rate, length of proximal margin, and lymph node yield. At a median follow-up of 24 months, there was no difference in recurrence rate and survival between the groups. CONCLUSION: Both left thoraco-abdominal and trans-abdominal are comparable surgical approaches for tumors involving the GEJ in terms of morbidity, perioperative, and long-term oncological outcomes. In patients with lower esophageal involvement, the left thoraco-abdominal approach is a feasible alternative with no added overall morbidity or mortality and can be preferred especially in cases, where a safe proximal margin and anastomosis is deemed technically challenging.

Prasugrel Versus Ticagrelor in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: a Systematic Review and Meta-analysis of Randomized Trials.

PURPOSE: Dual antiplatelet therapy (DAPT) with aspirin and ticagrelor or prasugrel is the mainstay of treatment for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). We aimed to systematically perform a head-to-head comparison of ticagrelor vs prasugrel in terms of efficacy and safety. METHODS: We searched PubMed/Medline, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) for relevant published randomized controlled trials (RCTs). The primary outcome was adverse cardiovascular events and secondary outcome was bleeding events. A random-effects meta-analysis was used to obtain the pooled estimate of each outcome. RESULTS: Nine RCTs with a total number of 6990 patients (3550 treated with prasugrel and 3481 treated with ticagrelor) were included. No significant difference between prasugrel and ticagrelor was observed in terms of mortality (OR 0.86, 95% CI 0.66 to 1.13, P = 0.28), major adverse cardiovascular events (MACEs) (OR 0.85, 95% CI 0.70 to 1.03, P = 0.10), non-fatal myocardial infarction (OR 0.78, 95% CI 0.57 to 1.06, P = 0.11), stroke (OR 1.02, 95% CI 0.60 to 1.72, P = 0.95), stent thrombosis (OR 0.76, 95% CI 0.47 to 1.21, P = 0.25), thrombolysis in myocardial infarction (TIMI) defined major (OR 0.94, 95% CI 0.19 to 4.67, P = 0.94), minor (OR 0.35, 95% CI 0.08 to 1.62, P = 0.18) and minimal (OR 0.48, 95% CI 0.19 to 1.18, P = 0.11) bleeding and Bleeding Academic Research Consortium (BARC) defined bleeding (OR 1.06, 95% CI 0.82 to 1.36, P = 0.68). CONCLUSION: In patients with ACS undergoing PCI, both prasugrel and ticagrelor were associated with similar cardiovascular outcomes and adverse bleeding events.

A Cost Variation Analysis of Drugs Available in the Indian Market for the Management of Thromboembolic Disorders.

Introduction Cardiovascular diseases (CVDs) have become one of the major causes of mortality among the Indian population. The costs of anticoagulant, antiplatelet, and fibrinolytic drugs that are used to treat various thromboembolic disorders and used as prophylactics for individuals at high risk of CVDs vary widely in the Indian pharmaceutical market. The aim of this study was to evaluate the cost variation of different brands of drug formulations and to compare the branded prices of the formulations with their corresponding generic and ceiling prices. Materials and methods This study followed an analytical method. Costs of various drugs were obtained from the October - December 2019 edition of the Current Index of Medical Specialities (CIMS) and December 2019 edition of the Monthly Index of Medical Specialities (MIMS) India. Cost ratio and percentage variation in cost per tablet/capsule/injection of different drugs available in the Indian market and manufactured by different pharmaceutical companies were calculated. Comparison of the branded prices with generic and ceiling prices was also performed for different drugs by using information available from official websites. Results Percentage variation in cost among the commonly prescribed drugs for the management of thromboembolic disorders was found to be highest for prasugrel 10 mg tablet (1,408.44%) while it was lowest for fondaparinux 2.5 mg / 0.5 ml injection (20%). Among the commonly prescribed drugs that are under Drugs Prices Control Order (DPCO) price control, streptokinase 1.5 MIU injection had the highest cost variation (132.02%) while enoxaparin 60 mg / 0.6 ml injection had the lowest (4.99%). Among some of the important formulations under the Jan Aushadhi scheme (JAS), acenocoumarol 2 mg tablet had the highest cost variation (680.09%) and cilostazol 50 mg tablet had the lowest (55.46%). Conclusions Wide differences exist in the costs of various anticoagulants, antiplatelets, and fibrinolytics available in the Indian market. The prescribing physician should be aware of theses variations and prescribe medicines accordingly, keeping in mind the financial status of the patients.