Incidence and Long-Term Outcomes of Acute Myocardial Infarction Among Survivors of Out-of-Hospital Cardiac Arrest.

BACKGROUND: Despite the increasing long-term survival after out-of-hospital cardiac arrest (OHCA), the risk of subsequent acute myocardial infarction (AMI) remains poorly understood. We aimed to determine the incidence, predictors, and long-term outcomes of AMI among survivors of OHCA. METHODS AND RESULTS: We assembled a retrospective cohort of 882 patients with OHCA who survived to 30 days or discharge from the hospital between 2010 and 2019. Survivors of OHCA had an increased risk of subsequent AMI, defined as AMI occurring 30 days after index OHCA or following discharge from the hospital after OHCA, compared with the general population when matched for age and sex (standardized incidence ratio, 4.64 [95% CI, 3.52-6.01]). Age-specific risks of subsequent AMI for men (standardized incidence ratio, 3.29 [95% CI, 2.39-4.42]) and women (standardized incidence ratio, 6.15 [95% CI, 3.27-10.52]) were significantly increased. A total of 7.2%, 8.3%, and 14.3% of survivors of OHCA had a subsequent AMI at 3 years, 5 years, and end of follow-up, respectively. Age at OHCA (hazard ratio [HR], 1.04 [95% CI, 1.02-1.06]) and past medical history of prior AMI, defined as any AMI preceding or during the index OHCA event (HR, 1.84 [95% CI, 1.05-3.22]), were associated with subsequent AMI, while an initial shockable rhythm was not (HR, 1.00 [95% CI, 0.52-1.94]). Survivors of OHCA with subsequent AMI had a higher risk of death (HR, 1.58 [95% CI, 1.12-2.22]) than those without. CONCLUSIONS: Survivors of OHCA are at an increased risk of subsequent AMI compared with the general population. Prior AMI, but not an initial shockable rhythm, increases this risk, while subsequent AMI predicts death. Preventive measures for AMI including cardiovascular risk factor control and revascularization may thus improve outcomes in selected patients with cardiac pathogenesis.

Magneto-optical detection of spin accumulation under the influence of mechanical rotation.

The generation of spin-polarised carriers in a non-magnetic material holds the key to realise highly efficient spintronic devices. Recently, it has been shown that the large spin-orbit coupling can generate spin-polarised currents in noble metals such as tungsten and platinum. Especially, if small samples of such metals are rotated on a plane disc in the presence of a perpendicular magnetic field, the orbital angular momentum is altered leading to a segregation of spin up and spin down electrons, i.e., a spin current in the samples. This is manifested via an induced magnetic moment on the metal. In this letter, magneto-optical Kerr effect (MOKE) is used to detect induced magnetic moments which allows remote measurements on metal samples rotating at 100~210 Hz. Our results confirm the mechanical generation of spin-polarised currents via optical detection of spin accumulation.

Antenna and coil design for wireless signal detection and charging of embedded power active contact lens.

This paper presents a screen printed 2.4 GHz antenna and induction charging coil for an active contact lens with a single large pixel user display and on-board 3.8 V 5 uAh rechargeable battery. The antenna traces are printed using silver conductive paste on a 25 um polyethylene terephthalate (PET) substrate. The incoming signal from the antenna feeds into an IC that amplifies and rectifies the signal. The coil provides wireless energy transfer to inductively charge a thin film battery [1] located on the contact lens. The printed antenna achieved a S11 of -4 dB at 2.4 GHz and a gain of -13 dB.

Self-assembling semiconducting polymers--rods and gels from electronic materials.

In an effort to favor the formation of straight polymer chains without crystalline grain boundaries, we have synthesized an amphiphilic conjugated polyelectrolyte, poly(fluorene-alt-thiophene) (PFT), which self-assembles in aqueous solutions to form cylindrical micelles. In contrast to many diblock copolymer assemblies, the semiconducting backbone runs parallel, not perpendicular, to the long axis of the cylindrical micelle. Solution-phase micelle formation is observed by X-ray and visible light scattering. The micelles can be cast as thin films, and the cylindrical morphology is preserved in the solid state. The effects of self-assembly are also observed through spectral shifts in optical absorption and photoluminescence. Solutions of higher-molecular-weight PFT micelles form gel networks at sufficiently high aqueous concentrations. Rheological characterization of the PFT gels reveals solid-like behavior and strain hardening below the yield point, properties similar to those found in entangled gels formed from surfactant-based micelles. Finally, electrical measurements on diode test structures indicate that, despite a complete lack of crystallinity in these self-assembled polymers, they effectively conduct electricity.

Using polymer conformation to control architecture in semiconducting polymer/viral capsid assemblies.

Cowpea chlorotic mottle virus is a single-stranded RNA plant virus with a diameter of 28 nm. The proteins comprising the capsid of this virus can be purified and reassembled either by themselves to form hollow structures or with polyanions such as double-stranded DNA or single-stranded RNA. Depending on pH and ionic strength, a diverse range of structures and shapes can form. The work presented here focuses on using these proteins to encapsulate a fluorescent polyanionic semiconducting polymer, MPS-PPV (poly-2-methoxy-5-propyloxy sulfonate phenylene vinlyene), in order to obtain optically active virus-like particles. After encapsulation, fluorescence from MPS-PPV shows two distinct peaks, which suggests the polymer may be in two conformations. A combination of TEM, fluorescence anisotropy, and sucrose gradient separation indicate that the blue peak arises from polymer encapsulated into spherical particles, while the redder peak corresponds to polymers contained in rod-like cages. Ionic strength during assembly can be used to tune the propensity to form rods or spheres. The results illustrate the synergy of hybrid synthetic/biological systems: polymer conformation drives the structure of this composite material, which in turn modifies the polymer optical properties. This synergy could be useful for the future development of synthetic/biological hybrid materials with designated functionality.

Exploiting fluorescent polymers to probe the self-assembly of virus-like particles.

The inside surfaces of the protein shells of many viruses are positively charged, thereby enhancing the self-assembly of capsid proteins around their (oppositely charged) RNA genome. These proteins have been shown to organize similarly around a variety of nonbiological, negatively charged, polymers, for example, poly(styrene sulfonate) (PSS), forming virus-like particles (VLPs). We have demonstrated recently that the VLPs formed from cowpea chlorotic mottle virus (CCMV) capsid protein increase in size (from T=2 to T=3 structures) upon increase in PSS molecular weight (from 400 kDa to 3.4 MDa), and that the total charge on the PSS exceeds that of the capsid protein by as much as a factor of 9. Here, we extend studies of this kind to PSS molecules that are sufficiently small that two or more can be packaged into VLPs. The use of 38 kDa PSS polymers that have been fluorescently labeled with Rhodamine B allows us to determine the number of PSS molecules per capsid. Electron micrographs of the VLPs show a bimodal distribution of particle diameters, with one peak centered around 19 nm, typical of a T=1 triangulation number, and the other around 21 nm, consistent with a pseudo T=2 structure; increasing the molar ratio of protein to PSS in the reaction mix shifts the VLP distribution from T=1 to T=2 structures. By combining fluorescence and gel electrophoresis measurements, it is determined that, on average, there are two polymers in each T=1 capsid and three in each T=2, with the PSS charge less than that of the capsid protein by as much as a factor of 2. VLPs of this kind provide a versatile model system for determining the principles underlying self-assembly of controlled numbers of cargo molecules in nanocontainers of increasing size.

Vaults are dynamically unconstrained cytoplasmic nanoparticles capable of half vault exchange.

Vaults are naturally occurring ribonucleoprotein particles with an enormous interior volume, large enough to encapsulate hundreds of proteins. They are highly conserved and are present in nearly all eukaryotic cells ranging from 10(4) to 10(7) particles per cell. Recombinant vaults can be produced in vitro and engineered to allow cell targeting and protein packaging. These nanometer-sized particles have many desirable characteristics that may give them advantages for use as drug delivery vehicles. Using photoactivatable green fluorescent protein (PAGFP) labeled vaults, we demonstrate that the particles rapidly diffuse throughout the cytoplasm following single pixel photoactivation in live cells. Their in vivo movement remained relatively unchanged despite exposure to a variety of cellular stresses, suggesting that vaults are largely unconstrained in the cytoplasm. Fluorescence resonance energy transfer (FRET) was observed from polyethylene glycol (PEG) fused hybrid cells that expressed either CFP or YFP labeled vaults, indicating that vaults can exchange major vault protein (MVP) subunits in vivo. Investigation into the mechanism of this exchange in vitro using recombinant vaults demonstrated that they were capable of rapidly separating at the particle waist and reassembling back into whole vaults, supporting a half vault exchange mechanism. This data suggests a means whereby vaults can functionally interact with their cellular environment and deliver materials packaged within their interior.

Encapsulation of semiconducting polymers in vault protein cages.

We demonstrate that a semiconducting polymer [poly(2-methoxy-5-propyloxy sulfonate phenylene vinylene), MPS-PPV] can be encapsulated inside recombinant, self-assembling protein nanocapsules called "vaults". Polymer incorporation into these nanosized protein cages, found naturally at approximately 10,000 copies per human cell, was confirmed by fluorescence spectroscopy and small-angle X-ray scattering. Although vault cellular functions and gating mechanisms remain unknown, their large internal volume and natural prevalence within the human body suggests they could be used as carriers for therapeutics and medical imaging reagents. This study provides the groundwork for the use of vaults in encapsulation and delivery applications.

Reversible pH lability of cross-linked vault nanocapsules.

Vaults are ubiquitous, self-assembled protein nanocapsules with dimension in the sub-100 nm range that are conserved across diverse phyla from worms to humans. Their normal presence in humans at a copy number of over 10,000/cell makes them attractive as potential drug delivery vehicles. Toward this goal, bifunctional amine-reactive reagents are shown to be useful for the reversible cross-linking of recombinant vaults such that they may be closed and opened in a controllable manner.