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关键词： acute coronary syndrome   cangrelor   high bleeding risk   P2Y12 inhibitors   percutaneous coronary intervention   ACS   Acute coronary syndrome   AKI   Acute kidney injury   BARC   Bleeding Academic Research Consortium   CAD   Coronary artery disease   CAMEO   Cangrelor in Acute MI: Effectiveness and Outcomes   CHAMPION   Cangrelor versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition   CHF   Congestive heart failure   GPI   Glycoprotein IIb/IIIa inhibitors   GUSTO   Global Use of Strategies to Open Occluded Coronary Arteries   HBR   High bleeding risk   IABP   Intra-aortic balloon pump   ICH   Intracranial hemorrhage   LVEF   Left ventricular ejection fraction   PCI   Percutaneous coronary intervention   SCAAR   Swedish Coronary Angiography and Angioplasty Registry   STE-ACS   ST-elevation acute coronary syndrome  

摘要： The safety and efficacy of cangrelor during percutaneous coronary intervention (PCI) in high-bleeding-risk (HBR) acute coronary syndrome (ACS) patients remain unclear. We evaluated the impact of cangrelor on outcomes after PCI in HBR ACS patients. ACS patients with data available to identify HBR status (per 2019 Academic Research Consortium criteria) who underwent PCI at our institution between 2018 and 2023 (n = 2509) were screened. Those presenting with cardiogenic shock or requiring thrombectomy or glycoprotein 2b/3a inhibitors during PCI were excluded (n = 201) and 1007 were categorized as HBR. In-hospital composite ischemic events (inpatient mortality, target vessel revascularization, stent thrombosis, and ischemic stroke) and major bleeding (intracranial hemorrhage, blood transfusion for hemoglobin drop >3g/dl) were compared between cangrelor and noncangrelor groups. The cohort had a mean age of 71.8 years and 54.5% were male. Cangrelor group had fewer chronic comorbidities but presented with higher acuity, with increased rates of ST-elevation (STE-ACS) (33.4% vs 6%, p <0.001), greater new-onset congestive heart failure (CHF) (10.3% vs 3.5%, p <0.001), intra-aortic balloon pump use (11.9% vs 4.4%, p <0.001), and new acute kidney injury (AKI) (10.9% vs 5.7%, p = 0.003). Multivariate analysis adjusting for age, STE-ACS, new onset CHF, and AKI showed similar ischemic (OR [CI]: 1.52 [0.68 to 3.27], p = 0.30) and major bleeding (OR [CI]: 1.65 [0.92 to 2.93], p = 0.09) outcomes among cangrelor and noncangrelor patients. In conclusion, cangrelor use in HBR ACS patients undergoing PCI was not associated with improved outcomes versus oral P2Y12 inhibitors, although similar event rates despite higher acuity in the cangrelor group may suggest potential benefit in select patients without added bleeding risk.

关键词： CAD-CAM   Cross-sectional studies   Dental prosthesis design   Dental technology   Dentist   Questionnaires  

摘要： Computer-aided design and computer-aided manufacturing (CAD/CAM) have transformed modern dentistry, yet evidence from the Caribbean remains limited.

关键词： EU-DEMO   Divertor   Eurofer97   Virtual prototyping   Systems engineering  

摘要： The EU-DEMO is one of the most ambitious projects of EUROfusion, aimed at designing a prototype of a nuclear fusion power plant. In 2025 a new Low-Aspect-Ratio (LAR) configuration has been introduced, replacing the past baseline by changing the aspect ratio (A) of the tokamak from 3.1 to 2.8. The LAR has several benefits from the divertor point of view, the main one is the lower heat load on the plasma facing components (PFCs). The peak heat flux to the divertor during reattachment decreased, with respect to the previous EU-DEMO configuration, by about 45%, from ≈82 MW/m² to ≈44 MW/m². This work presents the design of the divertor system in the LAR configuration by adopting System Engineering (SE) approach. Starting from previous baseline, the current design is updated with aim of improving the manufacturing, shielding and structural performances. Using the SE approach, previously implemented features can be transferred and modified in a rational way in the new LAR configuration. New PFCs have been proposed as well as new cooling layout for the cassette body. The inboard vertical target design has been modified based on the results obtained from the previous baseline, aiming to improve the shielding performance and reduce the temperature of the supports in normal operations.

关键词： coronary artery disease   chronic kidney disease   drug-coated balloon   drug-eluting stent   personalized therapy   ACS   acute coronary syndrome   BARC   Bleeding Academic Research Consortium   CAD   coronary artery disease   CI   confidence interval   CKD   chronic kidney disease   DAPT   dual antiplatelet therapy   DCB   drug-coated balloon   DES   drug-eluting stent   HR   hazard ratio   ISR   in-stent restenosis   MACE   major adverse cardiovascular events   MI   myocardial infarction   PCB   paclitaxel-coated balloons   PCI   percutaneous coronary intervention   PS   propensity score   SCB   sirolimus-coated balloons   TLR   target lesion revascularization   TVMI   target-vessel myocardial infarction  

摘要： Chronic kidney disease (CKD) is associated with adverse outcomes after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Drug-coated balloons (DCB) have emerged as a promising stentless alternative. This study aimed to compare the clinical outcomes of DCB-only PCI versus current-generation DES in patients with CKD. This pooled analysis integrated data from seven observational studies. The DCB cohort included the EASTBOURNE, Milan-DCB, RISE, and DRAGON registries. The DES cohort comprised the ULISSE, ASTUTE, RUDI-FREE, and DRAGON registries. The study population included 1.732 patients with CKD (eGFR <60 ml/min/1.73 m²), of whom 765 were treated with DCB and 967 with DES. The primary endpoint was major adverse cardiovascular events (MACE). Propensity score matching was applied to balance clinical and angiographic features. In the matched population (460 patients per group), the rate of MACE was similar between the two groups (hazard ratio [HR]: 1.09, 95% confidence interval: 0.71 to 1.66) at a mean follow-up of 564 days. DCB treatment was associated with a significantly lower incidence of Bleeding Academic Research Consortium major bleeding (HR 0.13; 95% confidence interval 0.03 to 0.48; p < 0.001). DCB-based PCI was associated with a lower risk of MACE in small-vessel disease (HR: 0.54; p for interaction = 0.04) and long (≥30 mm) lesions (HR: 0.44; p for interaction = 0.02). DCB treatment was associated with comparable rates of MACE at mid-term follow-up and a significantly lower incidence of major bleeding compared to current-generation DES in patients with CKD. These insights may facilitate a personalized revascularization approach in CKD patients.

关键词： Periodontal regeneration   Three-dimensional printing   CAD/CAM   Digital dentistry   Tissue engineering   Scaffolds  

摘要： This review aims to critically evaluate the current applications, advantages, limitations, and future prospects of 3D printing and computer-aided-design/computer assisted-manufacturing (CAD/CAM) technologies in periodontal regeneration.

摘要： The authors regret a discrepancy was identified between the sign convention described in the Methods and the sign used for computing pelvic axial rotation. Pelvic rotation values displayed in Fig. 3 were updated to reflect the correct sign convent...

关键词： 护坦   分块   配筋   CAD  

摘要： 针对水利工程中护坦分块与配筋设计依赖人工操作、效率低下且易受主观因素影响的问题,开展基于CAD的护坦分块及配筋软件研发,研究以护坦设计规范和工程实践经验为依据,结合C#编程技术,构建了集护坦参数化建模、自动分块、智能配筋及成果输出于一体的软件系统,显著提升了护坦分块与配筋设计的效率和精度,减少人工干预导致的误差,实现设计过程的标准化自动化,为护坦高效设计提供技术支持,具有较好的工程应用价值。

关键词： Digital dentistry   Digital overdenture   CAD/CAM   Monolithic denture  

摘要： The purpose of this retrospective pilot study was to evaluate patient-reported outcomes and satisfaction with palateless monolithic CAD/CAM implant-supported overdentures.

关键词： Dental implant   Cement-retained   CAD/CAM   Remnant cement   Implant abutment  

摘要： Purpose: To investigate the remnant cement in the subgingival regions (RCS) of abutments fabricated with different CAD/CAM parameters, including margin curvature radius, convergence angle, top fillet radius, and subgingival abutment shape. Methods: Twelve experimental groups were fabricated to test the following parameters: abutment margin curvature radii of 0.8 mm, 1.2 mm, and 1.6 mm;convergence angles of 4 degrees, 8 degrees, and 12 degrees;top fillet radii of 0.6 mm, 1.0 mm, and 1.4 mm;and subgingival abutment shapes of straight, S-curve, and concave. A constant amount of cement was injected into each crown. Vertical and continuous loads were applied to each specimen using a universal machine. RCS values were measured using a 3D intraoral scanner and an analytical balance. Statistical analysis was performed using one-way analysis of variance followed by post hoc Tukey test (alpha = .05). Results: Regarding margin curvature radius, RCS values were significantly higher in the order of 1.6 mm, 1.2 mm, and 0.8 mm (P < 0.001). For convergence angle, higher RCS values were observed at 12 degrees > 8 degrees > 4 degrees(P < 0.001). Among subgingival abutment shapes, concave yielded the highest RCS values, followed by S-curve and straight (P < 0.001). No significant differences in RCS values were found among the groups with different top fillet radii (P > 0.05). Conclusions: Within the limitations of this study, a smaller margin curvature radius, smaller convergence angle, and straight subgingival shape were associated with reduced RCS length, surface area, and weight.

关键词： Breast cancer cells   Carbonylation   Cell migration   Protein phosphatase   Pyrogallol  

摘要： CaM kinase phosphatase (CaMKP/PPM1F/POPX2) is widely expressed in various tissues and organs, and increasing evidence suggests its involvement in the pathogenesis of several diseases, including cancers. In this study, we identified a class of natural polyphenolic compounds with a pyrogallol structure as potent inhibitors of CaMKP. These compounds selectively inhibited CaMKP via protein carbonylation, while showing negligible effects on PPM1A or λ-phosphatase. Among the polyphenols tested, dihydromyricetin, myricetin, and delphinidin potently inhibited CaMKP, with dihydromyricetin being more potent than ethyl gallate, which was recently reported as a selective CaMKP inhibitor. The carbonylation of CaMKP by these polyphenols was restored by a free radical scavenger, cysteamine, suggesting that this inhibitory process involves free radical-mediated oxidative reactions. Taxifolin, an analogue of dihydromyricetin lacking one phenolic hydroxy group, failed to induce the carbonylation or inhibition of CaMKP, indicating the essential role of the pyrogallol moiety. Consistent with these findings, dihydromyricetin and myricetin significantly inhibited the migration of CaMKP-overexpressing MDA-MB-231 breast cancer cells, whereas their structural analogues taxifolin and quercetin showed no or only weak inhibitory effects. In addition, some other pyrogallol-containing polyphenols tested (delphinidin, scutellarein, baicalein) also exhibited significant inhibitory effects. In contrast, these polyphenols showed little to no inhibitory effects on the migration of T47D cells, in which CaMKP expression level is relatively low. Notably, the inhibition of migration by these pyrogallol-containing polyphenols, except quercetin, was not accompanied by significant cytotoxicity. Thus, these polyphenols are promising candidates for suppressing CaMKP-dependent cancer metastasis with minimal side effects.