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BACKGROUND A prediction model from the US Framingham Heart Study (FHS) population has been established to estimate an individual’s risk of developing hypertension. However, this model has not been widely tested in other cohorts. In this study, we examined the predictive capability of the FHS prediction model in a rural Chinese population. METHODS A total of 24,434 rural Chinese adults aged ≥35 years, without prevalent hypertension, diabetes mellitus, stroke, and coronary heart disease at baseline, were followed for the incidence of hypertension. Standard clinical examinations of blood pressure, weight and height, smoking status, and parental history of hypertension were observed biennially. RESULTS The mean age was 47.9 (SD = 10.2) years, and 49.5% of subjects were women. During a median 4.8 years of follow-up, we recorded a total of 8,675 incident hypertension cases. The cumulative 2-year and 4-year hypertension incidence rates were 7.7% and 25.6%, respectively. The C statistics for the 2-year and 4-year incidences of hypertension were 0.537 (95% confidence interval (CI) = 0.524–0.550) and 0.610 (95% CI = 0.602–0.618) for the FHS model, respectively. The Hosmer–Lemeshow χ2 test results for 2-year and 4-year incidence of hypertension were 2,287.7 (P < 0.0001) and 8,227.1 (P < 0.0001), respectively. Sensitivity analysis indicates that the FHS prediction model still has a poor performance, although the predictive ability was better than for the overall population. CONCLUSIONS The FHS hypertension prediction model is not a valid tool with which to estimate the risk of incidence of hypertension among the rural Chinese population. A new hypertension risk equation for the rural Chinese population is needed. [ABSTRACT FROM PUBLISHER]

BACKGROUND Hypertension is a definitive risk factor for stroke. We examined the associations between hypertension subtypes and stroke incidence in rural Chinese adults. METHODS We conducted a prospective study in a sample of 38,949 rural Chinese adults aged ≥35 years and free from stroke at baseline. The subtypes of hypertension were defined as isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), systolic and diastolic hypertension (SDH), and managed hypertension (MHT). The relative risks of stroke with the subtypes of hypertension, compared with normotensive subjects, were estimated using the Cox model after adjusting for age, sex, and other confounders. RESULTS The prevalence of hypertension was as follows: SDH = 18.6%, ISH = 10.2%, IDH = 5.8%, and MHT = 0.4%. During a total of 168,023 person-years of follow-up, 858 subjects developed stroke. The incidence rate per 100,000 person-years of overall first-ever stroke was 510.6. The SDH group was at the highest risk of stroke among all the hypertensive subjects. The hazard ratio was 2.13 (95% confidence interval (CI) = 1.78–2.55) for all stroke, 2.74 (95% CI = 2.08–3.60) for hemorrhagic stroke, and 1.92 (95% CI = 1.50–2.45) for ischemic stroke. CONCLUSIONS SDH patients warrant the most attention for prevent of stroke. However, ISH and IDH are also independent predictors of stroke. The risk factors for stroke, especially hypertension, were not controlled in the rural population we studied. More aggressive efforts to control the risk factors for stroke in rural areas are needed. [ABSTRACT FROM PUBLISHER]

The label-free detection and analysis of cancer cells using portable biosensing devices is crucial and promising. In this study, a novel reusable biosensing platform with a microfluidic-like based on terahertz plasmonic metasurfaces utilizing graphene integrated with an all-silicon groove for detecting liquid live cancer cells was developed. The proposed biosensor platform stands out because it can differentiate between the concentrations of three types of cancer cells by monitoring changes in resonance intensity and phase difference. The minimum concentration for identification was reduced to as low as 5 × 104 cells/mL. We effectively constructed two-dimensional optical intensity cards using continuous wavelet transforms, which presented a more accurate approach for the recognition and determination of the three types of cancer cells. Our proposed biosensors show great potential for the determination and recognition of label-free cancer cells in aqueous environments as alternatives to non-immune biosensing technology. [Display omitted] • A reusable THz sensor for detecting liquid cancer cells was proposed. • The sensor based on microfluidic utilizing graphene integrated with silicon groove. • The sensor can achieve ultra-sensitive detection of cancer cell concentrations. • The optical intensity cards were constructed for the recognition of cancer cells. [ABSTRACT FROM AUTHOR]

The tunnelling oxide passivation contact (TOPCon) solar cells have been impressive in the global photovoltaic (PV) market originating from their high efficiency and stability. However, it exhibits significant recombination losses due to its boron diffusion, laser damage and metal-semiconductor contact on front side. The bifacial TOPCon structure demonstrates massive potential in the improvement of passivation and contact performance with the premise that it can solve the parasitic absorption of polycrystalline silicon (poly-Si). In this study, the localized poly finger structure with excellent optics and passivation performance is designed in the front side of bifacial solar cells to compare with traditional TOPCon and full-area poly passivation devices. The theoretical efficiency and detailed power loss analysis in our simulation reveal that suppressing the recombination of FSF (front surface field) and the contact area is the crucial strategy to improve device performance, with optimized efficiency of 26.62 % and FF of 85.16 %. These results indicate that the route of BJ (back junction) structure containing localized selective contact and full coverage high-quality passivation holds potential in realizing both high J sc and V oc for FBC (front and back contact) solar cells, featuring great instructive significance for future industrialization of PV production. • The FELA of bifacial and traditional TOPCon solar cells is analyzed by simulation. • The optimization strategy of front poly-finger is explored to improve performance. • Contact mapping of device is investigated with bulk dopant and band bending. • The outlook and upgrade strategy of poly-Si(p) finger, ALD and LECO technology. [ABSTRACT FROM AUTHOR]

Cashew nut allergy shows an increasing prevalence along with its high consumption. Nowadays, food allergy still has no cure, and allergen avoidance is still the standard management, urging a sensitive and convenient cashew nut detection method. Herein, saltatory rolling circle amplification (SRCA), loop-mediated isothermal amplification (LAMP), as well as polymerase chain reaction (PCR) targeting the Ana o 2 gene were proposed and compared. In addition, a closed-tube SRCA assay using hydroxynaphthol blue (HNB) as a color indicator (HNB-SRCA) was developed to realize visual on-site detection of cashew nut. SRCA and HNB-SRCA can detect 75.3 fg of cashew nut DNA, which is 10- and 100-times more sensitive than LAMP and PCR, respectively. SRCA and HNB-SRCA exhibited a relative sensitivity of 0.01% in a binary mixture, which is comparable to LAMP and 10-times higher than that of PCR. When combined with a rapid DNA extraction method, SRCA and HNB-SRCA performed better applicability compared to LAMP and PCR. Additionally, compared to SRCA using electrophoresis to analyze the amplification products, the visual closed-tube HNB-SRCA combined with the rapid DNA extraction protocol is a better potential cashew nut on-site detection strategy in foods. • A rapid visual HNB-SRCA for on-site detection of cashew nut has been developed. • HNB-SRCA assay exhibits high sensitivity, detection 75.3 fg of target DNA. • The present assay exhibits high applicability for the rapid DNA extraction process. [ABSTRACT FROM AUTHOR]

Background: Few studies investigate sex difference in stroke incidence in rural China hypertensive population. Methods: A total of 5097 hypertensive patients aged ≥35 years (mean age, 56.3 ± 11.2 years; 43.8% men) were included in our analysis with a median follow-up 8.4 years in Fuxin county of Liaoning province in China. Cox proportional hazard models were used to analyze the association between the potential factors and incident stroke. Results: We observed 501 new strokes (310 ischemic, 186 hemorrhagic, and 5 unclassified stroke) during the follow-up. The overall incidence of stroke was 1235.21 per 100,000 person-years; for men, the rates were 1652.51 and 920.80 for women. This sex difference in all stroke can be explained by approximately 25% through age, systolic blood pressure, body mass index, low-density lipoprotein-cholesterol, current smoking, current drinking, antihypertensive drugs, education and physical activity. Subgroup analysis indicated that in hemorrhagic stroke this sex difference was more remarkable (63.89% can be explained). Conclusions: The incidence of stroke was higher in men than that in women and this difference was partly explained by several traditional cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

The development of efficient all perovskite tandem solar cells has faced challenges related to current matching and optical losses. In this work, a design of a non‐coplanar three‐terminal (3T) all perovskite tandem solar cell is presented, which consists of a p‐i‐n inverted NiOX‐based CsPbI2Br perovskite top cell, and a FA0.6MA0.4Sn0.5Pb0.5I3 perovskite bottom cell with back‐contact (BC) device structure. It effectively mitigated the optical losses introduced in non‐absorbing layers and resulted in a 2.9% absolute efficiency improvement compared to that of planar sandwich‐type 3T tandems. Both optical and electrical characteristics of the multi‐terminal tandem cells are investigated. Then, it is focused on understanding the impact of top cell thickness on overall non‐coplanar BC 3T‐tandem performance, considering low‐energy photon optical reflection and carrier transport distance. Following optimizations of energy level and device structure, an efficiency of 32.16% is achieved, with non‐coplanar BC 3T device architecture: top cell consisting of hole extraction layer (ITO/NiOx), CsPbI2Br absorber layer, and electron extraction layer (ZnO/FA0.6MA0.4Sn0.5Pb0.5I3/SnO2/Ag); and bottom cell (Ni/NiOx/FA0.6MA0.4Sn0.5Pb0.5I3/SnO2/Ag); bottom perovskite layer has two functions, one is electron transport layer for top cell, and the other is low‐energy photon absorption layer in bottom cell. It provides insight and a promising pathway for manufacturing high‐efficient all perovskite tandem solar cells. [ABSTRACT FROM AUTHOR]

Background: Studies have shown that non-traditional lipid profiles have a better association with stroke than traditional blood lipids in clinical applications, other studies have drawn different conclusions. Methods: This study was a large-scale study with a median follow-up of 8.4 years. The hazard ratio (HR) and 95% Confidence interval (CI) of lipid variables for risk of incident stroke were analyzed by multivariable Cox proportional hazard models. Results: During the follow-up, 502 new strokes (310 ischemic, 187 hemorrhagic, and 5 unclassified strokes) occurred among the 5099 hypertensive patients. Comparing with the lowest quarter, the HR of future ischemic stroke (IS) in the highest were 1.41(95%CI, 1.03–1.92) for TC, 1.60 (95%CI, 1.15–2.22) for TG, 1.03 (95%CI, 0.75–1.42) for HDL-C, 1.77 (95%CI, 1.29–2.44) for LDL-C, 1.42 (95%CI, 1.03–1.94) for non-HDL, 2.09 (95%CI, 1.45–3.00) for TC/HDL, 2.08 (95%CI, 1.46–2.96) for LDL/HDL, 1.86 (95%CI 1.33–2.60) for TG/HDL, respectively. No significant association was observed between lipid-related indicators and hemorrhagic stroke. The results of statistical differences showed that the correlation between LDL/HDL and the risk of ischemic stroke in non-traditional lipids was higher than that of other traditional lipids (P < 0.001), except for LDL (P = 0.056). Conclusions: We didn't find that HDL was associated with the risk of stroke and all the lipid parameters were not associated with the risk of hemorrhagic stroke. LDL/HDL was associated with a higher risk of ischemic stroke than other lipids and should be considered for clinical diagnosis and future disease prevention. [ABSTRACT FROM AUTHOR]

Background: Stroke has a high fatality and disability rate, and is one of the main burdens to human health. It is thus very important to identify biomarkers for the development of effective approaches for the prevention and treatment of stroke. Connexin37 is an anti-inflammatory cytokine and is involved in chronic inflammation and atherosclerosis. Recent studies have found that CONNEXIN37 gene variations are associated with atherosclerosis diseases, such as coronary heart disease and stroke, but its association with stroke in distinct human populations remains to be determined. We report here the analysis of the association of the single nucleotide polymorphisms (SNPs) of CONNEXIN37 with ischemic stroke in Han Chinese population. Methods: Two SNPs of CONNEXIN37 gene were analyzed in 385 ischemic stroke patients and 362 hypertension control patients using ligase detection reaction (LDR) method. Results: Logistic regression analysis demonstrated that, AG and GG genotypes of SNP rs1764390 and CC genotype of rs1764391 of CONNEXIN37 were associated with an increased risk of ischemic stroke, and that G allele of rs1764390 is a risk factor for ischemic stroke. Further, we found that SNP rs1764390 and SNP rs1764391 in CONNEXIN37 were associated with ischemic stroke under additive/dominant model, and recessive/dominant model, respectively. Conclusion: Our results indicate that CONNEXIN37 gene polymorphism is an ischemic stroke risk factor in Northern Han Chinese. [ABSTRACT FROM AUTHOR]

In crystalline silicon (c‐Si) solar cells, the hole transport layer (HTL) made of high oxygen content MoOx (x > 2.85, H‐MoOx) evaporating from molybdenum trioxide is not ideal due to low optical bandgap and interface reaction effects. This limits the power conversion efficiency (PCE) and stability of c‐Si solar cells. To improve this, low oxygen content MoOx (x < 2.85, L‐MoOx) with a wide bandgap of 3.87 eV, deposited using molybdenum dioxide (MoO2), is explored and implemented. The c‐Si/SiOx (FGA, forming gas annealing)/L‐MoOx heterojunction has a low contact resistivity of ≈15.06 mΩ cm2, which is almost one order of magnitude lower than that of c‐Si/SiOx(FGA)/H‐MoOx heterojunction. Using L‐MoOx as the HTL, a c‐Si solar cell based on the SiOx passivation layer shows a fill factor of 84.38% and PCE of 21.75%, representing the highest efficiency for MoOx‐based p‐type c‐Si solar cells. Scanning transmission electron microscopy results show that the L‐MoOx HTL effectively enhances the stability of c‐Si solar cells when exposed to air by reducing Ag and Si element diffusion into MoOx. This successful preparation of efficient and stable MoOx HTL films, while preserving their field‐effect passivation ability, provides valuable insights into the development of high‐performance HTL. [ABSTRACT FROM AUTHOR]

Objective: Accumulation evidence has reported that olfactory impairment may be an essential clinical marker and predictor of mild cognitive impairment or Alzheimer's disease. Method: Participants were enrolled in the population‐based, prospective study in Fuxin county, Liaoning province, China between 2019 and 2021. An inverse probability weighting logistic regression and mixed‐effect models were performed to explore the association between dysosmia and cognition and rate of change in cognition, respectively. Besides, we utilized the Robust Rank Aggregation method to integrated three eligible datasets from the Gene Expression Omnibus to identify differential expressed genes. Results: A total of 4695 participants were enrolled and 4221 of those were eligible for our cross‐sectional study. The mean (SD) age was 59.93(9.78) years, 64.8% were men. Over a 2‐year follow‐up, of the 2088 participants who completed follow‐up, 1559 participants were eligible for our longitude cohort study. We observed an association between dysosmia and an increased risk of cognitive impairment (OR, 0.47, [95% CI, 0.35–0.64]; p < 0.001). The OR (95% CI) for cognition in females with dysosmia was higher than (OR, 0.73[0.51, 1.05], p =.007) that for males with dysosmia (OR, 0.25[0.15, 0.42], p < 0.001; P for interaction <0.001). Dysosmia was also associated with more rapid decline in calculation ability (p < 0.001). Besides, several DEGs were identified, which are mainly associated with olfactory transduction, detection of chemical stimulus involved in sensory perception of smell, sensory perception of smell, olfactory receptor activity and odorant binding. Interpretation: These findings proved novel insight into identifying olfactory dysfunction as potential biomarker for diagnosis of cognitive impairment. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted to establish and validate a non-contrast T1 map–based radiomic nomogram for predicting major adverse cardiac events (MACEs) in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). Methods: This retrospective study included 157 consecutive patients (training sets, 109 patients; test sets, 48 patients) with acute STEMI undergoing PCI. An open-source radiomics software was used to segment the myocardium on the non-contrast T1 mapping and extract features. A radiomic signature was constructed to predict MACEs using the least absolute shrinkage and selection operator method. The performance of the radiomic nomogram for predicting MACEs in both the training and test sets was evaluated by its discrimination, calibration, and clinical usefulness. Results: The radiomic signature showed a good prognostic ability in the training sets with an AUC of 0.94 (95% CI, 0.86 to 1.00) and F1 score of 0.71, which was confirmed in the test sets with an AUC of 0.90 (95% CI, 0.74 to 1.00) and F1 score of 0.62. The nomogram consisting of the radiomic scores and cardiac troponin I showed good discrimination ability in the training and test sets with AUCs of 0.96 (95% CI, 0.91 to 1.00; F1 score, 0.71) and 0.94 (95% CI, 0.83 to 1.00; F1 score, 0.70), respectively. Conclusions: The non-contrast T1 map–based radiomic nomogram is a useful tool for the prediction of MACEs in patients with acute STEMI undergoing PCI that can assist clinicians for optimised risk stratification of individual patients. Key Points: • Radiomic signature improved MACE prediction in acute STEMI patients. • T1 mapping–derived radiomic signature outperformed conventional cardiac MRI parameters in predicting MACEs in acute STEMI patients. • The non-contrast T1 mapping–based radiomic nomogram can be used for prediction of MACEs and improvement of risk stratification in acute STEMI. [ABSTRACT FROM AUTHOR]

Systolic blood pressure increased in middle-aged person contributes significantly to the risk of major adverse cardiovascular events (MACE). Meanwhile, different patterns (short- or long-term change) of SBP increase may result in differential risk and lead to differences in predictive ability. A total of 19,544 and 22,610 participants in the Fuxin Cardiovascular Cohort Study underwent measurement of SBP at 2 examinations for short- and long-term change study population. Cox proportional hazards models were used to relate future clinical outcomes with change in SBP. During a median follow-up period of 12.5 years, 1064 (772 stroke, 247 myocardial infarction, 528 CVD deaths) and 1316 (958 stroke, 301 myocardial infarction, 660 CVD deaths) MACE were identified during short- and long-terms SBP change, respectively. For SBP increased participants, short-term change in SBP was associated with future MACE (hazard ratio [HR]: 1.241 per 1-SD increase; 95% confidence interval [CI]: 1.146–1.344; P < 0.001), long-term change in SBP (HR: 1.218; 95% CI: 1.123–1.322; P < 0.001). For prehypertension participants, long-term changes conferred a strong impact than short-term. For hypertensive participants, short-term changes conferred a strong impact than long-term. Having a SBP rise in short- or long-term both confer an increased risk of MACE and its subgroups. Furthermore, short- and long-term SBP increase patterns adds different additional information beyond one single baseline examination. Change in SBP may be a prognostic surrogate marker and future studies are needed to clarify the possible mechanism for predicting MACE. • Having a SBP rise in short- or long-term both conferred an increased risk of MACE. • For prehypertension patients, SBP long-term change had a more powerful predictive ability than short-term change on MACE. • For hypertension patients, SBP short-term change had a more powerful predictive ability than long-term change on MACE. [ABSTRACT FROM AUTHOR]

Background: Even though the effectiveness of lifestyle modifications and antihypertensive pharmaceutical treatment for the prevention of hypertension and its complications have been demonstrated in randomized controlled trials, the benefits of adhering to these treatments have not been popularized among the general public. Studies suggest that incentive approaches based on behavioral economic concepts can improve patients' adherence to treatment. Therefore, we aimed to test whether financial incentives will reduce the blood pressure (BP) of hypertensive patients in China.Methods/design: This is a multicenter, randomized controlled trial with two parallel arms. A total of 400 participants from six cities in the Liaoning and Shanxi provinces of China are block-randomized into intervention and control group with a 1:1 ratio. Patients in the control group will receive interactive management of mobile devices, including patient education and communication. Patients in the intervention group will receive financial incentives in addition to interactive management of mobile devices, conditional on them achieving their antihypertensive goals or hypertension control. Masking the arm allocation will be precluded by the behavioral nature of the intervention and investigators of BP measurement and statistics are masked to clinic assignment. The primary outcome is net change in systolic BP (SBP) from baseline to month 12 between the intervention and control groups. The secondary outcomes are net change in diastolic BP (DBP), BP control, change in medication adherence and lifestyle, and cost-effectiveness.Discussion: This trial will determine whether financial incentives will improve hypertension control and generate necessary data for controlling hypertension and concomitant cardiovascular diseases among hypertensive patients in China.Trial Registration: ISRCTN13467677. Registered on 16 May 2019. [ABSTRACT FROM AUTHOR]

Abstract Background and aims Recent studies have shown that trimethylamine N-oxide (TMAO) is a risk factor for cardiovascular disease (CVD) in different clinical settings, but few studies confirmed the association in a community-based general population. Methods This is a nested case-control study from a prospective cohort design. A total of 86 newly diagnosed CVD cases with a median follow-up period of 4.83 years and 86 matched controls were selected for the present analysis. Results Using the LC-MS/MS assays, we found that new CVD cases had a higher baseline levels of TMAO than controls [median (inter-quartile): 1.57 (0.79–2.29) μmol/L v.s 0.68 (0.23–1.40) μmol/L, p < 0.001]. After multivariable adjustment, individuals with TMAO ≥1.89 μmol/L (Q4) and 1.05–1.89 μmol/L (Q3) had odds ratio (OR) for CVD of 2.735 [95% confidence interval (CI): 1.328–5.630] and 2.544 (95% CI: 1.251–5.172) with the lowest quartile (<0.43 μmol/L) as reference. In addition, comparisons of areas under receiver operator characteristics curves confirmed that a model including TMAO had a better discrimination than one without (0.732 vs. 0.664, p = 0.045). Conclusions In the community-based general population, there was a positive association between TMAO and future risk of CVD. Addition of TMAO improved the prediction of CVD beyond traditional risk factors. We recommend considering TMAO as a potential novel preventive target in the management of low-risk CVD adults. Graphical abstract Image 1 Highlights • TMAO has a dose-dependent relationship with risk of CVD in the general population. • Addition of TMAO significantly improved the predictive ability of CVD risk. • TMAO is a potential novel preventive target for low-risk CVD adults. [ABSTRACT FROM AUTHOR]

Background Mean platelet volume to platelet count ratio (MPV/P ratio) has been demonstrated to be a predictor of adverse outcome in patients with non-ST-segment elevation myocardial infarction (NSTEMI). We aimed to assess whether MPV/P ratio is a useful marker to predict long-term prognosis in NSTEMI patients undergoing PCI. Moreover, the prognostic accuracy of MPV/P ratio was compared with MPV and GRACE score. Methods In a retrospective cohort study, according to the baseline MPV/P values, 887 consecutive NSTEMI patients undergoing PCI were divided into two groups: the high MPV/P group ( n = 296, MPV/P ≥ 0.054) and the low MPV/P group ( n = 591, MPV/P < 0.054). Clinical endpoints were all-cause mortality and all-cause mortality/nonfatal reinfarction. Results Multivariate analysis showed that high MPV/P was an independent predictor of all-cause mortality [HRs: 1.973, 95% CI: 1.528–2.549, P < 0.001], and all-cause mortality/nonfatal myocardial reinfarction [HRs: 1.289, 95% CI: 1.181–1.408, P < 0.001]. MPV/P ratio has good accuracy for predicting clinical endpoints. The discriminatory performance of MPV/P ratio was similar to GRACE score but better than MPV (for all-cause mortality: MPV/P vs. GRACE: z = 0.205, p = 0.837; MPV/P vs. MPV: z = 2.677, p = 0.008; GRACE vs. MPV: z = 3.017, p = 0.003; for all-cause mortality/nonfatal myocardial: MPV/P vs. GRACE: z = 1.098, p = 0.272; MPV/P vs. MPV: z = 4.026, p < 0.001; GRACE vs. MPV: z = 4.962, p < 0.001). Conclusions MPV/P ratio was similar to GRACE score but better than MPV for predicting all-cause mortality and all-cause mortality/nonfatal myocardial reinfarction in NSTEMI patients undergoing PCI. However, MPV/P ratio is easier to calculate than GRACE score. [ABSTRACT FROM AUTHOR]

Abstract: Background: It is necessary to develop a new thrombolytic agent which can be used by a single bolus at first aid sites to decrease the time to reperfusion in clinical practice. HTUPA, a genetically engineered new thrombolytic with a longer half-life, is well qualified. We aim to compare the thrombolytic efficacy and safety of human tissue urokinase type plasminogen activator (HTUPA) to recombinant tissue plasminogen activator (rt-PA) in Chinese patients with acute myocardial infarction (AMI). Methods: AMI patients (n=221) were randomized to rt-PA (a standard protocol) or HTUPA (25mg bolus) treatment groups. All patients also received oral aspirin and intravenous heparin. Coronary angiography was performed 90min after therapy initiation to determine infarct-related coronary artery (IRA) patency. Clinical outcomes and changes of clotting variables, heart rate, blood pressure, left ventricular ejection fraction (LVEF), and electrocardiogram were evaluated. Results: Patent IRA [thrombolysis in myocardial infarction (TIMI) grade 2 or 3] was observed in 77% of HTUPA-treated patients, compared to 76% of rt-PA-treated patients (P =0.76). TIMI grade 3 patency rates were 52% and 44% in the HTUPA and rt-PA groups, respectively (P =0.37). The total patency rate was 77% (86/111 patients) in the HTUPA group and 73% (80/110 patients) in the rt-PA group (P =0.41). Adverse events were infrequent in both groups, and no significant differences were detected in mortality, re-occlusion rate, revascularization rate, adverse effects, clotting index, LVEF, or electrocardiogram between the two groups. Conclusions: Intravenous HTUPA had a safe and efficacious profile as good as rt-PA in patients with AMI. [Copyright &y& Elsevier]

Abstract: Background: Little is known about the relationship between the electrocardiographic characteristics and the infarct related artery (IRA) in non-ST-elevation myocardial infarction (NSTEMI). We found a curious phenomenon in electrocardiograms of patients with acute occlusion of left circumflex artery in NSTEM: A notch or deflection was often present in the terminal QRS complex in leads II,III and aVF or I,aVL . The objective of this study was to determine whether the previously unreported ECG phenomenon that we have found in NSTEMI could identify the culprit artery in non-ST-elevation myocardial infarction. Methods and Results: Our study included 218 NSTEMI patients who presented to our institution and underwent coronary angiography within 24 hours of admission. For convenience, ‘N’ wave was defined as a notch or deflection in the terminal QRS complex of the surface ECG. The duration of QRS with N wave before PCI was more prolonged than the duration of QRS without N wave (121±12ms vs 106±11ms, P<0.01). In the LCX group, 66(77%) patients had N wave in leads II, III and aVF, whereas only 5(6%) patients in the LAD group and 9(18%) patients in the RCA group had such ECG feature (P<0.001). A greater proportion of patients in the LCX group also had N waves in leads I and aVL (P<0.001). N wave in leads II, III and aVF was associated with 77% sensitivity and 89% specificity, respectively. N wave in leads I and aVL was associated with 64% sensitivity and 96% specificity, respectively. Conclusion: The abnormal waveform in terminal QRS complex in NSTEMI ,which is described above, is the delayed activation wave of left ventricular basal region which the left circumflex artery supplies. It is associated with a higher specificity and higher sensitivity for culprit LCX in non-ST-elevation myocardial infarction. The delayed activation wave is a new pattern of ischemia in ECG. [Copyright &y& Elsevier]

Background: Polyamines, including spermidine (SPD), spermine (SPM) and putrescine (PUT), are essential for cellular physiology and various cellular processes. This study aimed to examine the associations of dietary polyamines intake and all-cause mortality and incident cardiovascular disease (CVD)., Methods: This prospective cohort study included 184,732 participants without CVD at baseline from the UK Biobank who had completed at least one dietary questionnaire. Diet was assessed using Oxford WebQ, a web-based 24 h recall questionnaire, with polyamines intakes estimated from previous studies. Cox proportional models with restricted cubic splines were employed to investigate nonlinear associations. The primary endpoint was all-cause mortality or incident CVD (including CVD death, coronary heart disease and stroke)., Results: During a median follow-up period of 11.5 years, 7348 (3.9%) participants died and 12,316 (6.5%) developed incident CVD. Polyamines intake showed nonlinear associations with all-cause mortality and incident CVD (P for nonlinear < 0.01). Compared to the lowest quintile group of dietary polyamines intake (≤17.4 mg/day), the quintile 2 to 5 groups demonstrated a reduced risk of all-cause mortality, with the lowest risk in quintile 2 group (>17.4-22.3 mg/day) (HR:0.82, 95% CI: 0.76-0.88). Similar results were observed for incident CVD, with the lowest risk in the quintile 4 group (>27.1-33.5 mg/day) (HR: 0.86, 95% CI: 0.82-0.92)., Conclusions: We found that dietary polyamines intake was associated with a lower risk of all-cause mortality or incident CVD. Furthermore, our study identified an optimal range of dietary polyamines intake.

Back-contact silicon solar cells, valued for their aesthetic appeal because they have no grid lines on the sunny side, find applications in buildings, vehicles and aircraft and enable self-power generation without compromising appearance 1-3 . Patterning techniques arrange contacts on the shaded side of the silicon wafer, which offers benefits for light incidence as well. However, the patterning process complicates production and results in power loss. We employed lasers to streamline the fabrication of back-contact solar cells and enhance the power-conversion efficiency. Using this approach, we produced a silicon solar cell that exceeded 27% efficiency. Hydrogenated amorphous silicon layers were deposited onto the wafer for surface passivation and to collect light-generated carriers. A dense passivating contact, which differs from conventional technology practice, was developed. Pulsed picosecond lasers operating at different wavelengths were used to create the back-contact patterns. The approach developed is a streamlined process for producing high-performance back-contact silicon solar cells, with a total effective processing time of about one-third that of the emerging mainstream technology. To meet the terawatt demand, we developed indium-less cells at 26.5% efficiency and precious silver-free cells at 26.2% efficiency. Thus, the integration of solar solutions into buildings and transportation is poised to expand with these technological advances., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Previous animal experiments have demonstrated the potential of spermidine to mitigate glucose intolerance, insulin resistance, and hyperinsulinemia. However, there remains a scarcity of epidemiological evidence supporting these findings. Therefore, we aimed to elucidate the associations of serum spermidine with T2DM and FPG., Materials and Methods: The cross-sectional study was conducted from June to August 2019 in the rural areas of Fuxin County, Liaoning Province, China. A total of 4,437 participants were included in the study. The serum spermidine was detected using high-performance liquid chromatography with a fluorescence detector. FPG was measured using the hexokinase method. T2DM was defined as participants with a FPG level of 7.0 mmol/L or greater, or self-reported diagnosis of diabetes by a doctor. Restricted cubic spline model and piecewise linear regression model were used to explore the associations of serum spermidine with T2DM and FPG, respectively., Results: The mean (SD) age of the participants was 59.3 (10.0) years, with 622 out of 4,437 participants being defined as T2DM. The serum spermidine in participants stratified by age and BMI categories was significantly different, with p values of 0.006 and 0.001, respectively. Among all the participants, the association of serum spermidine with T2DM was J-shaped. The log (spermidine) was negatively associated with T2DM (OR = 0.68, 95% CI: 0.52 to 0.92, p  = 0.01) below the inflection point, while log (spermidine) was not significantly associated with T2DM (OR = 1.97, 95% CI: 0.93 to 4.15, p  = 0.07) above the inflection point. Among the participants without T2DM, the association of serum spermidine with FPG was inverted J-shaped. The log (spermidine) was positively associated with FPG ( β  = 0.13, 95% CI: 0.05 to 0.21, p  = 0.001) below the inflection point, while log (spermidine) was negatively associated with FPG ( β  = -0.29, 95% CI: -0.42 to -0.16, p  < 0.001) above the inflection point., Conclusion: In conclusion, non-linear associations of serum spermidine with T2DM and FPG were found in the cross-sectional study in Chinese rural adults. This provided insights into the use of spermidine for the prevention of T2DM, highlighting the potential role in public health prevention strategies of spermidine., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zhang, Zhang, Li, Liu, Lu, He, Sun, Ma and Zheng.)

Aims: The body roundness index (BRI) has good predictive ability for both body fat and visceral adipose tissue. Longitudinal BRI trajectories can reveal the potential dynamic patterns of change over time. This prospective study assessed potential associations between BRI trajectories and incident cardiovascular disease (CVD) in rural regions of Northeast China., Methods: In total, 13,209 participants (mean age: 49.0 ± 10.3 years, 6,856 [51.9%] male) were enrolled with three repeated times of BRI measurements at baseline (2004-2006), 2008, and 2010, and followed up until 2017 in this prospective study. Using latent mixture model, the BRI trajectories were determined based on the data from baseline, 2008 and 2010. Composite CVD events (myocardial infarction, stroke, and CVD death combined) was the primary endpoint. Cox proportional-hazards models were used to analyze the longitudinal associations between BRI trajectories and incident CVD., Results: Three distinct BRI trajectories were identified: high-stable ( n  = 538), moderate-stable ( n  = 1,542), and low-stable ( n  = 11,129). In total, 1,382 CVD events were recorded during follow-up. After adjustment for confounders, the moderate-stable and high-stable BRI groups had a higher CVD risk than did the low-stable BRI group, and the HR (95%CI) were 1.346 (1.154, 1.571) and 1.751 (1.398, 2.194), respectively. Similar associations were observed between the trajectories of BRI and the risk of stroke and CVD death. The high-stable group was also significantly and independently associated with CVD, myocardial infarction, stroke, and CVD death in participants aged <50 years., Conclusion: BRI trajectory was positively associated with incident CVD, providing a novel possibility for the primary prevention of CVD in rural regions of China., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zhang, Han, Zheng, Sun and Sun.)

Background: Oral anti-coagulants (OAC) are the intervention for the prevention of stroke, which consistently improve clinical outcomes and survival among patients with atrial fibrillation (AF). The main purpose of this study is to identify problems in OAC utilization among hospitalized patients with AF in China., Methods: Using data from the Improving Care for Cardiovascular Disease in China-Atrial Fibrillation (CCC-AF) registry, guideline-recommended OAC use in eligible patients was assessed., Results: A total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019, of whom 38,203 were at a high risk of stroke, 9717 were at a moderate risk, and 4610 were at a low risk. On admission, only 20.0% (6075/30,420) of patients with a diagnosed AF and a high risk of stroke were taking OAC. The use of pre-hospital OAC on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population (adjusted odds ratio: 0.54, 95% confidence interval: 0.43-0.68; P  <0.001). At discharge, the prescription rate of OAC was 45.2% (16,757/37,087) in eligible patients with high stroke risk and 60.7% (2778/4578) in eligible patients with low stroke risk. OAC utilization in patients with high stroke risk on admission or at discharge both increased largely over time (all P  <0.001). Multivariate analysis showed that OAC utilization at discharge was positively associated with in-hospital rhythm control strategies, including catheter ablation (adjusted odds ratio [OR] 11.63, 95% confidence interval [CI] 10.04-13.47; P <0.001), electronic cardioversion (adjusted OR 2.41, 95% CI 1.65-3.51; P <0.001), and anti-arrhythmic drug use (adjusted OR 1.45, 95% CI 1.38-1.53; P <0.001)., Conclusions: In hospitals participated in the CCC-AF project, >70% of AF patients were at a high risk of stroke. Although poor performance on guideline-recommended OAC use was found in this study, over time the CCC-AF project has made progress in stroke prevention in the Chinese AF population.Registration:ClinicalTrials.gov, NCT02309398., (Copyright © 2024 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)