The causal effect of air pollution on the risk of essential hypertension: a Mendelian randomization study.

Background: Air pollution poses a major threat to human health by causing various illnesses, such as cardiovascular diseases. While plenty of research indicates a correlation between air pollution and hypertension, a definitive answer has yet to be found. Methods: Our analyses were performed using the Genome-wide association study (GWAS) of exposure to air pollutants from UKB (PM2.5, PM10, NO2, and NOX; n = 423,796 to 456,380), essential hypertension from FinnGen (42,857 cases and 162,837 controls) and from UKB (54,358 cases and 408,652 controls) as a validated cohort. Univariable and multivariable Mendelian randomization (MR) were conducted to investigate the causal relationship between air pollutants and essential hypertension. Body mass index (BMI), alcohol intake frequency, and the number of cigarettes previously smoked daily were included in multivariable MRs (MVMRs) as potential mediators/confounders. Results: Our findings suggested that higher levels of both PM2.5 (OR [95%CI] per 1 SD increase in predicted exposure = 1.24 [1.02-1.53], p = 3.46E-02 from Finn; OR [95%CI] = 1.04 [1.02-1.06], p = 7.58E-05 from UKB) and PM10 (OR [95%CI] = 1.24 [1.02-1.53], p = 3.46E-02 from Finn; OR [95%CI] = 1.04 [1.02-1.06], p = 7.58E-05 from UKB) were linked to an increased risk for essential hypertension. Even though we used MVMR to adjust for the impacts of smoking and drinking on the relationship between PM2.5 exposure and essential hypertension risks, our findings suggested that although there was a direct positive connection between them, it is not present after adjusting BMI (OR [95%CI] = 1.05 [0.87-1.27], p = 6.17E-01). Based on the study, higher exposure to PM2.5 and PM10 increases the chances of developing essential hypertension, and this influence could occur through mediation by BMI. Conclusion: Exposure to both PM2.5 and PM10 is thought to have a causal relationship with essential hypertension. Those impacted by substantial levels of air pollution require more significant consideration for their cardiovascular health.

4-Trifluorophenylammonium Iodide-Based Dual Interfacial Modification Engineering toward Improved Efficiency and Stability of SnO2-Based Perovskite Solar Cells.

Passivation engineering has been identified as an effective strategy to eliminate the targeted interfacial defects for improving the efficiency and stability of perovskite solar cells (PSCs). Herein, 4-trifluorophenylammonium iodide (CF3PhAI) is presented as a multifunctional passivation agent to modify buried SnO2/perovskite and perovskite/hole transport layer (HTL) interfaces. Upon incorporation of CF3PhAI between SnO2 and perovskite, CF3PhAI can chemically link to SnO2 via Lewis coordination and electrostatic coupling, thereby effectively passivating under-coordinated Sn and filling the oxygen vacancy. Meanwhile, CF3PhAI helps anchor PbI2 and organic cations (MA+/FA+) to control the crystallization of the perovskite. Consequently, reduced interfacial defects, homogeneous perovskite crystallites, and better energetic alignment can be simultaneously achieved. When CF3PhAI was further used to modify the perovskite/HTL interface, the fabricated PSCs yielded an impressive power conversion efficiency of 23.06% together with negligible J-V hysteresis. The unencapsulated devices exhibited long-term stability in wet conditions (91.8% efficiency retention after 1000 h) due to the water-resistant CF3PhAI. We also achieved good light soaking stability, maintaining 86.1% of its initial efficiency after aging for 720 h. Overall, our finding provides a promising strategy for modifying the dual contact interfaces of PSCs toward improved efficiency and stability.

Anastomotic leakage after intrathoracic versus cervical oesophagogastric anastomosis for oesophageal carcinoma in Chinese population: a retrospective cohort study.

OBJECTIVE: To investigate the characteristics and predictors for anastomotic leakage after oesophagectomy for oesophageal carcinoma from the perspective of anastomotic level. DESIGN: Retrospective cohort study. SETTINGS: A single tertiary medical centre in China. PARTICIPANTS: From January 2010 to December 2016, all patients with oesophageal cancer of the distal oesophagus or gastro-oesophageal junction undergoing elective oesophagectomy with a curative intent for oesophageal carcinoma with intrathoracic oesophagogastric anastomosis (IOA) versus cervical oesophagogastric anastomosis (COA) were included. We investigated anastomotic level and perioperative confounding factors as potential risk factors for postoperative leakage by univariate and multivariate logistic regression. PRIMARY OUTCOME MEASURES: The primary outcome was the odds of anastomotic leakage by different confounding factors. Secondary outcome was the association of IOA versus COA with other postoperative outcomes. RESULTS: Of 458 patients included, 126 underwent cervical anastomosis and 332 underwent intrathoracic anastomosis. Anastomotic leakage developed in 55 patients (12.0%), with no statistical differences between COA and IOA (16.6% vs 10.2%; p=0.058). Multivariable analysis identified active diabetes mellitus (OR 2.001, p=0.047), surgical procedure (open: reference; minimally invasive: OR 1.770, p=0.049) and anastomotic method (semimechanical: reference; stapled: OR 1.821; handsewn: OR 2.271, p=0.048) rather than anastomotic level (IOA: reference; COA: OR 1.622, p=0.110) were independent predictors of leakage. CONCLUSIONS: Surgical and anastomotic techniques rather than the level of anastomotic site were independent predictors of postoperative anastomotic leakage in patients undergoing oesophageal cancer surgery.

Feasibility of MRI-guided high intensity focused ultrasound treatment for adenomyosis.

PURPOSE: To test the feasibility of MRI-guided high intensity focused ultrasound ablation for adenomyosis. MATERIALS AND METHODS: Patients with symptomatic adenomyosis were treated with MRI-guided high intensity focused ultrasound (MRIgHIFU). Under conscious sedation, MRIgHIFU was performed by a clinical MRI-compatible focused ultrasound tumour therapeutic system (JM15100, Haifu® Technology Co. Ltd., Chongqing, China) which is combined with a 1.5 T MRI system (Magnetom Symphony, Siemens Healthcare, Erlangen, Germany). MRI was used to calculate the volume of the uterus and lesion. Non-perfused volume of the targeted lesions was evaluated immediately after MRIgHIFU. Patient symptoms were assessed using symptom severity score (SSS) and uterine fibroids symptoms and quality of life questionnaire (UFS-QOL). RESULTS: Ten patients with mean age of 40.3±4 years with an average lesion size of 56.9±12.7 mm in diameter were treated. Non-perfused volume and the percentage of non-perfused volume obtained from contrast-enhanced T1 Magnetic resonance images immediately post-treatment were 66.6±49.4 cm3 and 62.5±21.6%, respectively. The mean SSS and UFS-QOL showed significant improvements of 25%, 16% and 25% at 3, 6 and 12 months follow up, respectively, to pre-treatment scores. No serious complications were observed. CONCLUSION: Based on the results from this study, MRIgHIFU treatment appears to be a safe and feasible modality to ablate adenomyosis lesion and alleviate its symptoms.

Feasibility of magnetic resonance imaging-guided high intensity focused ultrasound therapy for ablating uterine fibroids in patients with bowel lies anterior to uterus.

PURPOSE: To prospectively evaluate the feasibility of magnetic resonance (MR) imaging-guided high intensity focused ultrasound (HIFU) therapeutic ablation of uterine fibroids in patients with bowel lies anterior to uterus. MATERIALS AND METHODS: Twenty-one patients with 23 uterine fibroids underwent MR imaging-guided high intensity focused ultrasound treatment, with a mean age of 39.4+/-6.9 (20-49) years, with fibroids average measuring 6.0+/-1.6 (range, 2.9-9.5)cm in diameter. After being compressed with a degassed water balloon on abdominal wall, MR imaging-guided high intensity focused ultrasound treatment was performed under conscious sedation by using fentanyl and midazolam. This procedure was performed by a Haifu JM focused ultrasound tumour therapeutic system (JM2.5C, Chongqing Haifu Technology Co., Ltd., China), in combination with a 1.5-Tesla MRI system (Symphony, Siemens, Germany), which provides real-time guidance and control. Contrast-enhanced MR imaging was performed to evaluate the efficacy of thermal ablation immediately and 3 months after HIFU treatment. The treatment time and adverse events were recorded. RESULTS: The mean fibroid volume was 97.0+/-78.3 (range, 12.7-318.3)cm(3). According to the treatment plan, an average 75.0+/-11.4% (range, 37.8-92.4%) of the fibroid volume was treated. The mean fibroid volume immediately after HIFU was 109.7+/-93.1 (range, 11.9-389.6)cm(3), slightly enlarged because of edema. The average non-perfused volume was 83.3+/-71.7 (range, 7.7-282.9)cm(3), the average fractional ablation, which was defined as non-perfused volume divided by the fibroid volume immediately after HIFU treatment, was 76.9+/-18.7% (range, 21.0-97.0%). There were no statistically significant differences between the treatment volume and the non-perfused volume. Follow-up magnetic resonance imaging (MRI) at 3 months obtained in 12 patients, the fibroid volume decreased by 31.4+/-29.3% (range, -1.9 to 60.0%) in average, with paired t-test showing a statistically significant reduction (P=0.002). The mean treatment time for ablating the average 83.3+/-71.7 (range, 7.7-282.9)cm(3) of fibroid volume was 2.5+/-1.4h (range, 27-390min) in this study, which was relatively short and acceptable to patient and therapist. Four patients experienced mild skin burn (two with skin redness, two with blisters), the skin burn subsided within approximately 2 days. No other adverse events were observed. CONCLUSIONS: After the bowel was compressed with a degassed water balloon, MR imaging-guided high intensity focused ultrasound treatment is safe and feasible in ablating uterine fibroids in patients with bowel lies anterior to uterus.