The Effects of Radiofrequency Catheter Ablation for Atrial Fibrillation on Right Ventricular Function.

BACKGROUND AND OBJECTIVE: The effects of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) on right ventricular (RV) function are not well known. METHODS: Patients who underwent RFCA for AF and underwent pre- and post-procedural echocardiography were enrolled consecutively. Fractional area change (FAC), RV free-wall longitudinal strain (RVFWSL), and RV 4-chamber strain including the ventricular septum (RV4CSL) were measured. Changes in FAC, RVFWSL, and RV4CSL before and after RFCA were compared among paroxysmal AF (PAF), persistent AF (PeAF), and long-standing persistent AF (LSPeAF) groups. RESULTS: A total of 164 participants (74 PAF, 47 PeAF, and 43 LSPeAF; age, 60.8 ± 9.8 years; men, 74.4%) was enrolled. The patients with PeAF and LSPeAF had worse RV4CSL (p<0.001) and RVFWSL (p<0.001) than those with PAF and reference values. Improvements in RVFWSL and RV4CSL after RFCA were significant in the PeAF group compared with the PAF and LSPeAF groups (ΔRV4CSL, 8.4% [5.1, 11.6] in PeAF vs. 1.0% [-1.0, 4.1] in PAF, 1.9% [-0.2, 4.4] in LSPeAF, p<0.001; ΔRVFWSL, 9.0% [6.9, 11.5] in PeAF vs. 0.9% [-1.4, 4.9] in PAF, 1.0% [-1.0, 3.6] in LSPeAF, p<0.001). In patients without recurrence, improvements in RVFWSL and RV4CSL after RFCA were significant in the PeAF group compared to the LSPeAF group. CONCLUSIONS: RV systolic function is more impaired in patients with PeAF and LSPeAF than in those with PAF. RV systolic function is more improved after RFCA in patients with PeAF than in those with PAF or LSPeAF.

Association Between Aortic Valve Sclerosis and Clonal Hematopoiesis of Indeterminate Potential.

Background: The mechanism and medical treatment target for degenerative aortic valve disease, including aortic stenosis, is not well studied. In this study, we investigated the effect of clonal hematopoiesis of indeterminate potential (CHIP) on the development of aortic valve sclerosis (AVS), a calcified aortic valve without significant stenosis. Methods: Participants with AVS (valves ≥2 mm thick, high echogenicity, and a peak transaortic velocity of <2.5 m/sec) and an age- and sex-matched control group were enrolled. Twenty-four CHIP genes with common variants in cardiovascular disease were used to generate a next-generation sequencing panel. The primary endpoint was the CHIP detection rate between the AVS and control groups. Inverse-probability treatment weighting (IPTW) analysis was performed to adjust for differences in baseline characteristics. Results: From April 2020 to April 2022, 187 participants (125 with AVS and 62 controls) were enrolled; the mean age was 72.6±8.5 yrs, and 54.5% were male. An average of 1.3 CHIP variants was observed. CHIP detection, defined by a variant allele frequency (VAF) of ≥0.5%, was similar between the groups. However, the AVS group had larger CHIP clones: 49 (39.2%) participants had a VAF of ≥1% (vs. 13 [21.0%] in the control group; P=0.020), and 25 (20.0%) had a VAF of ≥2% (vs. 4 [6.5%]; P=0.028). AVS is independently associated with a VAF of ≥1% (adjusted odds ratio: 2.44, 95% confidence interval: 1.11-5.36; P=0.027). This trend was concordant and clearer in the IPTW cohort. Conclusions: Participants with AVS more commonly had larger CHIP clones than age- and sex-matched controls. Further studies are warranted to identify causality between AVS and CHIP.

Impact of amlodipine on clinical outcomes for heart failure in patients with dilated cardiomyopathy: a Korean nationwide cohort study.

Introduction: Amlodipine, widely used as a first-line treatment for hypertension, has inconclusive clinical evidence regarding its efficacy in patients with heart failure. This retrospective cohort study aimed to investigate the clinical effectiveness of amlodipine treatment after hospitalization for heart failure in patients with dilated cardiomyopathy (DCMP). Methods: A total of 20,851 patients who were diagnosed with DCMP and admitted for heart failure between 2005 and 2016 according to Korean nationwide medical insurance service database were enrolled. Amlodipine use was defined as its prescription at the time of discharge and for at least 180 days within a year. The primary outcome was all-cause death, and the secondary outcome was heart failure rehospitalization during a 5-year period. The outcomes between patients who received amlodipine (n = 6,798) and those who did not (n = 14,053) were compared. Results: During the 5-year follow-up, the group treated with amlodipine exhibited a significantly lower risk of all-cause death and heart failure rehospitalization than the group not treated with amlodipine [all-cause death: adjusted hazard ratio (HR): 0.64, 95% confidence interval (CI): 0.59-0.70, p < 0.001; cardiovascular death: adjusted HR: 0.71, 95% CI: 0.62-0.81, p < 0.001; heart failure rehospitalization: adjusted HR: 0.92, 95% CI: 0.86-0.98, p = 0.006]. In a subgroup analysis, amlodipine had a significant impact on decreasing all-cause mortality in older adults, those with a higher systolic blood pressure, and those with a lower Charlson Comorbidity Index. Conclusion: In summary, amlodipine use after hospitalization for heart failure in patients with DCMP was associated with a lower risk of all-cause death and readmission for heart failure.

Relative importance of left atrial reservoir strain compared with components of the HFA-PEFF score: a cross-sectional study.

Background: The relative importance of left atrial reservoir strain (LASr) regarding the Heart Failure Association Pre-test assessment, Echocardiography and natriuretic peptide, Functional testing, Final etiology (HFA-PEFF) score, a diagnostic tool for patients with heart failure with preserved ejection fraction (HFpEF), remains unclear. We aimed to identify the relative importance of LASr compared with variables associated with HFpEF and HFA-PEFF scores. Methods: Between August 2021 and July 2022, we obtained retrospective data from the participants visiting a single cardiovascular center with subjective symptoms of heart failure, such as dyspnea or chest discomfort. In total, 2,712 participants with sinus rhythm and ejection fraction of more than 50% were enrolled. Multivariable logistic regression analysis, random forest analysis, and supervised machine learning algorithms were performed to identify the relative importance of LASr to the HFA-PEFF score. Results: The average HFA-PEFF score was 2.4 ± 1.6 points. Two hundred and thirty-eight participants had 5 or 6 points. LASr showed a moderate correlation with the HFA-PEFF score (r = -0.50, p < 0.001). Impaired LASr < 25.2% was an independent variable affecting a high HFA-PEFF score with traditional diastolic function parameters and components of the HFA-PEFF diagnostic algorithm. The odds ratio (OR) [1.74, 95% confidence interval (CI) 1.23-2.47] for LASr was higher compared to that of left ventricular global longitudinal strain (OR 1.59, 95% CI 1.14-2.21), septal E/e' (OR 1.23, 95% CI 0.85-1.77), and relative wall thickness (OR 1.20, 95% CI 0.76-1.89). LASr was also a relatively more important variable in estimating a high HFA-PEFF score than TR-Vmax, septal E/e', septal e', left ventricular mass index, and relative wall thickness, the major echocardiographic components of the HFA-PEFF score. Conclusions: LASr is an important factor with components of the HFA-PEFF score and is a useful tool to assess patients with HFpEF. Clinical Trial Registration: URL: https://clinicaltrials.org. Unique identifiers: NCT05638230.

Surface Overpotential as a Key Metric for the Discharge-Charge Reversibility of Aqueous Zinc-Ion Batteries.

Aqueous zinc-ion batteries (AZIBs) are receiving increasing attention for power-grid energy storage systems. Nevertheless, warranting long-term reversible operation is not trivial owing to uncontrolled interfacial phenomena related to zinc dendritic growth and parasitic reactions. Herein, the addition of hexamethylphosphoramide (HMPA) to the electrolyte revealed the surface overpotential (|ηs|) to be a key metric of the reversibility. HMPA adsorbs onto active sites on the zinc metal surface, raising the surface overpotential toward lowering the nucleation energy barrier and decreasing the critical size (rcrit) of nuclei. We also correlated the observed interface-to-bulk properties by the Wagner (Wa) dimensionless number. The controlled interface enables a Zn|V6O13 full cell to retain 75.97% capacity for 2000 cycles, with a capacity loss of only 1.5% after 72 h resting. Our study not only delivers AZIBs with unparalleled cycling and storage performance but also proposes surface overpotential as a key descriptor regarding the sustainability of AZIB cycling and storage.

Naked metallic skin for homo-epitaxial deposition in lithium metal batteries.

Regulating the morphology of lithium plating is the key to extending the cycle life of lithium metal batteries. Fatal dendritic growth is closely related to out-of-plane nucleation on the lithium metal surface. Herein, we report a nearly perfect lattice match between the lithium metal foil and lithium deposits by removing the native oxide layer using simple bromine-based acid-base chemistry. The naked lithium surface induces homo-epitaxial lithium plating with columnar morphologies and lower overpotentials. Using the naked lithium foil, the lithium-lithium symmetric cell maintains stable cycling at 10 mA cm-2 for more than 10,000 cycles, and the full-cell paired with LiFePO4 with high areal capacity of 3.3 mAh cm-2 and practical N/P ratio of 2.5 exhibits 86% capacity retention after 300 cycles. This study elucidates the usefulness of controlling the initial surface state to facilitate homo-epitaxial lithium plating for sustainable cycling of lithium metal batteries.

Prognostic value of preoperative left ventricular global longitudinal strain for predicting postoperative myocardial injury and mortality in patients undergoing major non-cardiac surgery (SOLOMON study).

BACKGROUND: The usefulness of preoperative measurement of left ventricular global longitudinal strain (LVGLS) for predicting prognosis in patients undergoing non-cardiac surgery has not been evaluated. We analyzed the prognostic value of LVGLS in predicting postoperative 30-day cardiovascular events and myocardial injury after non-cardiac surgery (MINS). METHODS: This prospective cohort study was conducted in two referral hospitals and included 871 patients who underwent non-cardiac surgery <1 month after preoperative echocardiography. Those with ejection fraction <40%, valvular heart disease, and regional wall motion abnormality were excluded. The co-primary endpoints were the (1) composite incidence of all-cause death, acute coronary syndrome (ACS), and MINS and (2) composite incidence of all-cause death and ACS. RESULTS: Among the 871 participants enrolled (mean age: 72.9 years; female: 60.8%), there were 43 cases of the primary endpoint (4.9%): 10 deaths, 3 ACS, and 37 MINS. Participants with impaired LVGLS (≤16.6%) had a higher incidence of the co-primary endpoints (log-rank P < 0.001 and 0.015) than those without. The result was similar after adjustment with clinical variables and preoperative troponin T levels (hazard ratio = 1.30, 95% confidence interval [CI] = 1.03-1.65; P = 0.027). In sequential Cox analysis and net reclassification index, LVGLS had an incremental value for predicting the co-primary endpoints after non-cardiac surgery. Among the 538 (61.8%) participants who underwent serial troponin assay, LVGLS predicted MINS independently from the traditional risk factors (odds ratio = 3.54, 95% CI = 1.70-7.36; P = 0.001). CONCLUSIONS: Preoperative LVGLS has an independent and incremental prognostic value in predicting early postoperative cardiovascular events and MINS. CLINICAL TRIAL REGISTRATION: URL: https://trialsearch.who.int/. Unique identifiers: KCT0005147.

Effects of radiofrequency catheter ablation for premature ventricular complexes originating from the right ventricular outflow tract on right ventricular function.

INTRODUCTION: This study aimed to elucidate the relationship between premature ventricular complexes (PVCs) and right ventricular (RV) dysfunction, and the effects of radiofrequency catheter ablation (RFCA) on RV function. METHODS: A total of 110 patients (age, 50.8 ± 14.4 years; 30 men) without structural heart disease who had undergone RFCA for RV outflow tract (RVOT) PVCs were retrospectively included. RV function was assessed using fractional area change (FAC) and global longitudinal strain (GLS) before and after RFCA. Clinical data were compared between the RV dysfunction (n = 63) and preserved RV function (n = 47) groups. The relationship between PVC burden and RV function was analyzed. Change in RV function before and after RFCA was compared between patients with successful and failed RFCA. RESULTS: PVC burden was significantly higher in the RV dysfunction group than in the preserved RV function group (p < .001). FAC and GLS were significantly worse in proportion to PVC burden (p < .001 and p < .001, respectively). The risk factor associated with RV dysfunction was PVC burden [odds ratio (95% confidence interval), 1.092 (1.052-1.134); p < .001]. Improvement in FAC (13.0 ± 8.7% and -2.5 ± 5.6%, respectively; p < .001) and GLS (-6.8 ± 5.7% and 2.1 ± 4.2%, respectively; p < .001) was significant in the patients with successful RFCA, compared to the patients in whom RFCA failed. CONCLUSIONS: Frequent RVOT PVCs are associated with RV dysfunction. RV dysfunction is reversible by successful RFCA.

Red cell distribution width as a prognosticator in patients with heart failure.

AIMS: Increased red cell distribution width (RDW) is a poor prognostic factor in patients with heart failure (HF). However, only a few large-scale studies have identified the clinical utility of RDW after adjusting for covariates affecting RDW. METHODS AND RESULTS: From January 2010 to April 2021, we retrospectively enrolled patients diagnosed with HF from three referral hospitals with available RDW data (taken within 3 months of HF diagnosis) using an integrated clinical data system. Patients with an ejection fraction (EF) < 50% or HFA-PEFF (Heart Failure Association Pre-test assessment, Echocardiography and natriuretic peptide, Functional testing, Final aetiology) score ≥ 2 without severe valvular heart disease or coronary revascularization were enrolled. The primary endpoint was all-cause mortality, and cardiovascular mortality was also collected. Multivariable Cox regression analysis and stabilized inverse probability of treatment weighting (IPTW) were used to identify any association between RDW and all-cause death by balancing covariates or compounding factors. The global χ2 score was calculated and discrimination analysis was performed to evaluate the incremental value of RDW in predicting prognosis. Among the 6599 participants enrolled in this study, 1256 (19.0%) cases of all-cause death occurred, and the median duration of follow-up was 887 (interquartile range 351-1589) days. Elevated RDW at the initial diagnosis was associated with poor prognosis [cumulative incidence: 819 (30.2%) vs. 437 (11.2%), relative risk 1.58, 95% confidence interval (CI) 1.51-1.67, log-rank P < 0.001]. Multivariable Cox analysis showed that elevated RDW was a poor prognostic factor for the primary endpoint [hazard ratio (HR) 1.11, 95% CI 1.06-1.16, P < 0.001], independent of clinical risk factors, N-terminal pro-brain natriuretic peptide (NT-proBNP), and EF, which was concordant with the stabilized IPTW (HR 1.29, 95% CI 1.10-1.49, P < 0.001). Adding RDW to model composed of traditional risk factors, NT-proBNP, and echocardiographic parameters showed incremental prognostic value for predicting poor prognosis (area under the receiver operating characteristic curve, 0.799-0.826; P < 0.001). CONCLUSIONS: Increased RDW at the time of diagnosis is associated with poor prognosis in patients with HF, independent of clinical risk factors, such as NT-proBNP, and echocardiographic parameters. Therefore, RDW may aid in the management of these patients beyond traditional risk factors.

Association between arterial stiffness and left ventricular diastolic function: A large population-based cross-sectional study.

Background: The association between arterial stiffness and left ventricular (LV) diastolic function has been demonstrated in several studies, but the samples size in those studies was small. This study aims to verify this issue in a large number of study subjects. Methods: A total of 7,013 consecutive participants (mean age 60.6 years and 43.3% female) who underwent both baPWV and transthoracic echocardiography were retrospectively analyzed. Subjects with significant cardiac structural abnormalities were excluded. Results: There were significant correlations of baPWV with septal e' velocity (r = - 0.408; P < 0.001), septal E/e' (r = 0.349; P < 0.001), left atrial volume index (LAVI) (r = 0.122; P < 0.001) and maximal velocity of tricuspid valve regurgitation (TR Vmax) (r = 0.322; P < 0.001). The baPWV values increased proportionally with an increase in the number of LV diastolic indices meeting LV diastolic dysfunction criteria (P-for-trend < 0.001). In multivariable analyses with adjustment for confounding effects of various clinical covariates, higher baPWV was independently associated with septal e' < 7 (odds ratio [OR], 1.30; 95% confidence interval [CI] 1.20-1.60; P < 0.001), septal E/e' ≥ 15 (OR, 1.46; 95% CI, 1.21-1.78; P < 0.001), and TR Vmax > 2.8 m/s (OR, 1.60; 95% CI, 1.23-2.09; P < 0.001) but not with LAVI ≥ 34 mL/m2 (OR, 0.89; 95% CI, 0.76-1.03; P = 0.123). Conclusions: Increased arterial stiffness, as measured by baPWV, was associated with abnormal diastolic function parameters in a large number of study participants, providing strong evidence to the existing data about ventricular-vascular coupling.

Cationic Additive with a Rigid Solvation Shell for High-Performance Zinc Ion Batteries.

Despite substantial progresses, in aqueous zinc ion batteries (AZIBs), developing zinc metal anodes with long-term reliable cycling capabilities is nontrivial because of dendritic growth and related parasitic reactions on the zinc surface. Here, we exploit the tip-blocking effect of a scandium (Sc3+ ) additive in the electrolyte to induce uniform zinc deposition. Additional to the tri-valency of Sc3+ , the rigidity of its hydration shell effectively prevents zinc ions from concentrating at the surface tips, enabling highly stable cycling under challenging conditions. The shell rigidity, quantified by the rate constant of the exchange reaction (kex ), is established as a key descriptor for evaluating the tip-blocking effect of redox-inactive cations, explaining inconsistent results when only the valence state is considered. Moreover, the tip-blocking effect of Sc3+ is maintained in blends with organic solvents, allowing the zinc anode to cycle reliably even at -40 °C without corrosion.

Optimal office blood pressure levels in younger (<50 years old) Korean hypertensive patients: a nationwide cohort study in South Korea.

BACKGROUND: It is unclear what thresholds and targets of office blood pressure (BP) for treatment are appropriate in younger (<50 years old) hypertensive patients. Thus, the aim of this study was to evaluate associations of office BP levels with major cardiovascular events (MACEs) in these patients. METHODS: Using the Korean National Health Insurance Service database, data of 98 192 younger (<50 years old) hypertensive patients having BP measurements available without any history of cardiovascular events from 2002 to 2011 were extracted. This cohort study evaluated associations of BP levels (<120/<70, 120-129/70-79, 130-139/80-89, 140-149/90-99, and ≥150/≥100 mmHg) with MACEs. The study outcome was MACE, a composite of cardiovascular death, myocardial infarction, stroke, and heart failure. RESULTS: In all patients, those treated with antihypertensive medication accounted for 34.7% and those who achieved BP less than 130/80 mmHg accounted for 35.5%. During a mean follow-up of 9.5 ±â€Š2.8 years, 4918 (5%) MACEs were documented in our cohort. The risk of MACE was the lowest [adjusted hazard ratio: 0.77, 95% confidence interval (CI) 0.66-0.89] for those with BP level of less than 120/less than 70 mmHg. It was the highest (hazard ratio 2.0, 95% CI 1.83-2.19) for those with BP level of at least 150/at least 100 mmHg in comparison with those with BP level of 130-139/80-89 mmHg. These results were consistent for all age groups (20-29, 30-39, and 40-49 years) and both sexes. CONCLUSION: Elevated BP level from less than 120 mmHg/less than 70 mmHg is significantly correlated with an increased risk of MACE in younger (<50 years old) Korean hypertensive patients. Lowering BP to less than 120 mmHg/less than 70 mmHg is needed for these patients.

Multi-illumination 3D holographic display using a binary mask.

We introduce a novel, to the best of our knowledge, method to increase the bandwidth in holographic displays. Here, multi-angle illumination using multiple laser diodes (LDs) is adopted to expand the limited diffraction angle of the spatial light modulator (SLM). To solve the problem of signal repetitions caused by sharing the same SLM pattern, we use a random binary mask (BM). We demonstrate via simulations and experiments that our method effectively increases the bandwidth with sufficient image quality. Furthermore, the speckle noise, a critical issue of the holographic display that decreases the contrast and is potentially harmful to eyes, is reduced by the advantage of incoherent summation in the reconstruction plane. We believe that this method is a practical approach that can expand the bandwidth of the holographic display by alleviating the bottleneck of hardware limitations.

Corrosion as the origin of limited lifetime of vanadium oxide-based aqueous zinc ion batteries.

Aqueous zinc ion batteries are receiving increasing attention for large-scale energy storage systems owing to their attractive features with respect to safety, cost, and scalability. Although vanadium oxides with various compositions have been demonstrated to store zinc ions reversibly, their limited cyclability especially at low current densities and their poor calendar life impede their widespread practical adoption. Herein, we reveal that the electrochemically inactive zinc pyrovanadate (ZVO) phase formed on the cathode surface is the main cause of the limited sustainability. Moreover, the formation of ZVO is closely related to the corrosion of the zinc metal counter electrode by perturbing the pH of the electrolyte. Thus, the dissolution of VO2(OH)2-, the source of the vanadium in the ZVO, is no longer prevented. The proposed amalgamated Zn anode improves the cyclability drastically by blocking the corrosion at the anode, verifying the importance of pH control and the interplay between both electrodes.

Artificial Intelligence-Enabled ECG Algorithm for the Prediction of Coronary Artery Calcification.

Coronary artery calcium (CAC), which can be measured in various types of computed tomography (CT) examinations, is a hallmark of coronary artery atherosclerosis. However, despite the clinical value of CAC scores in predicting cardiovascular events, routine measurement of CAC scores is limited due to high cost, radiation exposure, and lack of widespread availability. It would be of great clinical significance if CAC could be predicted by electrocardiograms (ECGs), which are cost-effective and routinely performed during various medical checkups. We aimed to develop binary classification artificial intelligence (AI) models that predict CAC using only ECGs as input. Moreover, we aimed to address the generalizability of our model in different environments by externally validating our model on a dataset from a different institution. Among adult patients, standard 12-lead ECGs were extracted if measured within 60 days before or after the CAC scores, and labeled with the corresponding CAC scores. We constructed deep convolutional neural network models based on residual networks using only the raw waveforms of the ECGs as input, predicting CAC at different levels, namely CAC score ≥100, ≥400 and ≥1,000. Our AI models performed well in predicting CAC in the training and internal validation dataset [area under the receiver operating characteristics curve (AUROC) 0.753 ± 0.009, 0.802 ± 0.027, and 0.835 ± 0.024 for the CAC score ≥100, ≥400, and ≥1,000 model, respectively]. Our models also performed well in the external validation dataset (AUROC 0.718, 0.777 and 0.803 for the CAC score ≥100, ≥400, and ≥1,000 model, respectively), indicating that our model can generalize well to different but plausibly related populations. Model performance in terms of AUROC increased in the order of CAC score ≥100, ≥400, and ≥1,000 model, indicating that higher CAC scores might be associated with more prominent structural changes of the heart detected by the model. With our AI models, a substantial proportion of previously unrecognized CAC can be afforded with a risk stratification of CAC, enabling initiation of prophylactic therapy, and reducing the adverse consequences related to ischemic heart disease.

Prognostic value of arterial stiffness in menopausal women.

OBJECTIVE: Because menopausal women have an increased cardiovascular risk, risk stratification is very crucial in this population. This study aimed to verify the prognostic value of arterial stiffness in menopausal women. METHODS: We retrospectively analyzed 2,917 menopausal women (age >55y) without overt cardiovascular disease who underwent brachial-ankle pulse wave velocity measurement. The primary endpoint was a composite of clinical events, including all-cause death, nonfatal myocardial infarction, coronary revascularization, and stroke, hereafter referred to as major adverse cardiovascular events. Propensity score matching and inverse probability-treatment weighting analysis were used to balance differences in baseline participant characteristics. RESULTS: The mean participant age was 66.8 ±â€Š7.7 years. During a median follow-up period of 4.0 (interquartile range of 1.9-6.3) years, the primary outcome was noted in 56 cases (1.9%). Pulse wave velocity was significantly higher in participants with the primary outcome than in those without (1,947 ±â€Š388 vs 1,690 ±â€Š348 cm/s; P  < 0.001). For every 100 cm/s increase in pulse wave velocity, the hazard ratio for the primary endpoint increased by 1.15 times (95% confidence interval, 1.08-1.22; P  < 0.001) in multivariable Cox regression analysis. A pulse wave velocity > 1,613 cm/s was associated with increased risk of the primary endpoint in the same multivariable analysis (hazard ratio, 3.06; 95% confidence interval, 1.40-6.68; P  = 0.005). The results were consistent after propensity score matching and inverse probability-treatment weighting analysis. CONCLUSIONS: Elevated brachial-ankle pulse wave velocity was associated with the occurrence of major adverse cardiovascular events in menopausal women without cardiovascular disease and may represent a useful screening tool.

Wide-Field Super-Resolution Optical Fluctuation Imaging through Dynamic Near-Field Speckle Illumination.

Stochastic optical fluctuation imaging (SOFI) generates super-resolution fluorescence images by emphasizing the positions of fluorescent emitters via statistical analysis of their on-and-off blinking dynamics. In SOFI with speckle illumination (S-SOFI), the diffraction-limited grain size of the far-field speckles prevents independent blinking of closely located emitters, becoming a hurdle to realize the full super-resolution granted by SOFI processing. Here, we present a surface-sensitive super-resolution technique exploiting dynamic near-field speckle illumination to bring forth the full super-resolving power of SOFI without blinking fluorophores. With our near-field S-SOFI technique, up to 2.8- and 2.3-fold enhancements in lateral spatial resolution are demonstrated with computational and experimental fluorescent test targets labeled with conventional fluorophores, respectively. Fluorescent beads separated by 175 nm are also super-resolved by near-field speckles of 150 nm grain size, promising sub-100 nm resolution with speckle patterns of much smaller grain size.

Cumulative exposure amount of PM2.5 in the ambient air is associated with coronary atherosclerosis - Serial coronary CT angiography study.

BACKGROUND: We investigated the change of coronary atherosclerosis with long-term exposure to fine particulate matter of aerodynamic diameter <2.5 â€‹µm (PM2.5) using coronary computed tomography angiography (CCTA). METHODS: Subjects undergoing serial CCTAs between January 2007 and December 2017 (n â€‹= â€‹3,127) were analyzed. Each individual's cumulative amount of PM2.5 exposure between the two CCTAs was evaluated by Kriging interpolation and zonal analysis, considering the time interval between the two CCTAs. The main outcome was progression of coronary artery calcium (CAC) with additional semiquantitative analysis on the changes in the severity and composition of atherosclerotic plaques. RESULTS: The CAC scores increased by 30.8 Agatston units per-year under a median PM2.5 concentration 24.9 â€‹µg/m3 and tended to increase with the cumulative amount of PM2.5 exposure (r â€‹= â€‹0.321, p â€‹<0.001). The CAC progressed in 1,361 (43.5%) subjects during a median 53 months follow-up. The cumulative amount of PM2.5 exposure was independently associated with CAC progression (adjusted OR 1.09, p â€‹<0.001). By random forest analysis, the relative impact of cumulative amount of PM2.5 exposure on CAC progression was higher than that of traditional cardiovascular risk factors and the average concentration of PM2.5. The extent of coronary atherosclerosis and newly developed calcified plaque on follow-up were also significantly associated with the cumulative amount of PM2.5 exposure. CONCLUSIONS: Cumulative exposure to air pollution is associated with the progression of diffuse coronary calcification, the importance of which may be more significant than other traditional cardiovascular risk factors. Further investigations into the causality between PM2.5 and coronary atherosclerosis are warranted to improve global cardiovascular health.

Development of a rapid plasma decontamination system for decontamination and reuse of filtering facepiece respirators.

The COVID-19 pandemic has caused a high demand for filtering facepiece respirators (FFRs), which has brought global challenges in sustaining the supply chain for FFRs. Because respirators are basic personal protective equipment to protect frontline healthcare workers against COVID-19, the chronic, global shortage of N95/N99 masks is one of the most urgent threats to our collective ability to save lives from the coronavirus. The reuse of masks may need to be considered as a crisis capacity strategy to ensure continued availability even though most of the masks are considered one-time use. Moreover, environmentalists warn that single-use masks add to the glut of plastic pollution, threatening the health of oceans and marine life. In this study, we develop a method to decontaminate respirators to reuse filtering facepiece respirators. Samples of SARS-CoV-2 are applied to the 4 × 4 cm2 samples of FFP2 and FFP3 respirator materials. The filtration efficiency of plasma treated samples is measured using a planar particle image velocimetry technique with a neutrally charged polydisperse aerosol particle of NaCl. The measured viral decontamination and filtration efficiencies show that the developed plasma decontamination system can achieve a 4-log reduction for the coronavirus without reducing the filtration efficiency of masks after 5-min plasma exposure. The developed plasma decontamination system demonstrates the feasibility to tackle the acute shortages of FFRs in many countries and their environmental and economic burdens against discarding reusable masks.

Compact tomographic near-eye display using a MEMS scanning mirror.

We propose a compact tomographic near-eye display by combining a micro-electro-mechanical systems (MEMS) scanning mirror device, focus tunable lens, and a single light-emitting diode source. A holographic optical element was used to elaborately focus the light source into the MEMS scanning mirror while providing further miniaturization. We implemented a drastically downsized multifocal display system that expresses a depth range of 4.8 D with eight focal planes by synchronizing these modules. Furthermore, the planar images are optimized to achieve correct retinal scenes at each accommodation state. The simulated and experimental results verify that the suggested near-eye display system can provide three-dimensional virtual images while showing physical feasibility.