JSENSE-Pro: Joint sensitivity estimation and image reconstruction in parallel imaging using pre-learned subspaces of coil sensitivity functions.

PURPOSE: To improve calibrationless parallel imaging using pre-learned subspaces of coil sensitivity functions. THEORY AND METHODS: A subspace-based joint sensitivity estimation and image reconstruction method was developed for improved parallel imaging with no calibration data. Specifically, we proposed to use a probabilistic subspace model to capture prior information of the coil sensitivity functions from previous scans acquired using the same receiver system. Both the subspace basis and coefficient distributions were learned from a small set of training data. The learned subspace model was then incorporated into the regularized reconstruction formalism that includes a sparsity prior. The nonlinear optimization problem was solved using alternating minimization algorithm. Public fastMRI brain dataset was retrospectively undersampled by different schemes for performance evaluation of the proposed method. RESULTS: With no calibration data, the proposed method consistently produced the most accurate coil sensitivity estimation and highest quality image reconstructions at all acceleration factors tested in comparison with state-of-the-art methods including JSENSE, DeepSENSE, P-LORAKS, and Sparse BLIP. Our results are comparable to or even better than those from SparseSENSE, which used calibration data for sensitivity estimation. The work also demonstrated that the probabilistic subspace model learned from T2 w data can be generalized to aiding the reconstruction of FLAIR data acquired from the same receiver system. CONCLUSION: A subspace-based method named JSENSE-Pro has been proposed for accelerated parallel imaging without the acquisition of companion calibration data. The method is expected to further enhance the practical utility of parallel imaging, especially in applications where calibration data acquisition is not desirable or limited.

Theoretical Exploration of Peculiar Sandwich-Type Clusters Formed by the Coordination of E92- (E = Si, Ge, Sn) Zintl Clusters: Structural Properties, Active Sites, and Hydrogen Storage.

A peculiar heterogeneous metal sandwich fragment {(Ge9)2[η6-Ge(PdPPh3)3]}4- anion cluster was synthesized for the first time by Xu et al. (Xu, H. L.; Tkachenko, N. V.; Wang, Z. C.; Chen, W. X.; Qiao, L.; Munoz-Castro, A.; Boldyrev, A. I.; Sun, Z. M. Nat. Commun.2020, 11, 5286). In this work, novel analogous sandwich compounds ({(E9)2[η6-E(PdPH3)3]}4- (E = Si (1), Ge (2), Sn (3)) were studied using quantum chemical calculations and wave function analysis to determine the geometry, bonding nature, aromaticity, active sites, and hydrogen storage. Structural analysis revealed that the clusters were compounds formed by the coordination of two E92- (E = Si, Ge, Sn) Zintl clusters with a central E@Pd3 (E = Si, Ge, Sn) interlayer. The steric hindrance at both ends is small, facilitating facile attachment to other molecules. The valence states of the central atom E (E = Si, Ge, Sn) are close to zero, indicating that they are stable novel heterometallic sandwich compounds, and the Zintl ligands at both ends are negative, thus they can react with Lewis acids. Bonding analysis showed that the E92- (E = Si, Ge, Sn) cluster has a delocalized framework bonding mode. For aromaticity analysis, we used AdNDP, ELF, LOL, ICSS, and NICS to qualitatively and quantitatively clarify that these clusters possess the characteristics of overall delocalization, σ aromaticity, and remarkable stability. By analyzing the unique structure and predicting the reaction sites, we concluded that the E92- ligand reacts with Lewis acids. Finally, through the adsorption of hydrogen molecules, the average adsorption energies of 1-3 were 0.387, 0.374, and 0.325 eV per H2 molecule, respectively, meeting the physical adsorption standard, with the adsorption effect of 3 being slightly more superior than that of 1 and 2. Our study represents a substantial step forward in the study of high-density materials for volumetric H2 storage applications.

Combined quantitative T2 mapping and [18F]FDG PET could improve lateralization of mesial temporal lobe epilepsy.

OBJECTIVES: To investigate whether quantitative T2 mapping is complementary to [18F]FDG PET in epileptogenic zone detection, thus improving the lateralization accuracy for drug-resistant mesial temporal lobe epilepsy (MTLE) using hybrid PET/MR. METHODS: We acquired routine structural MRI, T2-weighted FLAIR, whole brain T2 mapping, and [18F]FDG PET in 46 MTLE patients and healthy controls on a hybrid PET/MR scanner, followed with computing voxel-based z-score maps of patients in reference to healthy controls. Asymmetry indexes of the hippocampus were calculated for each imaging modality, which then enter logistic regression models as univariate or multivariate for lateralization. Stereoelectroencephalography (SEEG) recordings and clinical decisions were collected as gold standard. RESULTS: Routine structural MRI and T2w-FLAIR lateralized 47.8% (22/46) of MTLE patients, and FDG PET lateralized 84.8% (39/46). T2 mapping combined with [18F]FDG PET improved the lateralization accuracy by correctly lateralizing 95.6% (44/46) of MTLE patients. The asymmetry indexes of hippocampal T2 relaxometry and PET exhibit complementary tendency in detecting individual laterality, especially for MR-negative patients. In the quantitative analysis of z-score maps, the ipsilateral hippocampus had significantly lower SUVR (LTLE, p < 0.001; RTLE, p < 0.001) and higher T2 value (LTLE, p < 0.001; RTLE, p = 0.001) compared to the contralateral hippocampus. In logistic regression models, PET/T2 combination resulted in the highest AUC of 0.943 in predicting lateralization for MR-negative patients, followed by PET (AUC = 0.857) and T2 (AUC = 0.843). CONCLUSIONS: The combination of quantitative T2 mapping and [18F]FDG PET could improve lateralization for temporal lobe epilepsy. KEY POINTS: • Quantitative T2 mapping and18F-FDG PET are complementary in the characterization of hippocampal alterations of MR-negative temporal lobe epilepsy patients. • The combination of quantitative T2 and18F-FDG PET obtained from hybrid PET/MR could improve lateralization for temporal lobe epilepsy.

Accelerated J-resolved 1 H-MRSI with limited and sparse sampling of ( k,t1,t2 -space.

PURPOSE: To accelerate the acquisition of J-resolved proton magnetic resonance spectroscopic imaging (1 H-MRSI) data for high-resolution mapping of brain metabolites and neurotransmitters. METHODS: The proposed method used a subspace model to represent multidimensional spatiospectral functions, which significantly reduced the number of parameters to be determined from J-resolved 1 H-MRSI data. A semi-LASER-based (Localization by Adiabatic SElective Refocusing) echo-planar spectroscopic imaging (EPSI) sequence was used for data acquisition. The proposed data acquisition scheme sampled k,t1,t2 -space in variable density, where t1 and t2 specify the J-coupling and chemical-shift encoding times, respectively. Selection of the J-coupling encoding times (or, echo time values) was based on a Cramer-Rao lower bound analysis, which were optimized for gamma-aminobutyric acid (GABA) detection. In image reconstruction, parameters of the subspace-based spatiospectral model were determined by solving a constrained optimization problem. RESULTS: Feasibility of the proposed method was evaluated using both simulated and experimental data from a spectroscopic phantom. The phantom experimental results showed that the proposed method, with a factor of 12 acceleration in data acquisition, could determine the distribution of J-coupled molecules with expected accuracy. In vivo study with healthy human subjects also showed that 3D maps of brain metabolites and neurotransmitters can be obtained with a nominal spatial resolution of 3.0 × 3.0 × 4.8 mm3 from J-resolved 1 H-MRSI data acquired in 19.4 min. CONCLUSIONS: This work demonstrated the feasibility of highly accelerated J-resolved 1 H-MRSI using limited and sparse sampling of k,t1,t2 -space and subspace modeling. With further development, the proposed method may enable high-resolution mapping of brain metabolites and neurotransmitters in clinical applications.

Novel Strategy for Predicting Conduction Abnormalities During Transcatheter Closure of Perimembranous Ventricular Septal Defect in Adults.

BACKGROUND: In this study we evaluated the feasibility and efficacy of predicting conduction system abnormalities under 3-dimensional (3D) electroanatomic mapping guidance during transcatheter closure of perimembranous ventricular septal defects (pmVSDs) in adults.Methods and Results:The distribution of the His-Purkinje system (HPS) close to the margins of pmVSDs in the left ventricle was identified using 3D electroanatomic mapping and near-field HPS was further confirmed by different pacing protocols. Of the 20 patients in the study, 17 (85%) were successfully treated by transcatheter intervention. The minimum distance between the margins of the pmVSD and near-field HPS, as measured by 3D electroanatomic mapping, ranged from 1.3 to 3.9 mm (mean [± SD] 2.5±0.7 mm). Five patients with a minimum distance <2 mm had a higher risk (3/5; 60%) for adverse arrhythmic events, whereas patients with a distance >2 mm were at a much lower risk (1/15; 6.7%) of procedure-related conduction block (P=0.032). No other adverse events were recorded during the follow-up period (median 30 months). CONCLUSIONS: A minimum distance between the pmVSD and near-field HPS <2 mm was associated with a relatively high risk of closure-related conduction block. 3D electroanatomic mapping may be helpful in guiding decision making for transcatheter closure and reduce the incidence of adverse arrhythmic events.

Association between elevated blood glucose level and non-valvular atrial fibrillation: a report from the Guangzhou heart study.

BACKGROUND: To estimate the prevalence of elevated blood glucose level (EBG, including type 2 diabetes mellitus and impaired fasting glucose), and its association with non-valvular atrial fibrillation (NVAF) in Guangzhou, China. METHODS: The population-based follow-up Guangzhou Heart Study collected baseline data from July 2015 to August 2017 among 12,013 permanent residents aged > 35 from 4 Guangzhou districts. Two streets (Dadong and Baiyun) in the Yuexiu District, and one street (Xiaoguwei) and two towns (Xinzao and Nancun) in the Panyu District were chosen as representative of urban and rural areas, respectively. Each participant completed a comprehensive questionnaire, and underwent physical examination, blood sample collection for laboratory testing, electrocardiography, and other evaluations. Multivariable logistic regression analyses were used to estimate the independent association between hyperglycemia and NVAF prevalence. RESULTS: The prevalence of EBG in overall study population was 29.9%. Compared with residents without EBG, the odds ratio (OR) for AF among residents with EBG was significantly higher (1.94, 95% confidence interval [CI]: 1.40-2.70, P <  0.001), even after multivariate adjustment for metabolic abnormalities (OR = 1.60, 95% CI: 1.14-2.25, P = 0.007), and driven by women (OR = 1.80, 95% CI: 1.12-2.91, P = 0.016). CONCLUSIONS: In Guangzhou, China, prevalence of EBG is high among residents aged > 35 years and associated with a multivariate adjusted increase in prevalence of NVAF overall and in women.

Improvement of the process of removing phosphorus from high-phosphorus distillery effluent by ferric chloride using response surface methodology and three-step method.

The purpose of this study was to optimize the coagulation-flocculation effect of a wastewater treatment system using the response surface methodology (RSM) and three-step method to minimize phosphorus concentration in the distillate wastewater. In order to minimize the concentration of total phosphorus (TP), experiments were carried out using 33-factorial designs with three levels and three factors. A Box-Behnken design, which is the standard design of RSM, was used to evaluate the effects and interactions of three major factors (Fe:P (w/w) ratio, coagulation pH and fast mixing speed (FMS)) on the treatment efficiency. A multivariable quadratic model developed for studying the response indicated that the values for optimum conditions for Fe:P (w/w) ratio, coagulation pH and FMS were 2.40, 6.48 and 100 rev min-1, respectively. Under optimal process conditions, the TP concentration in the distillery effluent was reduced from 10 mg L-1 to 0.215 mg L-1, representing a removal efficiency of 97.85%. Based upon the statistical evaluation of results, it is inferred that RSM can be used as an appropriate approach to optimize the coag-flocculation process. Meanwhile, the study has shown that, for the equivalent dose of ferric chloride, the average three-step effect is better than that of the one-time addition.

Adsorption-oxidation of hydrogen sulfide on Fe/walnut-shell activated carbon surface modified by NH3-plasma.

Walnut-shell activated carbon (WSAC) supported ferric oxide was modified by non-thermal plasma (NTP), and the removal efficiency for hydrogen sulfide over Fe/WSAC modified by dielectric barrier discharge (DBD) was significantly promoted. The sample modified for 10min and 6.8kV output (30V input voltage) maintained 100% H2S conversion over a long reaction time of 390min. The surface properties of adsorbents modified by NTP under different conditions were evaluated by the methods of X-ray photoelectron spectroscopy (XPS), Brunauer-Emmett-Teller (BET) analysis and in-situ Fourier transform infrared spectroscopy (FTIR), to help understand the effect of the NTP treatment. NTP treatment enhanced the adsorption capacity of Fe/WSAC, which could due to the formation of micro-pores with sizes of 0.4, 0.5 and 0.75nm. XPS revealed that chemisorbed oxygen changed into lattice oxygen after NTP treatment, and lattice oxygen is beneficial for H2S oxidation. From the in-situ FTIR result, transformation of the reaction path on Fe/WSAC was observed after NTP modification. The research results indicate that NTP is an effective method to improve the surface properties of the Fe/WSAC catalyst for H2S adsorption-oxidation.

[Prevalence and risk factors of latent tuberculosis infection in close contacts of tuberculosis patients among non-resident populations in Shanghai, China].

OBJECTIVE: To investigate the prevalence of latent tuberculosis (TB) infection (LTBI), and to identify the risk factors in close contacts of pulmonary TB patients among non-resident population in Shanghai. METHODS: The study subjects were the close contacts of pulmonary TB patients among non-resident populations in Xuhui, Minhang and Songjiang Districts in Shanghai from 2013 to 2014.Questionnaire interview was applied to collect the socio-demographics, TB-related clinical and TB exposure information from the enrolled TB patients and their close contacts. The T-SPOT.TB test was used to identify the infection of M. TB. LTBI was defined as a positive T-SPOT.TB result inthe absence of signs and symptoms related to TB. RESULTS: In total, 182 pulmonary TB patients and 360 close contacts were enrolled in the present study. The mean age of the close contacts was (34±14) years(range, 2-83 years), including 160 men and 200 women. The T-SPOT.TB test and TB related examination revealed that 17.2% (62/360) of the close contacts were latently infected with M. TB. All the LTBI subjects were household contacts (χ(2)=16.814, P<0.001). In multivariate analysis, the risk of LTBI was statistically associated with the presence of TB symptoms of the index case (OR=2.696, 95%CI: 1.060-6.857) and duration of exposure (OR=1.007, 95%CI: 1.001-1.014); whereas there were no statistically significant associations among age, gender, diagnostic delay of index case, environment of contact place and the risk of LTBI among the studied close contacts. CONCLUSIONS: The prevalence of LTBI in close contacts of pulmonary TB patients among non-resident population in Shanghai is 17.2%.Contact with patients with TB symptoms and longer duration of exposure might increase the risk of LTBI.

Understanding the Enhanced Catalytic Desulfurization Mechanism: Gas-Phase and Surface Reactions with a CuCeOx Catalyst under Nonthermal Plasma Conditions.

To understand the mechanisms of enhanced catalytic technologies under nonthermal plasma (NTP) conditions, complex surface processes must be assessed. However, the predictive capability of the Langmuir-Hinshelwood (L-H) and Eley-Rideal (E-R) processes is limited by various factors. The present study aimed to clarify the interaction mechanisms between NTP and catalysts in the enhancement process, explore the specific pathways of the enhancement process based on E-R and L-H model validations, and obtain data to support the rational design of NTP-enhanced catalytic processes. We investigated CuCeOx catalysts and SO2 removal reaction as a probing reaction using two enhancement scheme configurations, combined with gas-phase reaction process simulations. During the gas-phase reaction stage of the enhancement process, no significant differences were observed among the different configurations caused by the generation of radicals that were induced by N2 (A3Σu+)-excited species. However, introducing CuCeOx catalysts altered the enhancement process, and the placement of the catalyst influenced the corresponding desulfurization mechanism.

Recyclable Fe3O4@UiO-66-PDA core-shell nanomaterials for extensive metal ion adsorption: Batch experiments and theoretical analysis.

With the ever-increasing challenge of heavy metal pollution, the imperative for developing highly efficient adsorbents has become apparent to remove metal ions from wastewater completely. In this study, we introduce a novel magnetic core-shell adsorbent, Fe3O4@UiO-66-PDA. It features a polydopamine (PDA) modified zirconium-based metal-organic framework (UiO-66) synthesized through a simple solvothermal method. The adsorbent boasts a unique core-shell architecture with a high specific surface area, abundant micropores, and remarkable thermal stability. The adsorption capabilities of six metal ions (Fe3+, Mn2+, Pb2+, Cu2+, Hg2+, and Cd2+) were systematically investigated, guided by the theory of hard and soft acids and bases. Among these, three representative metal ions (Fe3+, Pb2+, and Hg2+) were scrutinized in detail. The activated Fe3O4@UiO-66-PDA exhibited exceptional adsorption capacities for these metal ions, achieving impressive values of 97.99 mg/g, 121.42 mg/g, and 130.72 mg/g, respectively, at pH 5.0. Moreover, the adsorbent demonstrated efficient recovery from aqueous solution using an external magnet, maintaining robust adsorption efficiency (>80%) and stability even after six cycles. To delve deeper into the optimized adsorption of Hg2+, density functional theory (DFT) analysis was employed, revealing an adsorption energy of -2.61 eV for Hg2+. This notable adsorption capacity was primarily attributed to electron interactions and coordination effects. This study offers valuable insights into metal ion adsorption facilitated, by magnetic metal-organic framework (MOF) materials.

Identification of Potential Driver Genes and Pathways Based on Transcriptomics Data in Alzheimer's Disease.

Alzheimer's disease (AD) is one of the most common neurodegenerative diseases. To identify AD-related genes from transcriptomics and help to develop new drugs to treat AD. In this study, firstly, we obtained differentially expressed genes (DEG)-enriched coexpression networks between AD and normal samples in multiple transcriptomics datasets by weighted gene co-expression network analysis (WGCNA). Then, a convergent genomic approach (CFG) integrating multiple AD-related evidence was used to prioritize potential genes from DEG-enriched modules. Subsequently, we identified candidate genes in the potential genes list. Lastly, we combined deepDTnet and SAveRUNNER to predict interaction among candidate genes, drug and AD. Experiments on five datasets show that the CFG score of GJA1 is the highest among all potential driver genes of AD. Moreover, we found GJA1 interacts with AD from target-drugs-diseases network prediction. Therefore, candidate gene GJA1 is the most likely to be target of AD. In summary, identification of AD-related genes contributes to the understanding of AD pathophysiology and the development of new drugs.

Stability study of the As(V)-Fe(III) oxyhydroxide coprecipitate over a broad pH range: Characteristics and mechanism.

Fe(III)-oxyhydroxide composites are efficient adsorption materials, however, their detailed geometrical structures and adsorption mechanisms in a broad pH range are still unclear. In this study, the structures of arsenic(V) adsorbed on Fe(III)-oxyhydroxide adsorption complexes were investigated using hybrid density functional theory calculations together with experimental Fourier transform infrared (FT-IR) spectroscopy. Adsorption experiments showed higher arsenic(V) removal rates in the range of pH 5.0-10.0. FT-IR and X-ray diffraction (XRD) revealed that arsenic(V) is stably adsorbed by Fe(III)-oxyhydroxide complexes. The formation of monomeric As(V) appears to be favored in the 1.0-4.0 pH range, while dimeric and trimeric As(V)-Fe(III) oxyhydroxide complexes are preferably formed at higher pH (4.0-10.0). Namely, dimeric and trimeric Fe(III)-oxyhydroxides exhibited good removal efficiencies for arsenic(V) over a wide pH range. Interestingly, the stabilities of the complexes formed between As(V) and monomeric, dimeric and trimeric Fe(III)-oxyhydroxides follow the orders: As(V) trimer > As(V) dimer > As(V) monomer; these complexes are also interconvertible.

Excellent capture of Pb(II) and Cu(II) by hierarchical nanoadsorbent Fe3O4@SiO2@PAA-SO3H: A combined experimental and theoretical study.

A novel magnetic nanoadsorbent (Fe3O4@SiO2@PAA-SO3H) was synthesized by grafting acrylic acid and sulfonic group to Fe3O4@SiO2 using a facile cross-link technology. The adsorbent presented water-stability and biocompatibility in wastewater, which exhibited high-selectivity capture for Pb(II) and Cu(II) of 182.5 mg/g and 250.7 mg/g, respectively, at pH 6.0. Furthermore, the adsorption-desorption processes show that nanoadsorbent still retains high uptake capacity after 6 cycles, revealing structural stability and advanced recycling. Effects from other ions existed weak interference in removal of Pb(II) and Cu(II). Meanwhile, the mechanism was further analyzed from both electrostatic potential (ESP) and average local ionization energy (ALIE) based on the density functional theory (DFT). The results indicate that interaction among nanoadsorbent and heavy metal ions is bridged by oxygen active sites. As the Fe3O4@SiO2@PAA-SO3H adsorbent is a hierarchical, highly water-dispersible and biocompatible adsorbent, it is a potential new treatment option for wastewater.

Prevalence of latent tuberculosis infection and incidence of active tuberculosis in school close contacts in Shanghai, China: Baseline and follow-up results of a prospective cohort study.

Background: The management of latent tuberculosis infection (LTBI) is a key action for the realization of the "End tuberculosis (TB) Strategy" worldwide, and it is important to identify priority populations. In this prospective cohort study, we evaluated the prevalence of LTBI and incidence of active TB among close contacts and explored the suitable TB control strategy in schools. Methods: We designed a cohort with 2 years of follow-up, recruiting freshman/sophomore TB patients' close contacts from three administrative districts in Shanghai. These were chosen based on different levels of TB incidence reported in 2019. Questionnaires were included and all participants received both tuberculin skin test (TST) and QuantiFERON-TB Gold (QFT) at baseline, then tracked the outcomes of them during the follow-up period. Results: The prevalence of LTBI was 4.8% by QFT. Univariate analysis showed that the risk of LTBI was higher in those contacting bacteriologically confirmed patients or did not have BCG scars, including smokers. The risk increased with poor lighting and ventilation conditions at contact sites. Multivariate analysis showed that those contacting with bacteriologically confirmed patients (OR=4.180; 95%CI, 1.164-15.011) or who did not have BCG scars (OR=5.054; 95%CI, 2.278-11.214) had a higher risk of being LTBI, as did the current smokers (OR=3.916; 95%CI, 1.508-10.168) and those who had stopped smoking (OR=7.491; 95%CI, 2.222-25.249). During the 2-year follow-up period, three clinically diagnosed cases of TB were recorded, the 2-year cumulative incidence was 0.4% (95%CI 0.1-1.2), the median duration for TB occurrence was 1 year, the incidence rate of active TB was 2.0 per 1000 person-years with a total of 1497.3 observation person-years. For those LTBI, no one initiated preventive treatment, in the QFT (+) cohort, 1 TB case was observed, 71 person-years with an incidence rate of 14.1 14.1 (95%CI 2.5-75.6) per 1000 person-years, in the TST (+++) cohort, 2 TB cases were observed 91.5 person-years with an incidence rate of 21.9 (95%CI 6.0-76.3) per 1000 person-years. Conclusions: The results suggest that school close contacts are one of the key populations for LTBI management. Measures should be taken to further reduce the prevalence of LTBI and the incidence of active TB among them.

Diagnosis of bronchobiliary fistula by bilirubin crystallization in the alveolar lavage fluid: case reports and literature review.

Bronchobiliary fistula (BBF) refers to the abnormal traffic between the biliary tract and the bronchus. The condition is very rare and usually develops secondary to liver echinococcosis or amebiasis, liver abscess, trauma, biliary obstruction, or tumors. BBF has a high mortality rate and currently, there are no accurate and effective diagnostic methods. This study reports the diagnosis and treatment of two patients with BBF which were confirmed by detecting bilirubin crystallization in the sputum. The first patient was a 45-year-old woman admitted to the hospital with "recurrent cough and lung infection". She had a history of multiple biliary tract surgeries and bilirubin crystallization was detected in bronchoalveolar lavage fluid (BALF) upon examination. Computed tomography (CT) imaging and magnetic resonance cholangiopancreatography (MRCP), together with clinical features, confirmed a diagnosis of BBF. The second patient was a 53-year-old woman admitted to the hospital with coughing and bile-like sputum. She had a history of cholangiocarcinoma surgery and bilirubin crystallization was detected in the cytomorphological BALF examination. Endoscopic retrograde cholangiopancreatography (ERCP) combined with clinical features confirmed a diagnosis of BBF. Both patients recovered after treatment and were discharged from the hospital. The clinical diagnosis of BBF largely relies upon imaging combined with clinical standards, and BALF examinations are rarely performed. This current investigation retrospectively analyzed the diagnosis and treatment of two cases of BBF, and demonstrated that bilirubin crystallization in the BALF may be an important diagnostic indicator for BBF.

Minimally Interrupted Non-Vitamin K Antagonist Oral Anticoagulants vs. Bridging Therapy and Uninterrupted Vitamin K Antagonists During Atrial Fibrillation Ablation: A Retrospective Single-Center Study.

Objectives: Although the latest international guidelines recommend the use of uninterrupted non-vitamin K antagonist oral anticoagulants (NOAC) during atrial fibrillation (AF) ablation, it does not reflect current clinical practice, as most centers still use a minimally interrupted NOAC strategy. The purpose of this study was to evaluate the safety and effectiveness of minimally interrupted NOAC compared with bridging therapy and uninterrupted vitamin K antagonist (VKA) for nonvalvular AF ablation. Patients and Methods: A total of 4520 patients who underwent AF ablation between January 2010 and December 2018 were included in the analysis. According to their periprocedural anticoagulation strategies, patients were divided into three groups: Bridging heparin group (n = 1848); Uninterrupted VKA group (n = 796) and Minimally interrupted NOAC group (Total n = 1876; dabigatran: n = 865; rivaroxaban, n = 1011). A combined complication endpoint (CCE) as composed of any bleeding complications and thromboembolic events was analyzed. Results: Rates of thromboembolisms were similar among the three groups (0.22% for Bridging heparin group, 0.25% for Uninterrupted VKA group, and 0.11% for Minimally interrupted NOAC group, p = 0.626). There was a significant difference among the three groups for the incidence of overall bleeding events (8.50% for Bridging heparin group, 4.52% for Uninterrupted VKA group, and 2.67% for Minimally interrupted NOAC group, p < 0.001). A significant difference of CCE rates was shown in the Minimally interrupted NOAC group as compared with the Uninterrupted VKA group (2.77 vs. 4.77%, p = 0.008) and the Bridging heparin group (2.77 vs. 8.71%, p < 0.001). There was no significant difference in CCE rates among the different NOACs (dabigatran 2.89% vs. rivaroxaban 2.67%, p = 0.773). Conclusions: In patients undergoing AF ablation, minimally interrupted NOACs during the periprocedural period appears safer and equally effective when compared to the bridging heparin and uninterrupted VKA therapy.

Incidence and risk factors of tuberculosis among the elderly population in China: a prospective cohort study.

BACKGROUND: China is facing challenges of the shifting presentation of tuberculosis (TB) from younger to elderly due to an ageing population, longer life expectancy and reactivation disease. However, the burden of elderly TB and influence factors are not yet clear. To fill the gap, we generated a cohort study to measure the magnitude of TB incidence and associated factors among the elderly population aged 65 years and above in China. METHODS: In this cohort established in 2013 through a prevalence survey conducted in selected sites, a total of 34 076 elderlies without TB were enrolled into two-year follow-up. We used both active and passive case findings to find out all TB patients among them. The person-year (PY) incidence rates for both bacteriologically positive TB and active TB were calculated. Cox proportional regression model was performed to test effect of risk factors, and the population attributable fraction (PAF) of each risk factor contributing to incident TB among elderlies was calculated. RESULTS: Over the two-year follow-up period, a total of 215 incident active TB were identified, 62 of which were bacteriologically positive. The incidence rates for active TB and bacteriologically positive TB were 481.8 per 100 000 PY (95% CI: 417.4-546.2 per 100 000 PY) and 138.9 per 100 000 PY (95% CI: 104.4-173.5 per 100 000 PY), respectively. Incident cases detected by active case finding were significantly higher (P < 0.001). Male, non-Han nationality, previously treated TB, ex/current smoker and body mass index (BMI) < 18.5 presented as independent predictors for developing TB disease. For developing bacteriologically positive TB, the biggest contribution was from self-reported ex or current smoker (18.06%). And, for developing active TB, the biggest contribution was from non-Han nationality (35.40%), followed by male (26.80%) and age at 75 years and above (10.85%). CONCLUSIONS: Ageing population in China had a high TB incidence rate and risk to develop TB disease, implying that National TB Program (NTP) needs to prioritize for elderly. Active case finding should be applied capture more active TB cases among this particular population, especially for male, non-Han nationality, and those with identified risk factors.

Density functional theory analysis of selective adsorption of AsH3 on transition metal-doped graphene.

The removal of AsH3 from synthesis gas is crucial to prevent methanol synthesis catalyst from poisoning. In this work, Ti-, Mn-, Fe-, Co-, Ni-, Cu-, and Ag-doped graphene were proposed and their adsorption capabilities for AsH3 and CO were investigated by DFT method. The optimized structures, adsorption energies, electron transfers, electron density difference, and density of states were thoroughly discussed. It was found that pristine graphene had a slight interaction with AsH3 or CO, while doping Ti, Mn, Fe, Co, Ni, and Ag could greatly facilitate the AsH3 or CO adsorption with the adsorption energies of - 0.95 to - 1.45 eV (AsH3) and - 1.00 to 2.02 eV (CO). The partial density of states (PDOS) results showed that hybridizations between AsH3 orbitals, CO orbitals, and transition metals orbitals indicate that there were chemical interactions between them. The charge transfer and density of states (DOS) plots showed that AsH3 and CO have the same adsorption modes on transition metals-doped graphene. Among seven transition metals-doped graphene, Ni-doped graphene had the best selectivity for AsH3 but not for CO due to its larger adsorption energy discrepancy between AsH3 and CO than that of other transition metals-doped graphene, suggesting that Ni-doped graphene is a good candidate adsorbent for AsH3 removal in CO gas stream. Graphical abstract Seven transition metal (Ti, Mn, Fe, Co, Ni, Cu, Ag)-doped graphenes were investigated for AsH3 and CO adsorption by DFT method. Their most stable structure, adsorption energy, and electronic characters were thoroughly studied. The results showed that Ni-doped graphene was a good candidate for selective AsH3 adsorption.

Adsorption of Cadmium Ions from an Aqueous Solution on a Highly Stable Dopamine-Modified Magnetic Nano-Adsorbent.

Magnetic nanomaterials were functionalized with dopamine hydrochloride as the functional reagent to afford a core-shell-type Fe3O4 modified with polydopamine (Fe3O4@PDA) composite, which was used for the adsorption of cadmium ions from an aqueous solution. In addition, the effects of environmental factors on the adsorption capacity were investigated. Furthermore, the adsorption kinetics, isotherm, and thermodynamics of the adsorbents were discussed. Results revealed that the adsorption of cadmium by Fe3O4@PDA reaches equilibrium within 120 min, and kinetic fitting data are consistent with the pseudo-second-order kinetics (R2 > 0.999). The adsorption isotherm of Cd2+ on Fe3O4@PDA was in agreement with the Freundlich model, with the maximum adsorption capacity of 21.58 mg/g. The thermodynamic parameters revealed that adsorption is inherently endothermic and spontaneous. Results obtained from the adsorption-desorption cycles revealed that Fe3O4@PDA exhibits ultra-high adsorption stability and reusability. Furthermore, the adsorbents were easily separated from water under an enhanced external magnetic field after adsorption due to the introduction of an iron-based core. Hence, this study demonstrates a promising magnetic nano-adsorbent for the effective removal of cadmium from cadmium-containing wastewater.