Orthostatic blood pressure changes do not influence cognitive outcomes following intensive blood pressure control.

BACKGROUND: Effects of intensive blood pressure (BP) control on cognitive outcomes in patients with excess orthostatic BP changes are unclear. We aimed to evaluate whether orthostatic BP changes modified the effects of BP intervention on cognitive impairment. METHODS: We analyzed 8547 participants from the Systolic Blood Pressure Intervention Trial Memory and cognition IN Decreased Hypertension. Associations between orthostatic BP changes and incident cognitive outcomes were evaluated by restricted cubic spline curves based on Cox models. The interactions between orthostatic BP changes and intensive BP intervention were assessed. RESULTS: The U-shaped associations were observed between baseline orthostatic systolic BP changes and cognitive outcomes. However, there were insignificant interactions between either change in orthostatic systolic BP (P for interaction = 0.81) or diastolic BP (P for interaction = 0.32) and intensive BP intervention for the composite outcome of probable dementia or mild cognitive impairment (MCI). The hazard ratio of intensive versus standard target for the composite cognitive outcome was 0.82 (95% CI 0.50-1.35) in those with an orthostatic systolic BP reduction of >20 mmHg and 0.41 (95% CI 0.21-0.80) in those with an orthostatic systolic BP increase of >20 mmHg. Results were similar for probable dementia and MCI. The annual changes in global cerebral blood flow (P for interaction = 0.86) consistently favored intensive BP treatment across orthostatic systolic BP changes. CONCLUSION: Intensive BP control did not have a deteriorating effect on cognitive outcomes among hypertensive patients experiencing significant postural BP changes.

Electrocleavage Synthesis of Solution-Processed, Imine-Linked, and Crystalline Covalent Organic Framework Thin Films.

Developing a general, facile, and direct strategy for synthesizing thin films of covalent organic frameworks (COFs) is a major challenge in this field. Herein, we report an unprecedented electrocleavage synthesis strategy to produce imine-linked COF films directly on electrodes from electrolyte solutions at room temperature. This strategy enables the cathodic exfoliation of the COF powders to nanosheets by electrochemical reduction and protonation, followed by nanosheets migrating to the anode and reproducing the COF structures by anodic oxidation. Our method is adaptable with most imine-linked COFs by virtue of the low redox potential of the imine bonds, whereas the COF films possess high crystallinity and hierarchical porosity. We highlight these COF films as a superb platform for promoting mass transfer by demonstrating their extraordinarily rapid iodine adsorption with record-high rate constants.

Association Between Atrial Fibrillation and Domain-Specific Cognitive Decline　- Insights From the Systolic Blood Pressure Intervention Trial.

BACKGROUND: There is a dearth of evidence to characterize longitudinal changes in domain-specific cognitive function related to atrial fibrillation (AF).Methods and Results: This study enrolled 2,844 participants from the Systolic Blood Pressure Intervention Trial (SPRINT). Cognitive function was assessed at baseline and biennially during the follow-up period. Declines in global function and 4 major cognitive domains (i.e., memory, processing speed, language, and executive function) were fitted and compared between participants with and without AF using robust linear mixed-effect models. There were 252 participants with prevalent AF (mean [±SD] age 72.0±8.5 years; 30% women) and 2,592 participants without AF (mean age 67.9±8.4 years; 38% women). The annual decline in global function scores was greater among participants with than without AF (-0.016 vs. -0.012 points); however, the difference was not statistically significant (P=0.33). Processing speed declined faster in participants with prevalent AF, with a distinct difference of -0.013 points/year (95% CI -0.024~-0.001 points/year; P=0.02). For the memory, executive function, and language domains, there were no significant differences in the rate of cognitive decline between participants with and without AF. CONCLUSIONS: In this post hoc analysis of the SPRINT trial, processing speed was the most prominent cognitive domain affected by AF, which may be beneficial for the early screening of cognitive dysfunction.

A facile synthesis of water-soluble copper nanoclusters as label-free fluorescent probes for rapid, selective and sensitive determination of alizarin red.

Copper nanoclusters (FA@CuNCs) emitting blue fluorescence were successfully developed via a one-pot technique. In this method, the copper chloride, folic acid and hydrazine hydrate were applied as a precursor, protective agent and reducing agent, respectively. The absorption, fluorescence excitation and emission spectra of FA@CuNCs were carried out by using ultraviolet-visible and fluorescence spectrometry, respectively. The morphology, particle size, functional groups, oxidation states of elements of FA@CuNCs were discussed via using transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FT-IR) and X-ray photoelectron spectroscopy (XPS). The stability of FA@CuNCs was studied under various conditions, such as storage time at 25 ℃, ultraviolet radiation time, sodium chloride solutione and pH. The FA@CuNCs displayed blue fluorescence under the excitation wavelength of 361 nm, and the fluorescence quantum yield was 7.45 %. As a result of the inner filter effect, the alizarin red could significantly weaken the blue fluorescence of FA@CuNCs. Thus, the as-prepared FA@CuNCs could be utilized as fluorescence nanosensors for the trace determination of alizarin red. This platform suggested an excellent linear range for alizarin red varying from 0.5 to 200 µM with a fitting coefficient of 0.9955. The detection limit was calculated to be 0.064 µM in the light of the 3b/k (b and k refer to the standard deviation and slope of fitted curve, respectively). Furthermore, the as-developed FA@CuNCs could be used to detect the alizarin red in real samples and for the sensing of temperature.

Association between the preprocedural serum potassium level and atrial fibrillation recurrence after catheter ablation.

BACKGROUND: The association between serum potassium and atrial fibrillation (AF) recurrence after catheter ablation remains unclear. OBJECTIVE: The purpose of this study was to investigate whether preprocedural serum potassium level influences AF recurrence in patients who underwent catheter ablation. METHODS: We used data of patients with AF who underwent de novo catheter ablation from the prospective Chinese Atrial Fibrillation Registry Study. Patients with prior ablation and without baseline serum potassium were excluded. The primary outcome was 1-year AF recurrence after a 3-month blanking period from the ablation procedure. Restricted cubic spline and Cox proportional models were used to compare outcomes across serum potassium groups. RESULTS: A total of 4838 patients with AF who underwent de novo catheter ablation was enrolled. At 1 year, AF recurrence occurred in 1347 patients (27.8%). The relationship between preprocedural serum potassium levels and 1-year AF recurrence after ablation presented as U shape (P for nonlinear = .048). Compared with the group of serum potassium within 4.41-4.60 mmol/L, the risk of AF recurrence increased significantly in the lowest serum potassium group (≤4.00 mmol/L) after multivariable analysis (hazard ratio [HR] 1.26; 95% confidence interval 1.06-1.51; P = .010). Other groups with lower or higher serum potassium levels including 4.01-4.20 mmol/L (HR 1.18), 4.21-4.40 mmol/L (HR 1.16), 4.61-4.80 mmol/L (HR 1.07), and ≥4.81 mmol/L (HR 1.11) showed nonsignificant higher recurrence risk. CONCLUSION: The relationship between preprocedural potassium and AF recurrence was U shaped, with an optimal potassium range (4.41-4.60 mmol/L). Lower potassium level is associated with increased AF recurrence risk after catheter ablation.

Small Left Ventricle in Patients With Atrial Fibrillation Is Associated With Increased Cardiovascular Risk.

BACKGROUND: It is still unclear whether small left ventricle (LV) is an adverse structural prognostic feature in patients with atrial fibrillation (AF). OBJECTIVES: The purpose of this study was to evaluate the association between small LV and risk of cardiovascular events in AF population. METHODS: From the China-AF registry, 7,764 patients with AF were enrolled and divided into groups with normal, small, and large LV size based on left ventricular end-diastolic dimension (LVEDD) measurement per the American Society of Echocardiography references. Cox models were used to assess the association between LV size or LVEDD with composite cardiovascular events (cardiovascular death, ischemic stroke or systemic embolism, or major bleeding). RESULTS: There were 308 (4.0%) participants assessed with small LV who were older, with lower body mass and blood pressure, and fewer comorbidities, and 429 (5.5%) were identified with large LV. Compared with the normal LV group, small LV and large LV were significantly associated with higher incidence of composite cardiovascular events (adjusted HR [aHR]: 1.54 [95% CI: 1.07-2.20] for small LV; aHR: 1.36 [95% CI: 1.02-1.81] for large LV) and cardiovascular death (aHR: 1.94 [95% CI: 1.14-3.28] for small LV; aHR: 1.83 [95% CI: 1.24-2.69] for large LV). Small LV was also associated with increased risk of major bleeding [aHR: 2.21 [95% CI: 1.01-4.86]). A U-shaped relationship between LVEDD and composite cardiovascular events was identified (Pnonlinear < 0.001). CONCLUSIONS: In a prospective AF cohort, small LV was independently associated with an increased risk of cardiovascular events, which needed consideration in risk stratification and management for patients with AF. (ChiCTR-OCH-13003729).

Genetic Evidence for Causal Association Between Atrial Fibrillation and Dementia: A Mendelian Randomization Study.

Background The knowledge gap regarding whether the correlation between atrial fibrillation (AF) and dementia in observational studies is causation or driven by other shared risk factors remains substantially unfilled. Methods and Results We performed a comprehensive 2-sample Mendelian randomization study to evaluate the causal effect of AF on overall dementia and its subtypes, including vascular dementia, Alzheimer dementia, Lewy body dementia, and frontotemporal dementia. The primary results in inverse variance-weighted analyses were further validated by various Mendelian randomization sensitivity analyses. Additionally, we conducted multivariable Mendelian randomization to examine 10 candidate mediators of the causal association of AF and dementia. Genetic predisposition to AF was modestly associated with an increased risk of overall dementia (odds ratio, 1.140 [95% CI, 1.023-1.271]; P=0.018) and strongly associated with vascular dementia (odds ratio, 1.350 [95% CI, 1.076-1.695]; P=0.010). Genetically predicted AF indicated neutral effects on Alzheimer dementia, Lewy body dementia, and frontotemporal dementia. In multivariable Mendelian randomization analysis, the total effect of AF on overall dementia was remarkably attenuated by adjusting for genetic effect for ischemic stroke (odds ratio, 1.068 [95% CI, 0.953-1.197]; P=0.259) and low cardiac output (odds ratio, 1.046 [95% CI, 0.926-1.181]; P=0.475), indicating that the causal association of genetically predicted AF with dementia was potentially mediated by ischemic stroke and low cardiac output. The causal effect of genetically predicted AF on dementia was independent of cerebral small-vessel disease and brain volume phenotypes. Conclusions Our findings provided novel evidence supporting the causal effect of genetically predicted AF on dementia mediated by ischemic stroke and low cardiac output. Future clinical trials are warranted to evaluate the potential role of appropriate AF management in dementia prevention.

Diastolic Blood Pressure and Intensive Blood Pressure Control on Cognitive Outcomes: Insights From the SPRINT MIND Trial.

BACKGROUND: The potential benefits or harms of intensive systolic blood pressure (BP) control on cognitive function and cerebral blood flow in individuals with low diastolic blood pressure (DBP) remain unclear. METHODS: We conducted a post hoc analysis of the SPRINT MIND (Systolic Blood Pressure Intervention Trial Memory and Cognition in Decreased Hypertension) that randomly assigned hypertensive participants to an intensive (<120 mm Hg; n=4278) or standard (<140 mm Hg; n=4385) systolic blood pressure target. We evaluated the effects of BP intervention on cognitive outcomes and cerebral blood flow across baseline DBP quartiles. RESULTS: Participants in the intensive group had a lower incidence rate of probable dementia or mild cognitive impairment than those in the standard group, regardless of DBP quartiles. The hazard ratio of intensive versus standard target for probable dementia or mild cognitive impairment was 0.91 (95% CI, 0.73-1.12) in the lowest DBP quartile and 0.70 (95% CI, 0.48-1.02) in the highest DBP quartile, respectively, with an interaction P value of 0.24. Similar results were found for probable dementia (interaction P=0.06) and mild cognitive impairment (interaction P=0.80). The effect of intensive treatment on cerebral blood flow was not modified by baseline DBP either (interaction P=0.25). Even among participants within the lowest DBP quartile, intensive versus standard BP treatment resulted in an increasing trend of annualized change in cerebral blood flow (+0.26 [95% CI, -0.72 to 1.24] mL/[100 g·min]). CONCLUSIONS: Intensive BP control did not appear to have a detrimental effect on cognitive outcomes and cerebral perfusion in patients with low baseline DBP. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT01206062.

Systolic Blood Pressure Time in Target Range and Cognitive Outcomes: Insights From the SPRINT MIND Trial.

BACKGROUND: The prognostic value of systolic blood pressure (SBP) time in target range (TTR) on cognitive outcomes among adults with hypertension remains unclear. METHODS: We performed secondary analysis of SPRINT MIND (Systolic Blood Pressure Intervention Trial Memory and Cognition in Decreased Hypertension), which compared intensive (<120 mm Hg) versus standard (<140 mm Hg) SBP intervention in hypertensive individuals. TTR was calculated from baseline to month 3 using 110 to 130 mm Hg and 120 to 140 mm Hg as target range for the intensive and standard groups, respectively. Cognitive outcomes included probable dementia, mild cognitive impairment, and the composite of probable dementia or mild cognitive impairment. Cox regression models were used to evaluate the relationship between SBP-TTR and cognitive outcomes. RESULTS: A total of 8298 patients were included. Participants with higher TTR were younger and less likely to be women or to have a history of cardiovascular disease. After adjustment of baseline demographics, medical history, and mean SBP, a 1-SD (31.5%) increase in TTR was independently associated with a 14% lower risk of probable dementia (hazard ratio, 0.86 [95% CI, 0.76-0.98]; P=0.023). Sensitivity analysis showed consistent results when combining target range as 110 to 140 mm Hg. However, there was no significant association between SBP-TTR and mild cognitive impairment. CONCLUSIONS: In this post hoc analysis of SPRINT MIND, SBP-TTR was an independent predictor of probable dementia beyond mean SBP. Maintaining SBP within 110 to 140 mm Hg over time may be beneficial for dementia prevention. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT01206062.

Stability of the Charged Nonfullerene Acceptors.

As an electric current passes through an organic semiconductor, a small number of organic molecules will inevitably act as a polaron state that is similar to an ionic charged state. The continuous device operation of organic semiconducting molecules is directly associated with the stability of the charged state. Herein, we choose the high-performance Y-series of nonfullerene acceptors to investigate the stability by a spectro-electrochemical technique. The results reveal the discoloration of molecules in the charged state and can be partially recovered after neutralization with about 10% irreversible part. It is found that the degree of the irreversible process is associated with halogen substituents at the end groups, and the irreversible reactions are also discussed. Our results reveal that the stability of a charged state can be improved by the fine-tuning of the molecular structures, and the local charge density can also be rapidly reduced by the high carrier mobility, the key factor to improving the stability of nonfullerene acceptors for better practical applications.

Validation of T-MoCA in the Screening of Mild Cognitive Impairment in Chinese Patients With Atrial Fibrillation.

Background: Atrial fibrillation (AF) is associated with a high risk of mild cognitive impairment (MCI) and dementia. However, feasible and simple instruments that facilitate the regular assessment of cognitive status in patients with AF remain underdeveloped. Methods: Cognitive function was first evaluated using telephone Montreal cognitive assessment (T-MoCA), and then patients were invited for an in-person interview for cognitive assessment using both Clinical Dementia Rating (CDR) and mini-mental status evaluation (MMSE). Using CDR = 0.5 as a reference standard, the ability of T-MoCA and MMSE to discriminate cognitive dysfunction, stratified by education level, was tested by receiver-operating curve (ROC) analysis. The net reclassification index was calculated for comparison between the performance of T-MoCA and MMSE. Results: One hundred and one patients completed both telephone and in-person interview. Thirty-five MCI patients were identified as MCI using the criteria of CDR = 0.5. The areas under the ROC curve of T-MoCA were 0.80 (0.71-0.89), 0.83 (0.71-0.95), and 0.85 (0.64-0.92) for all patients, patients with high educational level, and patients with low education level, respectively. The optimal threshold was achieved at 16/17 with a sensitivity of 85.7% and a specificity of 69.7% in overall patients, 15/16 with a sensitivity of 88.2% and a specificity of 64.5% in the low educational level patients, and 16/17 with a sensitivity of 77.8% and a specificity of 87.9% in the high educational level patients. Compared to the criterion MMSE ≤ 27 and MMSE norms for the elderly Chinese community, the stratified T-MoCA threshold improves correct classification by 23.7% (p = 0.033) and 30.3% (p = 0.020), respectively. Conclusion: T-MoCA is a feasible and effective instrument for MCI screening in patients with AF.

Enhanced Long-Term Stability of Organic Electrode Materials by a Trap Filler Strategy.

The sensitivity of organic electrode materials to water and oxygen has long been the bottleneck of their further development. The residual and penetrative water and oxygen in electrochemical cells form electron traps that trigger irreversible side reactions, which is detrimental to their long-term stability. A trap filler strategy by introducing molecules with low ionization energy in a cell, bis(pentamethylcyclopentadienyl)cobalt(II) (DMC) as an example, is demonstrated to deactivate traps spontaneously by donating electrons to traps without causing undesirable reactions with electrode materials. The electrode materials BthCz and AQCz, with lowest unoccupied molecular orbital levels above or near the electron traps (-3.6 to -3.8 eV), exhibit conspicuous stability increment of 68.6 and 26.3%, respectively, with the optimized DMC concentration of 5 × 10-4 M in acetonitrile electrolyte.

Organic Electropolymerized Multilayers for Light-Emitting Diodes and Displays.

In electrochemistry, the carbazole is generally coupled to dimer but not to polymer. This work has reported that organic electropolymerization (OEP) of 4,4',4″-tri(N-carbazolyl)triphenylamine (TCTA) would form a high cross-linked carbazole polymer by its high activity/reversibility and a synchronous viscosity control. It has significantly improved the OEP film quality of both hole-transporting and electroluminescent layers in organic light-emitting diodes. As a result, the conductivity and power efficiency of the organic light-emitting diodes with TCTA are eight and four times of that without TCTA. A prototype display device with a 1.7 in. monochrome passive matrix of 58 ppi under the driving chip is successfully fabricated with accurate pixel size and uniform electroluminescence, which shows a great potential of OEP in the electroluminescent application.

Polarized Species in an Organic Semiconductor Laser.

Meeting the challenge of direct electrically driven organic semiconductor lasers (OSLs), the design of OSL materials is being studied. Polarized species generally exist in conjugated organic materials and play an important role in the photophysics procedure; therefore, understanding these species is beneficial for designing novel OSL materials. Here, we use the amplified spontaneous emission effect as a medium to reveal a carbazole-benzothiadiazole-based polarized species induced by a charge transfer process. Spectroscopic analysis confirms that this polarized species that acted as a CT pair defect has a negative influence on the ASE stability and solid state fluorescent quantum yield. This inspires us to be cautious in terms of some specific molecular group combinations when designing OSL materials.

[Study on correlation between histocompatibility leukocyte antigen class II gene and gestational diabetes mellitus].

OBJECTIVE: To investigate correlation between part of histocompatibility leukocyte antigen (HLA) class II gene and gestational diabetes mellitus (GDM). METHODS: Part of HLA-II gene was examined by polymerase chain reaction sequence specific primer (PCR-SSP). Forty-eight GDM women were served as study group, and forty-eight normal pregnant women were selected as control group. RESULTS: The frequencies of DRB1*0301, DRB1*1302 and DQA1*0301 of GDM (18.8%, 45.8% and 64.6%) in study group were significantly increased compared with control group (4.2%, 18.8% and 41.7%) (P < 0.05). CONCLUSIONS: The results suggest that there is correlation between HLA class II gene and gestational diabetes mellitus. DRB1*0301, DRB1*1302 and DQA1*0301 are the susceptible alleles of GDM.

[Study on anti-endotoxin of baicalin].

OBJECTIVE: To study the anti-endotoxin of different concentration baicalin. METHODS: 6.250 microg/mL, 3.125 microLg/mL, 1.562 microg/mL and 0.781 microg/mL baicalin solutions were mixed with I EU/mL endotoxin, respectively. The mixtures were put into water of (37+/-1) degrees C for 15 min, 30 min and 60 min. The degrading effects were determined by using limulus amebocyte lysate test (LAL test). RESULTS: 1) The degrading effect of 6.250 microg/mL, 3.125 microg/mL and 1.562 microg/mL baicalin solution on I EU/mL endotoxin was degraded completely in 15 min, 30 min and 60 min, respectively. 2)The degrading effect of 3.125 microg/mL, 1.562 microg/mL and 0.781 microg/mL baicalin solution on 1 EU/mL endotoxin after these mixtures had been incubated for 15 min. Endotoxin values were (0.155 5 +/- 0.002 8) EU/mL, (0.212 1+/-0.004 9) EU/mL, (0.355 9+/-0.013 9) EU/mL, respectively. These differences among them were statistically significant (P<0.01). 3) The degrading effect of 1.562 microg/mL and 0.781 microg/mL baicalin solution on 1 EU/mL endotoxin after these mixtures had been incubated for 30 min. Endotoxin values were (0.1640+/-0.0025) EU/mL and (0.2094+/-0.004 4) EU/mL, respectively. These differences between them were statistically significant (P<0.01). CONCLUSION: The action of anti-endotoxin of baicalin is dose-dependent and time-dependent. The results show that baicalin has the stronger anti-endotoxin effect.