Selectively "size-excluding" water molecules to enable a highly reversible zinc metal anode.

Significant water-related side reactions hinder the development of highly safe, low-cost aqueous zinc metal batteries (AZMBs) for grid-scale energy storage. Herein, by regulating the length of alkyl chains, we successfully adjust interstitial voids between the polymer chains of a metal soap interface between 1.48 Å (size of a zinc ion) and 4.0 Å (size of a water molecule). Therefore, water molecules are selectively "size-excluded," while smaller zinc ions are permitted to pass through. Consequently, water-related side reactions (including hydrogen evolution and corrosion) could be effectively inhibited. Furthermore, abundant zinc ion tunnels accompanied with zincophilic components facilitate the homogenization of the Zn2+ flux, thus preventing dendrite growth. Therefore, the Zn symmetric cell shows a lifespan of approximately 10 000 cycles at 20 mA cm-2 and 1 mA h cm-2, and the Zn//Na5V12O32 (NVO) full cell delivers much better cycling stability with much higher capacity retention of around 93% after 2000 cycles at 2 A g-1 compared to its bare Zn counterpart (19%). This work provides valuable insights for the utilization of metal soap interfaces and regulation of their channel size between perpendicular alkyl chains to realize precise water shielding, which is not only applicable in ZMBs but also in other aqueous batteries.

Experimental study on the treatment of deep miscellaneous fill foundation in Xinjiang by vibrating rod compaction method.

Currently, the treatment of miscellaneous fill foundations, composed of a mixture of domestic garbage, construction solid waste, and natural soil, presents a significant challenge in urban peripheral engineering construction. This paper discusses the application of vibrating rod compaction technology for foundation treatment in Xinjiang. It evaluates the effectiveness of cross-section vibrating rod compaction equipment in reinforcing fine-grained miscellaneous fill foundations. The study analyzes the impact of construction disturbances caused by the insertion of the vibrating rod, monitoring horizontal stresses at various depths. Both laboratory and field tests show significant improvements: soil dry density increased by 8% to 18%, porosity decreased by 10% to 23%, compression modulus increased by 22% to 246%, and compression coefficient decreased by 8% to 70%. Additionally, cohesion (C) and angle of friction (ɸ) saw increases ranging from 7 to 38% and 3% to 25%, respectively. Below a depth of 3 m, cone tip resistance exceeded 10 MPa, and sidewall friction resistance increased to over 100 kPa, surpassing pre-treatment values. The standard penetration test results doubled stroke length compared to pre-treatment, indicating a substantial improvement in foundation bearing capacity. Surface wave tests before and after treatment showed a 15% increase in wave velocity, reflecting a more compact soil structure. The vibrating rod compaction method is innovative, energy-efficient, environmentally friendly, and economically beneficial, holding great potential for future miscellaneous fill treatments.

Combined short-term and long-term emission controls improve air quality sustainably in China.

The effectiveness of national policies for air pollution control has been demonstrated, but the relative effectiveness of short-term emission reduction measures in comparison with national policies has not. Here we show that short-term abatement measures during important international events substantially reduced PM2.5 concentrations, but air quality rebounded to pre-event levels after the measures ceased. Long-term adherence to strict emission reduction policies led to successful decreases of 54% in PM2.5 concentrations in Beijing, and 23% in atmospheric nitrogen deposition in China from 2012 to 2020. Incentivized by "blue skies" type campaigns, economic development and reactive nitrogen pollution are quickly decoupled, showing that a combination of inspiring but aggressive short-term measures and effective but durable long-term policies delivers sustainable air quality improvement. However, increased ammonia concentrations, transboundary pollutant flows, and the complexity to achieving reduction targets under climate change scenarios, underscore the need for the synergistic control of multiple pollutants and inter-regional action.

Bioavailability and ecological risk assessment of metal pollutants in ambient PM2.5 in Beijing.

Metal pollutants in fine particulate matter (PM2.5) are physiologically toxic, threatening ecosystems through atmospheric deposition. Biotoxicity and bioavailability are mainly determined by the active speciation of metal pollutants in PM2.5. As a megacity in China, Beijing has suffered severe particulate pollution over the past two decades, and the health effects of metal pollutants in PM2.5 have received significant attention. However, there is a limited understanding of the active forms of metals in PM2.5 and their ecological risks to plants, soil or water in Beijing. It is essential that the ecological risks of metal pollutants in PM2.5 are accurately evaluated based on their bioavailability, identifying the key pollutants and revealing historic trends to future risks control. A two-year project measured the chemical speciation of pollution elements (As, Cd, Cu, Cr, Ni, Mn, Pb, Sb, Sr, Ti, and Zn) in PM2.5 in Beijing, in particular their bioavailability, assessing ecological risks and identifying key pollutants. The mass concentrations of total and active species of pollution elements were 199.12 ng/m3 and 114.97 ng/m3, respectively. Active fractions accounted for 57.7 % of the total. Cd had the highest active proportion. Based on the risk assessment code (RAC), most pollution elements except Ti had moderate or high ecological risk, with RAC exceeding 30 %. Cd, with an RAC of 70 %, presented the strongest ecological risk. Comparing our data with previous research shows that concentrations of pollution elements in PM2.5 in Beijing have decreased over the past decade. However, although the total concentrations of Cd in PM2.5 have decreased by >50 % over the past decade, based on machine model simulation, its ecological risk has reduced by only 10 %. Our research shows that the ecological risks of pollution elements remain high despite their decreasing concentrations. Controlling the active species of metal pollutants in PM2.5 in Beijing in the future is vital.

Perfluoro-1-butanesulfonic acid etching strategy for dendrite suppression in aqueous zinc metal batteries.

Perfluoro-1-butanesulfonic acid (PFBS) was used to etch on the surface of a zinc anode to introduce a 3D C4F9O3S-Zn interface layer with unique fluorine groups (Zn@PFBS) to inhibit the formation of dendrites. The C-F chains in the Zn@PFBS coating enhance the anode hydrophobicity of the zinc metal, which not only suppresses the HER of the surface of the zinc metal, but also strengthens the corrosion resistance of the zinc metal. Meanwhile, -SO3 - in the coating enhanced the binding energy with Zn2+, which acted as a nucleation site on the surface of the zinc anode to induce the uniform deposition of Zn2+ and inhibited the disordered growth of zinc dendrites. As a result, the symmetric battery assembled with the Zn@PFBS anode achieved a stable cycling of 6200 cycles at 5 mA cm-2 to 1 mA h cm-2. Meanwhile, the Zn@PFBS anode exhibited a higher cycling performance with a capacity retention rate of 78.6% after 1000 cycles in a Zn@PFBS//Na5V12O32 (NVO) full cell.

Biodegradable film mulching increases soil microbial network complexity and decreases nitrogen-cycling gene abundance.

Biodegradable plastic films have emerged as a substitute for conventional plastic films. Nevertheless, responses of plant-associated microbiomes to the application of biodegradable film mulching at field scale have received little attention. A field experiment was conducted to assess the influence of different film mulching treatments on various microbial attributes and nitrogen (N) cycling functional genes in bulk and rhizosphere soils. Biodegradable film mulching raised the bacterial Shannon index in bulk soils but not in rhizosphere soils. Biodegradable film mulching has led to an increase in the complexity and connectivity of microbial networks, as well as an enhancement in the positive association among microorganisms owing to raised soil nutrients and increased crop biomass. In biodegradable film-treated soils, both bacterial and fungal communities were primarily influenced by stochastic processes associated with dispersal limitation. Moreover, conventional plastic film mulching increased denitrification, anammox, N fixation, and dissimilatory nitrate-reduction (DNRA) gene abundance in bulk soils. In rhizosphere soils, biodegradable film mulching reduced nitrification, denitrification, anammox, N fixation, and DNRA gene abundance. Furthermore, keystone genera (e.g., Nitrosospira, Truepera, Adhaeribacter, Opitutus, and Fusarium) were affected by edaphic variables, contributing to decreased N-cycling gene abundance in biodegradable film-treated soils. Collectively, biodegradable film mulching transformed soil microbiome assembly and functional adaptation, and soil nutrient availability and plant biomass were the critical factors influencing the microbial community. These findings present a novel perspective on the diverse impacts of biodegradable and conventional film mulching on soil microbiome and N-cycling processes.

Atmospheric wet and dry phosphorus deposition in Lake Erhai, China.

Lake Erhai is a potentially phosphorus (P)-limited lake and its water quality may have been affected by atmospheric P deposition. However, there have been few studies on atmospheric P deposition in this lake. In this study, we established five wet deposition monitoring sites and two dry deposition monitoring sites around Lake Erhai to quantify the wet and dry deposition of total phosphorus (TP), including dissolved inorganic phosphorus (DIP), dissolved organic phosphorus (DOP) and particulate phosphorus (PP) from July 2022 to June 2023. Wet deposition fluxes of P species were collected by automatic rainfall collection instrument, and dry deposition fluxes were estimated using airborne concentration measurements and inferential models. The results reveal that among the different P components, DOP had the highest contribution (50%) to wet TP deposition (average all sites 12.7 ± 0.7 mg P m2/yr), followed by PP (40%) and DIP (10%). Similarly, DOP (51%) was the major contributor to dry TP deposition (average two sites 2.4 ± 0.9 mg P m2/yr), followed by DIP (35%) and PP (14%). Wet deposition dominated the annual total TP deposition (wet plus dry), accounting for approximately 83%. The key seasons for dry deposition were spring and autumn, which accounted for 64% of the annual total dry TP deposition. In comparison, wet deposition was significantly higher in the summer, accounting for 73% of the annual total wet TP deposition. The results of the potential source contribution function and concentration-weighted trajectories analysis indicate that local source emission and long-range transport from surrounding cities jointly exerted a substantial influence on aerosol P concentrations, particularly in the eastern and northwestern regions of the lake. These findings provide a comprehensive understanding of the different P components in atmospheric deposition, which is beneficial for developing effective strategies to manage the P cycle in Lake Erhai.

Characterization of chitosan film incorporated pine bark extract and application in carp slices packaging.

Active films based on chitosan incorporated with pine bark extract (PBE) were prepared and characterized. Subsequently, these films were utilized for packaging carp slices in refrigerated storage at 4 ± 1 °C. Analysis of the physicochemical properties and biological activity of the active films revealed that, except for water content, all assessed indices showed an increasing trend with an increase in the amount of supplemental PBE. As this trend progresses, scanning electron microscopy (SEM) analysis revealed deposition on the film surface accompanied by transverse lines and fractures, while the color of the film gradually changed from light yellow to reddish-brown. Fourier transform infrared spectroscopy (FTIR) indicated that the phenolic hydroxyl groups in PBE interacted with the hydrogen in the amino groups of chitosan molecules to form non-covalent bonds. X-ray diffraction analysis (XRD) showed that the reaction between PBE and chitosan altered the crystalline structure of chitosan molecules. Moreover, the analysis of the effects of active films on the pH, water-holding capacity, thiobarbituric acid values, and the total bacterial counts of carp slices revealed that in terms of preservation, films containing 30 % PBE were the most effective, using which the shelf life of carp slices could be extended by 50 %.

Temporal-spatial characteristics and sources of heavy metals in bulk deposition across China.

With the rapid development of industries, agriculture, and urbanization (including transportation and population growth), there has been a significant alteration in the emission and atmospheric deposition of heavy metal pollutants. This has consequently given rise to a range of ecological and environmental health issues. In this study, we conducted a comprehensive two-year investigation on the temporal and spatial distribution characteristics of heavy metals in atmospheric deposition across China based on the Nationwide Nitrogen Deposition Monitoring Network (NNDMN). The atmospheric bulk deposition of Lead (Pb), Arsenic (As), Nickel (Ni), Selenium (Se), Chromium (Cr) and Cadmium (Cd) were 6.32 ± 1.59, 4.49 ± 0.57, 1.31 ± 0.21, 1.05 ± 0.16, 0.60 ± 0.06 and 0.21 ± 0.03 mg m-2 yr-1, respectively, with a large variation among the different regions of China. The order for atmospheric deposition flux was Southwest China > Southeast China > North China > Northeast China > Qinghai-Tibet Plateau and rural area > urban area > background area. The concentrations of heavy metals in bulk deposition exhibit seasonal variation with higher levels observed during winter compared to summer and spring, which are closely associated with anthropogenic activities. The Positive Matrix Factorization (PMF) results indicated that combustion, industrial emissions and traffic are the primary contributors to atmospheric deposition of heavy metals. The single factor pollution index (Pi) of heavy metals is consistently below 1, and the composite pollution index (Ni) is 0.16 across China, indicating that atmospheric heavy metal deposition is at a pollution-free level. The comprehensive potential ecological risk index of heavy metals is 11.8, with Cd exhibiting the highest single factor potential ecological risk index at 7.09, suggesting that more attention should be paid to Cd deposition in China. The present study reveals the spatial-temporal distribution pattern of atmospheric heavy metals deposition in China, identifying regional source characteristics and providing a theoretical foundation and strategies for reducing emissions of atmospheric pollutants.

Renewable lignin-derived heteroatom-doped porous carbon nanosheets as an efficient oxygen reduction catalyst for rechargeable zinc-air batteries.

Lignin upgrading to various functional products is promising to realize high-value utilization of low-cost and renewable biomass waste, but is still in its infancy. Herein, using industry waste lignosulfonate as the biomass-based carbon source and urea as the dopant, we constructed a heteroatom-doped porous carbon nanosheet structure by a simple NaCl template-assisted pyrolytic strategy. Through the synergistic effect of the NaCl template and urea, the optimized lignin-derived porous carbon catalyst with high content of active nitrogen species and large specific surface area can be obtained. As a result, the fabricated catalysts exhibited excellent electrocatalytic oxygen reduction activity, as well as good methanol tolerance and stability, comparable to that of commercial Pt/C. Moreover, rechargeable Zn-air batteries assembled with this electrocatalyst have a peak power density of up to 150 mW cm-2 and prominent long-term cycling stability. This study offers an inexpensive and efficient way for the massive production of highly active metal-free catalysts from the plentiful, inexpensive and environmentally friendly lignin, offering a good direction for biomass waste recycling and utilization.

Source apportionment of atmospheric ammonia in suburban Beijing revealed through 15N-stable isotopes.

Addressing the urgent issue of atmospheric ammonia (NH3) emissions is crucial in combating poor air quality in megacities. Previous research has highlighted the significant contribution of nonagricultural sources, particularly fossil fuel emissions, to urban NH3 levels. However, there is limited assessment of NH3 dynamics in suburban areas. This study focuses on four suburban sites in Beijing, covering a 16 to 22-month observation period, to investigate spatial and temporal patterns of NH3 concentrations. The δ15N-stable isotope method is employed to identify NH3 sources and their contributions. Our results demonstrate that agricultural sources (53 %) dominate atmospheric NH3 emissions in suburban areas of Beijing, surpassing nonagricultural sources, and primarily emanate from local sources. Notably, fertilizer application (37 ± 11 %) and livestock breeding (32 ± 6 %) emerge as the primary contributors in summer and spring, respectively, leading to significantly elevated NH3 concentrations during these seasons. Even in autumn and winter, both agricultural (49 %) and nonagricultural (51 %) sources contribute almost equally to NH3 emissions. This study emphasizes the need for coordinated efforts to control atmospheric NH3 pollution in Beijing City, with particular attention to addressing both vehicular and agricultural emissions.

An MRI-Based Deep Transfer Learning Radiomics Nomogram to Predict Ki-67 Proliferation Index of Meningioma.

The objective of this study was to predict Ki-67 proliferation index of meningioma by using a nomogram based on clinical, radiomics, and deep transfer learning (DTL) features. A total of 318 cases were enrolled in the study. The clinical, radiomics, and DTL features were selected to construct models. The calculation of radiomics and DTL score was completed by using selected features and correlation coefficient. The deep transfer learning radiomics (DTLR) nomogram was constructed by selected clinical features, radiomics score, and DTL score. The area under the receiver operator characteristic curve (AUC) was calculated. The models were compared by Delong test of AUCs and decision curve analysis (DCA). The features of sex, size, and peritumoral edema were selected to construct clinical model. Seven radiomics features and 15 DTL features were selected. The AUCs of clinical, radiomics, DTL model, and DTLR nomogram were 0.746, 0.75, 0.717, and 0.779 respectively. DTLR nomogram had the highest AUC of 0.779 (95% CI 0.6643-0.8943) with an accuracy rate of 0.734, a sensitivity value of 0.719, and a specificity value of 0.75 in test set. There was no significant difference in AUCs among four models in Delong test. The DTLR nomogram had a larger net benefit than other models across all the threshold probability. The DTLR nomogram had a satisfactory performance in Ki-67 prediction and could be a new evaluation method of meningioma which would be useful in the clinical decision-making.

Risk of Venous Thromboembolism by Cancer Type: A Network Meta-Analysis.

Patients with cancer have an increased risk of venous thromboembolism (VTE). Comparing tumor-specific VTE risk is complicated by factors such as surgery, disease stage, and chemotherapy. Network meta-analysis (NMA) using cancer types as network nodes enabled us to estimate VTE rates by leveraging comparisons across cancer types while adjusting for baseline VTE risk in individual studies. This study was conducted to estimate the risk of VTE by cancer type and factors influencing VTE risk. The Embase, MEDLINE, and Cochrane Library repositories were systematically searched to identify clinical trials and observational studies published from 2005 to 2022 that assessed the risk of primary cancer-related VTE among two or more distinct cancer types. Studies with similar cancer populations and study methods reporting VTE occurring within 1 year of diagnosis were included in the NMA. Relative VTE rates across cancer types were estimated with random-effects Bayesian NMAs. Absolute VTE rates were calculated from these estimates using the average VTE incidence in lung cancer (the most frequently reported type) as the "anchor." From 2,603 records reviewed, 30 studies were included in this NMA. The general network described 3,948,752 patients and 18 cancer types: 3.1% experienced VTE within 1 year of diagnosis, with cancer-specific rates ranging from 0.7 to 7.4%. Consistent with existing VTE risk prediction tools, pancreatic cancer was associated with higher-than-average VTE risk. Other cancer types with high VTE risk were brain and ovarian cancers. The relative rankings of VTE risk for certain cancers changed based on disease stage and/or receipt of chemotherapy or surgery.

Nitrogen fertilization reduces plant diversity by changing the diversity and stability of arbuscular mycorrhizal fungal community in a temperate steppe.

Nitrogen (N) deposition resulting from anthropogenic activities poses threats to ecosystem stability by reducing plant and microbial diversity. However, the role of soil microbes, particularly arbuscular mycorrhizal fungi (AMF), as mediators of N-induced shifts in plant diversity remains unclear. In this study, we conducted 6 and 11 years of N addition field experiments in a temperate steppe to investigate AMF richness and network stability and their associations with plant species richness in response to N deposition. The N fertilization, especially in the 11 years of N addition, profoundly decreased the AMF richness and plant species richness. Furthermore, N fertilization significantly decreased the AMF network complexity and stability, with these effects becoming more enhanced with the increase in N addition duration. AMF richness and network stability showed positive associations with plant diversity, and these associations were stronger after 11 than 6 years of N addition. Our findings suggest that N deposition may lead to plant diversity loss via a reduction of AMF richness and network stability, with these effects strengthened over time. This study provides a better understanding of plant-AMF interactions and their response to the prevailing global N deposition.

Dilemma of Low-Cost Filter Paper as Separator: Toughen Its Wet Strength for Robust Aqueous Zinc-Ion Batteries.

The industrialization of aqueous zinc-ion batteries (AZIBs) is hampered by poor-performance separators. Filter paper (FP), with mature production processes and low prices, has potential as a separator. However, its swelling and decline of mechanical durability in aqueous environments make it easily punctured by dendrites. In response, wet strength promotion is proposed to toughen FP for robust AZIBs, termed wet-strengthened FP (WSFP). Due to the self-cross-linking network formed on cellulose fibers, water molecules are prevented from easily permeating and disrupting the hydrogen bonds between cellulose molecules. Moreover, the positively charged network can anchor SO42-, thus increasing the Zn2+ transference number and facilitating uniform zinc deposition. Surprisingly, the half and full cells with the WSFP separator present much more stable cycling than untreated FP and glass fiber (GF) separators. These results suggest that robust and low-cost WSFP separators provide a new avenue for the development of high-performance AZIBs with potential for commercialization.

Exposure risk to rural Residents: Insights into particulate and gas phase pesticides in the Indoor-Outdoor nexus.

Rural residents are exposed to both particulate and gaseous pesticides in the indoor-outdoor nexus in their daily routine. However, previous personal exposure assessment mostly focuses on single aspects of the exposure, such as indoor or gaseous exposure, leading to severe cognition bias to evaluate the exposure risks. In this study, residential dust and silicone wristbands (including stationary and personal wearing ones) were used to screen pesticides in different phases and unfold the hidden characteristics of personal exposure via indoor-outdoor nexus in intensive agricultural area. Mento-Carlo Simulation was performed to assess the probabilistic exposure risk by transforming adsorbed pesticides from wristbands into air concentration, which explores a new approach to integrate particulate (dust) and gaseous (silicone wristbands) pesticide exposures in indoor and outdoor environment. The results showed that particulate pesticides were more concentrated in indoor, whereas significantly higher concentrations were detected in stationary outdoor wristbands (p < 0.05). Carbendazim and chlorpyrifos were the most frequently detected pesticides in dust and stationary wristbands. Higher pesticide concentration was found in personal wristbands worn by farmers, with the maximum value of 2048 ng g-1 for difenoconazole. Based on the probabilistic risk assessment, around 7.1 % of farmers and 2.6 % of bystanders in local populations were potentially suffering from chronic health issues. One third of pesticide exposures originated mainly from occupational sources while the rest derived from remoting dissipation. Unexpectedly, 43 % of bystanders suffered the same levels of exposure as farmers under the co-existence of occupational and non-occupational exposures. Differed compositions of pesticides were found between environmental samples and personal pesticide exposure patterns, highlighting the need for holistic personal exposure measurements.

Setting goals for agricultural nitrogen emission reduction to ensure safe air and groundwater quality: A case study of Quzhou, the North China Plain.

Setting nitrogen (N) emission targets for agricultural systems is crucial to prevent to air and groundwater pollution, yet such targets are rarely defined at the county level. In this study, we employed a forecasting-and-back casting approach to establish human health-based nitrogen targets for air and groundwater quality in Quzhou county, located in the North China Plain. By adopting the World Health Organization (WHO) phase I standard for PM2.5 concentration (35 µg m-3) and a standard of 11.3 mg NO3--N L-1 for nitrate in drinking water, we found that ammonia (NH3) emissions from the entire county must be reduced by at least 3.2 kilotons year-1 in 2050 to meet the WHO's PM2.5 phase I standard. Additionally, controlling other pollutants such as sulfur dioxide (SO2) and nitrogen oxides (NOx) is necessary, with required reductions ranging from 16% to 64% during 2017-2050. Furthermore, to meet the groundwater quality standard, nitrate nitrogen (NO3--N) leaching to groundwater should not exceed 0.8 kilotons year-1 by 2050. Achieving this target would require a 50% reduction in NH3 emissions and a 21% reduction in NO3--N leaching from agriculture in Quzhou in 2050 compared to their respective levels in 2017 (5.0 and 2.1 kilotons, respectively). Our developed method and the resulting N emission targets can support the development of environmentally-friendly agriculture by facilitating the design of control strategies to minimize agricultural N losses.

Spatial-temporal distribution and potential risk of pesticides in ambient air in the North China Plain.

The intensive use of pesticides in the North China Plain (NCP) has resulted in widespread contamination of pesticides in the local atmosphere, posing risks to air quality and human health. However, the occurrence and distribution of atmospheric pesticides in the NCP as well as their risk assessment have not been well investigated. In this study, 300 monthly samples were collected using passive air samplers with polyurethane foam at ten rural sites with different crop systems in Quzhou county, the NCP, from June 2021 to May 2022. The pesticides were quantified using mass-spectrometric techniques. Our results revealed that chlorpyrifos, carbendazim, and atrazine were the most frequently found pesticides in the air samples, with detection frequencies of ≥ 87 % across the samples. The average concentrations of atmospheric pesticides during spring (7.47 pg m-3) and summer (16.05 pg m-3) were significantly higher than those during autumn (2.04 pg m-3) and winter (1.71 pg m-3), attributable to the intensified application of pesticides during the warmer seasons. Additionally, cash crop sites exhibited higher concentrations (10.26 pg m-3) of atmospheric pesticides compared to grain crop (5.59 pg m-3) and greenhouse sites (3.81 pg m-3), primarily due to more frequent pesticides spraying events in cash crop fields. These findings indicate a distinct spatial-temporal distribution pattern of atmospheric pesticides influenced by both seasons and crop systems. Furthermore, the model-based inhalation risk assessment indicates that inhalation exposure to atmospheric pesticides is unlikely to pose a significant public concern.

Antiplatelet Treatment Patterns and Outcomes for Secondary Stroke Prevention in the United Kingdom.

INTRODUCTION: Stroke is a leading cause of death and disability worldwide. Antiplatelet therapies are recommended to reduce the risk of recurrent stroke in patients with ischemic stroke/transient ischemic attack (IS/TIA). This study evaluated outpatient antiplatelet treatment patterns and outcomes for secondary stroke prevention (SSP) among UK adults without atrial fibrillation who were hospitalized for IS/TIA. METHODS: This retrospective observational study utilized data from the UK Clinical Practice Research Datalink linked with Hospital Episode Statistics data (01/01/2011-30/06/2019). Treatment patterns included type and duration of treatments. Treatment outcomes included IS, myocardial infarction, major bleeding, and cardiovascular-related and all-cause mortality. Descriptive statistics were reported. RESULTS: Of 9270 patients, 13.9% (1292) might not receive antithrombotic therapy within 90 days of hospital discharge. Of 7978 patients who received antiplatelet therapies, most used clopidogrel (74.8%) or aspirin (16.7%) single antiplatelet therapy and clopidogrel + aspirin dual antiplatelet therapy (DAPT, 5.9%). At 1-year post-hospitalization, 36.9, 43.3, and 35.1% of those receiving these treatments discontinued them, respectively, and of the patients initiating DAPT, 62.3% switched to single antiplatelet therapy. At 1-year post-discharge, the incidence rate (per 100 person-years) of IS, myocardial infarction, major bleeding, cardiovascular-related mortality, and all-cause mortality among the treated were 6.5, 0.7, 4.1, 5.0, and 7.3, respectively, and among the untreated were 14.9, 0.7, 8.6, 28.1, and 39.8, respectively. CONCLUSIONS: In the United Kingdom, 13.9% of patients hospitalized for stroke might not have any antiplatelet treatment to prevent secondary stroke; among the treated, clopidogrel, aspirin, and DAPT were commonly used. These study findings suggest that improved anti-thrombotic therapies for long-term SSP treatment are needed, which may lead to higher treatment and persistence rates and, therefore, improved outcomes in this population.