A case of endocardial dissection caused by Micra implantation.

BACKGROUND: Leadless pacemakers are a recent technological advancement. It has many advantages, but there are still a few serious complications. CASE PRESENTATION: This article reports the case of a patient with an endocardial tear and dissection caused by contact with the tip of the Micra cup during surgery and summarises the relevant data. CONCLUSIONS: This case report details the occurrence and management of the incident and provides some guidance for future clinical management.

Enhancing understanding of healthy aging based on time-varying dependencies among multidimensional health, life satisfaction, and health behaviors of older adults aged 60 years and over.

BACKGROUND: Healthy aging is a process of not only achieving good health but also increasing the life satisfaction of older adults aged 60 years and over, in which health behaviors play an important role. There is a lack of research on the time-varying dependencies between health, life satisfaction, and health behaviors, impeding a deeper understanding of healthy aging. PURPOSE: To develop an integrated framework for modeling the interrelationships among the components of healthy aging between multiple time slices. METHODS: Based on the Chinese Longitudinal Healthy Living Survey (CLHLS) data in the three waves of 2011/2012, 2014, and 2017/2018, Bayesian network and dynamic Bayesian network are jointly employed to study the relationships among the components of healthy aging within one time slice, as well as to explore the time-varying dependencies among the components between time slices. RESULTS: The results of structure learning reveal the direction of effects between different dimensions of health, with mental health and social health affecting physical health and self-rated health affecting both physical and mental health. In addition, health behaviors are found to affect mental health and social health, while self-rated health can influence life satisfaction. The parameters learned from the data show the magnitude and direction of concurrent effects, one-period lagged effects and two-period lagged effects between the factors, which find that the time-varying dependencies vary but are generally positive, long-term, and accumulative over time. In addition, the results of autoregressive effects show the positive predictive effects of health and life satisfaction. CONCLUSIONS: It confirms the influence pathway from health behaviors to multidimensional health to life satisfaction, and the time-varying dependencies among the components of healthy aging, which facilitates a deeper understanding of healthy aging. Combining the results of autoregressive effects and descriptive statistics, it further indicates that healthy aging is a comprehensive result arising from interactions of multiple factors. Policymakers should guide older adults aged 60 years and over to adopt healthier behaviors and ensure the long-term sustainability and continuity of policies.

Optical frequency comb assisted reconfigurable broadband spread spectrum signal generation.

A photonic-assisted scheme for spread spectrum communication signals generation is proposed and demonstrated in this article. The spreading sequence and the baseband data codes are modulated on the photonic link by electro-optic modulators, and the spread spectrum process is completed through stream processing on the analog microwave photonic link. By combining optical frequency comb and injection locking technologies, the carrier frequency of the communication signals can be tuned over an ultra-broadband range of 3-39 GHz. In the proof-of-concept experiments, spread spectrum signals at 3 GHz and 6 GHz are obtained with a spread factor of 31. The analysis results indicate that the generated signals possess excellent reconfiguration, anti-interference, and anti-interception properties. Overall, our proposed scheme offers a flexible photonic architecture with significant potential in the application of ultra-broadband covert communication systems.

Epicardial implantation of a lumenless active fixation lead in a neonate.

BACKGROUND: We present a case of epicardial pacemaker implantation in a low birth weight newborn using a lumenless active fixation lead. RESULTS: We found that superior pacing parameters can be obtained by implanting a lumenless active fixation lead into the epicardium, but more evidence is needed to support this hypothesis.

Decoration of alkalization-intercalated Ti3C2 with ZIF-8@ZIF-67-derived N-doped carbon nanocage for detecting 4-nitrophenol.

The highly effective alk-Ti3C2/bimetallic Co, Zn embedded N-doped carbon (Co-Zn-NC) composite was fabricated by a convenient self-assembled method strategy and applied to  the reduction of 4-nitrophenol(4-NP). Co-Zn-NC nanocage was synthesized by using designed core-shell ZIF-8@ZIF-67 as sacrificial template. The Co-Zn-NC was prepared by pyrolysis of ZIF-8@ZIF-67 at 900 °C with high-specific surface area and hollow structure, which facilitates the dispersion of Co species and produces abundant Co-Nx active sites. In addition, the electrochemical property and specific surface area of Ti3C2 were improved by alkaline treatment. As a result, compared with alk-Ti3C2 and Co-Zn-NC, the alk-Ti3C2/Co-Zn-NC sensor showed higher activity and stability in detecting 4-NP. The alk-Ti3C2/Co-Zn-NC sensor has a wide determination range of 2-500 µM and a low detection limit of 0.23 µM for 4-NP. In addition, the newly developed alk-Ti3C2/Co-Zn-NC sensor displayed satisfactory reproducibility and  good stability in detecting 4-NP in aqueous samples.

Use of symptom diary in primary students: association of nitrogen dioxide with prevalence of symptoms.

Air pollution is a global public health concern, and numerous studies have attempted to identify the health effects of air pollutants, including nitrogen dioxide (NO2). In China, there are few studies investigating the relationship between NO2 exposure and symptoms among children at an individual level. The aim of the study was to evaluate the acute effects of NO2 on prevalence of symptoms of primary students. An environmental and health questionnaire survey was administered to 4240 primary students in seven districts of Shanghai. Daily symptoms, as well as the daily air pollution and meteorological data from each community, were recorded during the corresponding period. A multivariable logistic regression model was utilized to analyze the relationship between the prevalence of symptoms and NO2 exposure in school-age children. A model with interaction items was adopted to estimate the interactive effects of NO2 and confounding factors on symptoms. The average NO2 level in central urban, industrial and rural areas were 62.07 ± 21.66, 54.86 ± 18.32 and 36.62 ± 21.23 µg m-3, respectively. Our findings demonstrate that the occurrence of symptoms was significantly affected by NO2 exposure in the short-term. The largest associations were observed for a 10 µg m-3 increase in 5-day moving average (lag04) NO2 concentration with prevalence of general symptoms (odds ratio [OR] = 1.15, 95% confidence interval [95% CI]: 1.07-1.22), throat symptoms (OR = 1.23, 95% CI: 1.13-1.35) and nasal symptoms (OR = 1.142, 95% CI: 1.02-1.27). Subgroup analysis showed that non-rural areas, boys, nearby environmental pollution source and history of present illness were all susceptible factors to the effects of NO2 exposure. Furthermore, there were interactive effects between NO2 exposure and area types on reported symptoms. NO2 can increase the risk of symptoms in primary students in the short-term, which could be significantly enhanced in central urban and industrial areas.

Deep-learning-assisted linearization for the broadband photonic scanning channelized receiver.

An autoencoder-residual (AE-Res) network is designated to assist the linearization of the wideband photonic scanning channelized receiver. It is capable of adaptively suppressing spurious distortions over multiple octaves of signal bandwidth, obviating the need for calculating the multifactorial nonlinear transfer functions. Proof-of-concept experiments indicate that the improvement of the third-order spur-free dynamic range (SFDR2/3) is 17.44 dB. Moreover, the results for real wireless communication signals demonstrate that the improvement of the spurious suppression ratio (SSR) is 39.69 dB and the reduction of the noise floor is ∼10 dB.

Influence of thermal processing on the quality of hawthorn: Quality markers of heat-processed hawthorn.

Hawthorn and its derived products are used worldwide as foods as well as complementary medicine. During the preparation of hawthorn, heating and thermal processing are frequently reported. The thermal processing will change the medicinal purposes and modify the efficacy of hawthorn. However, details including the chemical profile shifting and quality markers of heat-processed hawthorn have not been well understood. In this study, we analyzed the hawthorn samples processed at different temperatures and different times by ultraviolet visible absorption spectrum and liquid-mass spectrometry technologies combined with multivariate statistical analysis. It was revealed for the first time that thermal processing could greatly change the ultraviolet-visible absorption spectra and chemical profiles of hawthorn even with heat treatment at 130°C for 10 min. And the ultraviolet visible absorption spectrum, especially the ratio value (RA500 nm/400 nm ), was a descriptive and qualitative indicator of heating degree for the thermal processing at the macroscopic level. Several components, such as hyperoside, chlorogenic acid, quercetin, and apigenin, decreased or increased in content during the processing, and they could be utilized as the chemical quality markers. The proposed quality markers for heat-processed hawthorn will be helpful for further optimizing the processing conditions of hawthorn.

Incidence, Risk Factors, and Prognosis of Tricuspid Regurgitation After Cardiac Implantable Electronic Device Implantation: A Systematic Review and Meta-analysis.

This study aimed to determine the pooled incidence, risk factors, and clinical prognosis of tricuspid regurgitation (TR) deterioration after implantation of a cardiac implantable electronic device (CIED). The study was designed as a meta-analysis of randomized controlled trials and observational studies. Patients with indications for CIEDs were selected as participants and CIED implantation was the intervention. PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, and China Science and Technology Journal Database were searched systematically to identify studies. Thirty-seven studies with 8,144 patients were included. The pooled incidence of TR deterioration of at least one grade was 25.1% (95% confidence interval [CI], 20.9-29.3; Z = 11.60; p < 0.01; I2 = 94.8%, p < 0.01). Compared with TR incidence after permanent pacemaker implantation, that after implantable cardioverter-defibrillator implantation did not significantly increase (22.68% v 29.18%; odds ratio [OR], 0.615; 95% CI, 0.271-1.339; Z =1.16; p = 0.246). The pooled incidence of TR deterioration of at least two grades was 9.4% (95% CI, 6.6-12.1; Z = 6.72; p < 0.01; I2 = 86.0%, p < 0.01). Lead interference (OR, 8.704; 95% CI,4.450-17.028; Z= 6.32; p < 0.001) and pacemaker implantation time (OR, 1.153; 95% CI, 1.082-1.229; Z = 4.37; p < 0.001) were risk factors for worsening TR. Baseline atrial fibrillation, age, baseline mild TR, and left ventricular ejection fraction were not associated with TR. All-cause mortality (>one year after pacemaker implantation) was higher in patients with TR deterioration (hazard ratio, 1.598; 95% CI, 1.275-2.002; Z = 4.07; p < 0.01; I2 = 0%). TR is a common complication after CIED implantation. Lead interference and pacemaker implantation time were risk factors for TR worsening. Compared with patients without TR deterioration after pacemaker implantation, patients with TR deterioration had a poorer prognosis.

Acidolysis of phospholipids with medium-chain fatty acids over M-SBA-15 (M = Zn, Al) silicas as efficient solid catalysts.

BACKGROUND: Efficient and sustainable production of structured phospholipids (SPLs) enriched in medium-chain fatty acids (MCFAs) in a heterogeneous manner is crucial for their potential applications in functional foods and drugs. Herein, for the first time, Zn- and Al-incorporated SBA-15 silicas were prepared by the coprecipitation method and further researched for catalytic synthesis of MCFA-enriched SPLs through acidolysis reaction of natural phospholipids with capric or caprylic acid. RESULTS: The as-prepared Zn- and Al-incorporated SBA-15 samples exhibited superior catalytic activities under mild experimental conditions (50 °C, 6 h) to commercial homogeneous Lewis acids and benchmark enzymes. Correspondingly, the capric acid and caprylic acid incorporations were respectively achieved up to ~40.25 ± 0.40% (or 35.08 ± 0.09%) and 37.26 ± 0.38% (or 33.02 ± 0.13%) for Zn- (or Al-) incorporated SBA-15 catalyst. Moreover, various methods such as scanning electron microscopy with energy-dispersive X-ray spectrometry, ultraviolet-visible diffuse reflectance spectroscopy and pyridine-Fourier transform infrared spectroscopy were utilized to characterize the two catalysts in order to elucidate the possible structure-performance relationship. Accordingly, the above-mentioned satisfactory results are most probably due to the well-ordered mesostructures and large amounts of active Lewis acid sites existing in the investigated materials. Noticeably, the two catalysts featured good separation and excellent recyclability as well. CONCLUSION: The Zn- and Al-incorporated SBA-15 catalysts studied in this work might shed light on novel, sustainable and economic alternatives for effective SPL production to diminish the applications of conventional homogeneous catalysts and biocatalysts in food industries. © 2022 Society of Chemical Industry.

Binder-free and flexible delta-MnO2@multiwalled carbon nanotubes as high-performance cathode material for aqueous magnesium ion battery.

In order to develop a high-performance electrode material for aqueous magnesium ion battery (AMIB), we report a binder-free and flexibleδ-MnO2@multiwalled carbon nanotubes on carbon cloth (δ-MnO2@MWCNTs/CC) composite by a simple hydrothermal method. The MnO2nanoflakes are deposited on the surface of CC coated with high conductivity MWCNTs to form three-dimensional hierarchy architecture, which improves the electrochemical performances. Theδ-MnO2@MWCNTs/CC electrode displays a discharge capacity of 246.7 mAh g-1at a current density of 50 mA g-1and its capacitance retention at a current density of 1000 mA g-1can reach 80% after 2000 cycles. Furthermore, the AMIB system is assembled byδ-MnO2@MWCNTs/CC as cathode and activated carbon as anode, which dispays a discharge capacity of 72.4 mAh g-1at 100 mA g-1. Theδ-MnO2with interlayer structure can provide sufficient space for the insertion/deinsertion of Mg2+ions into/from the lattice of host materials without the change of phase. This work prepares a high-performance and flexible electrode material for low-cost AMIB system.

Evaluation of safety and feasibility of leadless pacemaker implantation following the removal of an infected pacemaker.

BACKGROUND: Leadless pacemakers provide safe and effective pacing options for patients with device-related infections. This study was aimed at observing and evaluating the safety and feasibility of extracting an infected pacemaker device followed by the implantation of a leadless pacemaker in the same location for patients without systemic infection. METHODS: Between December 2019 and September 2020, following a well-planned re-implantation strategy, pacemaker electrodes were removed from patients with device infection and leadless pacemakers were immediately implanted at our center. The patients were then followed up for up to 10 months to assess the safety and practicality of the procedure. RESULTS: Pacemaker electrode removal and immediate leadless pacemaker implantation were successfully achieved in eight patients with pocket infection. After a minimum follow-up period of 1 month and a maximum follow-up of 10 months, the pacing parameters for the patients remained stable and there was no infection at the original capsular bag or in the leadless pacemaker. CONCLUSION: Direct implantation of a leadless pacemaker is safe and feasible for patients with local infection of the pacing system after removal of the electrode as an alternative to a bridge period with a temporary pacemaker. This strategy may be a better option for pacing-dependent patients.

Factor structure and sex invariance of the temporal experience of pleasure scale (TEPS) in Chinese university students and clinical population.

BACKGROUND: A motivation dimension of the core psychiatric symptom anhedonia additional has been suggested. The Temporal Experience of Pleasure Scale (TEPS) has been reported to assess anticipatory and consummatory pleasure separately in multiple factor-structure models. This study explored the factor structure of a Chinese version of the 18-item TEPS and further explored the measurement invariance of the TEPS across sex and clinical status (non-clinical, psychiatric). METHODS: Best-fit factor structure of the TEPS was examined in a non-clinical cohort of 7410 undergraduates, randomized into sample 1 (N = 3755) for exploratory factor analysis (EFA) and sample 2 (N = 3663) for confirmatory factor analysis (CFA). Additionally, serial CFA was conducted to evaluate measurement invariance across sex and between clinical (N = 313) and non-clinical (N = 341) samples. RESULTS: EFA supported a new four-factor structure with a motivation component, based on the original two-factor model (consummatory pleasure with/without motivation drive, anticipatory pleasure with/without motivation drive). CFA confirmed the four-factor model as the best-fit structure and revealed a second-order hierarchy in non-clinical and clinical samples. Full scalar invariance was observed across clinical and non-clinical samples and across sex in the clinical sample; only partial scalar invariance was observed across sex in the non-clinical sample. CONCLUSIONS: A four-factor structured TEPS can assess motivation-driving dimensions of anticipatory and consummatory pleasure, consistent with the recently advanced multidimensional structure of anhedonia. CFA and measurement invariance results support application of the TEPS for assessing motivation aspects of anhedonia.

Personality inventory for DSM-5 brief form(PID-5-BF) in Chinese students and patients: evaluating the five-factor model and a culturally informed six-factor model.

BACKGROUND: The Personality Inventory for DSM-5 Brief Form (PID-5-BF) is a 25-item measuring tool evaluating maladaptive personality traits for the diagnosis of personality disorders(PDs). As a promising scale, its impressive psychometric properties have been verified in some countries, however, there have been no studies about the utility of the PID-5-BF in Chinese settings. The current study aimed to explore the maladaptive personality factor model which was culturally adapted to China and to examine psychometric properties of the PID-5-BF among Chinese undergraduate students and clinical patients. METHODS: Seven thousand one hundred fifty-five undergraduate students and 451 clinical patients completed the Chinese version of the PID-5-BF. Two hundered twenty-eight students were chosen randomly for test-retest reliability at a 4-week interval. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to discover the most suitable factor structure in China, measurement invariance(MI), internal consistency, and external validity were also calculated. RESULTS: The theoretical five-factor model was acceptable, but the exploratory six-factor model was more applicable in both samples (Undergraduate sample: CFI = 0.905, TLI = 0.888, RMSEA = 0.044, SRMR = 0.039; Clinical sample: CFI = 0.904, TLI = 0.886, RMSEA = 0.047, SRMR = 0.060). In the Chinese six-factor model, the Negative Affect domain was divided into two factors and the new factor was named "Interpersonal Relationships", which was in line with the Big-Six Personality model in Chinese. Measurement invariance across non-clinical and clinical sample was established (configural, weak, strong MI, and partial strict MI). Aside from acceptable internal consistency (Undergraduate sample: alpha = 0.84, MIC = 0.21; Clinical sample: alpha = 0.86, MIC = 0.19) and test-retest reliability(0.73), the correlation between the 25-item PID-5-BF and the 220-item PID-5 was significant(p < 0.01). The six PDs measured by Personality diagnostic questionnaire-4+ (PDQ-4+) were associated with and predicted by expected domains of PID-5-BF. CONCLUSIONS: Both the theoretical five-factor model and the exploratory six-factor model of the PID-5-BF were acceptable to the Chinese population. The five-factor model could allow for comparison and integration with other work on the original theoretical model. However, the Chinese six-factor structure may be more culturally informed in East Asian settings. In sum, the PID-5-BF is a convenient and useful screening tool for personality disorders.

A prospective comparison of four methods for preventing pacemaker pocket infections.

This study aims to evaluate four pacemaker pocket cleaning methods for preventing implantation-related infections. This single-center trial prospectively randomized 910 patients undergoing first-time pacemaker implantation or replacement into four pocket cleaning methods: hemocoagulase (group A, n = 228), gentamicin (group B, n = 228), hemocoagulase plus gentamicin (group C, n = 227), and normal saline (group D, n = 227). Before implanting the pacemaker battery, the pockets were cleaned with gauze presoaked in the respective cleaning solutions. Then, these patients were followed up to monitor the occurrence of infections for 1 month after implantation. Twelve implantation-related infections occurred in 910 patients (1.32%): four patients from group A (1.75%), three patients from group B (1.32%), two patients from group C (0.88%), and three patients from group D (1.32%) (P > .05). Furthermore, two patients developed bloodstream infections (0.22%), and both of these patients were associated with pocket infection (one patient was from group A, while the other patient was from group C, respectively). No cases of infective endocarditis occurred. The differences in the number of infections in these study groups were not statistically significant. The application of hemocoagulase, gentamicin, hemocoagulase plus gentamicin, or normal saline on the presoaked gauze before implantation was equally effective in preventing pocket-associated infections.

Sub-100 fs all-fiber broadband electro-optic optical frequency comb at 1.5†µm.

A sub-100 fs all-fiber broadband optical frequency comb seeded from a 12.5 GHz electro-optic modulated pulse is presented. Combining pulse reshaping, nonlinear mixing with dispersion compensation processes, a frequency comb with the main pulse width of 86 fs was achieved. The frequency comb has a 6 dB spectral bandwidth spanning over 150 nm which corresponding to more than 1500 comb tones. The measured average power of the broadband comb is over 550 mW, and the calculated average power of each comb line is roughly -4 dBm. To illustrate the whole spectral broadening process, a numerical investigation was also brought out, showing a very good match with the experiments. With a delayed self-heterodyne interferometer, the evolutions of the seed comb linewidths and the broadened comb linewidths were measured revealing the same parabolic trend. Specifically, the linewidths of the 20 seed comb lines are less than 10 kHz, while the linewidths of the 400 broadened comb lines are less than 1 MHz. The results also indicate that the nonlinear mixing led to an accumulation of the phase noise with respect to the comb line number, indicating that a low phase noise RF source or phase locking technique is essential to produce ultra-low phase noise broadband electro-optic combs.

BER evaluation in a multi-channel graphene-silicon photonic crystal hybrid interconnect: a study of fast- and slow-light effects.

A comprehensive theoretical investigation on the bit-error ratio (BER) performance of multi-channel photonic interconnects operating in pulsed regimes is presented. Specifically, the optical link contains either a silicon photonic crystal (SiPhC) or a SiPhC-graphene (SiPhC-GRA) waveguide, possessing slow-light (SL) and fast-light (FL) regimes. A series of Gaussian pulses plus complex white noise are placed at input of each channel, with output signals demultiplexed and analyzed by a direct-detection receiver. Moreover, a rigorous theoretical model is proposed to measure signal propagation in SiPhC and SiPhC-GRA, which incorporates all crucial linear and nonlinear optical effects, as well as influences of free-carriers and SL effects. BER results of multi-channel systems are evaluated by utilizing the Fourier series Karhunen-Loeve expansion method. Our findings reveal that good BER performance is acquired at SiPhCs and SiPhC-GRAs in SL regimes but with their footprint about 2.5-fold smaller than FL waveguides. Moreover, the enhanced nonlinearity in SiPhC-GRAs induced by strong graphene-SiPhC coupling causes extra signal degradation than SiPhCs at the same length. This work provides additional insights into the coupling effect between SiPhCs operating in SL regimes and graphene, and their influence on WDM signal transmission, highlighting the potential applications of SiPhC-GRA interconnects in next-generation super-computing systems.

Application of Transition-Metal Catalysis, Biocatalysis, and Flow Chemistry as State-of-the-Art Technologies in the Synthesis of LCZ696.

LCZ696 is a novel treatment for patients suffering from heart failure that combines the two active pharmaceutical ingredients sacubitril and valsartan in a single chemical compound. While valsartan is an established drug substance, a new manufacturing process suitable for large-scale commercial production had to be developed for sacubitril. The use of chemocatalysis, biocatalysis, and flow chemistry as state-of-the-art technologies allowed to efficiently build up the structure of sacubitril and achieve the defined performance targets.

A novel construct of anhedonia revealed in a Chinese sample via the Revised Physical and Social Anhedonia Scales.

BACKGROUND: Anhedonia is a core clinical symptom of mental disorders. The Revised Physical Anhedonia Scale (RPAS) and the Revised Social Anhedonia Scale (RSAS) have been applied in clinical and non-clinical samples since 1980s. However, the construct of a unified RPAS&RSAS for comprehensive measurement of anhedonia has never been explored. Therefore, the purpose of our study was to examine the factor structure of the unified RPAS&RSAS among undergraduates and clinical patients. METHODS: A total of 3435 undergraduates from two universities and 294 clinical patients with mental disorders had completed the Chinese version of the RPAS and the RSAS. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were each conducted to reveal the constructs of the RPAS and the RSAS. CFA was used to evaluate first- and second-order models for the unified RPAS&RSAS in undergraduates and clinical patients. The internal consistency and test-retest reliability of the RPAS and the RSAS were also evaluated. RESULTS: EFA and CFA indicated 2-factor structures for RPAS and RSAS, with the factors being defined as anticipatory anhedonia and consummatory anhedonia. The second-order model of the unified RPAS&RSAS in the undergraduates and clinical patients both had satisfactory fit index values (Undergraduate sample: CFI = 0.901, TLI = 0.899, RMSEA = 0.055, SRMR = 0.086; Clinical sample: CFI = 0.922, TLI = 0.911, RMSEA = 0.052, SRMR = 0.078). The psychometric robustness of the RPAS&RSAS were confirmed by high internal consistency and test-retest reliability values. CONCLUSIONS: The unified RPAS&RSAS with a second-order structure was confirmed in both undergraduates and clinical samples in Chinese. The construct of anhedonia was refreshed as covering physical and social domains, and each of them includes both anticipatory and consummatory components.

LDL-C/HDL-C is associated with ischaemic stroke in patients with non-valvular atrial fibrillation: a case-control study.

BACKGROUND: This study explored the relationships between the low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and other clinical indicators and ischaemic stroke (IS) in patients with non-valvular atrial fibrillation (NVAF) in Xinjiang. The findings could provide a theoretical and therapeutic basis for NVAF patients. METHODS: NVAF patients who were admitted to 10 medical centres across Xinjiang were divided into stroke (798 patients) and control (2671 patients) groups according to the occurrence of first acute IS. Univariate and multivariate logistic regression analysis were used to examine the independent risk factors for IS in NVAF patients. Factor analysis and principal component regression analysis were used to analyse the main factors influencing IS. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminatory ability of LDL-C/HDL-C for predicting the occurrence of IS. RESULTS: The stroke group had an average age of 71.64 ± 9.96 years and included 305 females (38.22%). The control group had a mean age of 67.30 ± 12.01 years and included 825 females (30.89%). Multivariate logistic regression showed that the risk of IS in the highest LDL-C/HDL-C quartile (≥2.73) was 16.23-fold that of the lowest quartile (< 1.22); IS risk was 2.27-fold higher in obese patients than in normal-weight subjects; IS risk was 3.15-fold higher in smoking patients than in non-smoking patients. The area under the ROC curve of LDL-C/HDL-C was 0.76, the optimal critical value was 2.33, the sensitivity was 63.53%, and the specificity was 76.34%. Principal component regression analysis showed that LDL-C/HDL-C, age, smoking, drinking, LDL-C and hypertension were risk factors for IS in NVAF patients. CONCLUSIONS: LDL-C/HDL-C > 1.22, smoking, BMI ≥24 kg/m2 and CHA2DS2-VASc score were independent risk factors for IS in NVAF patients; LDL-C/HDL-C was the main risk factor.