Standardization and clinical applications of retinal imaging biomarkers for cardiovascular disease: a Roadmap from an NHLBI workshop.

The accessibility of the retina with the use of non-invasive and relatively low-cost ophthalmic imaging techniques and analytics provides a unique opportunity to improve the detection, diagnosis and monitoring of systemic diseases. The National Heart, Lung, and Blood Institute conducted a workshop in October 2022 to examine this concept. On the basis of the discussions at that workshop, this Roadmap describes current knowledge gaps and new research opportunities to evaluate the relationships between the eye (in particular, retinal biomarkers) and the risk of cardiovascular diseases, including coronary artery disease, heart failure, stroke, hypertension and vascular dementia. Identified gaps include the need to simplify and standardize the capture of high-quality images of the eye by non-ophthalmic health workers and to conduct longitudinal studies using multidisciplinary networks of diverse at-risk populations with improved implementation and methods to protect participant and dataset privacy. Other gaps include improving the measurement of structural and functional retinal biomarkers, determining the relationship between microvascular and macrovascular risk factors, improving multimodal imaging 'pipelines', and integrating advanced imaging with 'omics', lifestyle factors, primary care data and radiological reports, by using artificial intelligence technology to improve the identification of individual-level risk. Future research on retinal microvascular disease and retinal biomarkers might additionally provide insights into the temporal development of microvascular disease across other systemic vascular beds.

Prominent Intrinsic Proton Conduction in Two Robust Zr/Hf Metal-Organic Frameworks Assembled by Bithiophene Dicarboxylate.

To date, developing crystalline proton-conductive metal-organic frameworks (MOFs) with an inherent excellent proton-conducting ability and structural stability has been a critical priority in addressing the technologies required for sustainable development and energy storage. Bearing this in mind, a multifunctional organic ligand, 3,4-dimethylthiophene[2,3-b]thiophene-2,5-dicarboxylic acid (H2DTD), was employed to generate two exceptionally stable three-dimensional porous Zr/Hf MOFs, [Zr6O4(OH)4(DTD)6]·5DMF·H2O (Zr-DTD) and [Hf6O4(OH)4(DTD)6]·4DMF·H2O (Hf-DTD), using solvothermal means. The presence of Zr6 or Hf6 nodes, strong Zr/Hf-O bonds, the electrical influence of the methyl group, and the steric effect of the thiophene unit all contribute to their structural stability throughout a wide pH range as well as in water. Their proton conductivity was fully examined at various relative humidities (RHs) and temperatures. Creating intricate and rich H-bonded networks between the guest water molecules, coordination solvent molecules, thiophene-S, -COOH, and -OH units within the framework assisted proton transfer. As a result, both MOFs manifest the maximum proton conductivity of 0.67 × 10-2 and 4.85 × 10-3 S·cm-1 under 98% RH/100 °C, making them the top-performing proton-conductive Zr/Hf-MOFs. Finally, by combining structural characteristics and activation energies, potential proton conduction pathways for the two MOFs were identified.

Four Lanthanide(III) Metal-Organic Frameworks Fabricated by Bithiophene Dicarboxylate for High Inherent Proton Conduction.

Currently, it is still a challenge to directly achieve highly stable metal-organic frameworks (MOFs) with superior proton conductivity solely through the exquisite design of ligands and the attentive selection of metal nodes. Inspired by this, we are intrigued by a multifunctional dicarboxylate ligand including dithiophene groups, 3,4-dimethylthieno[2,3-b]thiophene-2,5-dicarboxylic acid (H2DTD), and lanthanide ions with distinct coordination topologies. Successfully, four isostructural three-dimensional lanthanide(III)-based MOFs, [Ln2(DTD)3(DEF)4]·DEF·6H2O [LnIII = TbIII (Tb-MOF), EuIII (Eu-MOF), SmIII (Sm-MOF), and DyIII (Dy-MOF)], were solvothermally prepared, in which the effective proton transport will be provided by the coordinated or free solvent molecules, the crystalline water molecules, and the framework components, as well as a large number of highly electronegative S and O atoms. As expected, the four Ln-MOFs demonstrated the highest proton conductivities (σ) being 0.54 × 10-3, 3.75 × 10-3, 1.28 × 10-3, and 1.92 × 10-3 S·cm-1 for the four MOFs, respectively, at 100 °C/98% relative humidity (RH). Excitingly, Dy-MOF demonstrated an extraordinary ultrahigh σ of 1 × 10-3 S·cm-1 at 30 °C/98% RH. Additionally, the plausible proton transport mechanisms were emphasized.

10-year trends in noncommunicable disease mortality in the Caribbean region

[ABSTRACT]. Objective. Between 2006 and 2016, 70% of all deaths worldwide were due to noncommunicable diseases (NCDs). NCDs kill nearly 40 million people a year globally, with almost three-quarters of NCD deaths occurring in low- and middle-income countries. The objective of this study was to assess mortality rates and trends due to deaths from NCDs in the Caribbean region. Methods. The study examines age-standardized mortality rates and 10-year trends due to death from cancer, heart disease, cerebrovascular disease, and diabetes in two territories of the United States of America (Puerto Rico and the U.S. Virgin Islands) and in 20 other English- or Dutch-speaking Caribbean countries or territories, for the most recent, available 10 years of data ranging from 1999 to 2014. For the analysis, the SEER*Stat and Joinpoint software packages were used. Results. These four NCDs accounted for 39% to 67% of all deaths in these 22 countries and territories, and more than half of the deaths in 17 of them. Heart disease accounted for higher percentages of deaths in most of the Caribbean countries and territories (13%-25%), followed by cancer (8%-25%), diabetes (4%-21%), and cerebrovascular disease (1%-13%). Age-standardized mortality rates due to cancer and heart disease were higher for males than for females, but there were no significant mortality trends in the region for any of the NCDs. Conclusions. The reasons for the high mortality of NCDs in these Caribbean countries and territories remain a critical public health issue that warrants further investigation.

[RESUMEN]. Objetivo. Entre los años 2006 y 2016, las enfermedades no transmisibles (ENT) ocasionaron un 70 % de todas las muertes mundiales. Las ENT son responsables de la muerte de aproximadamente 40 millones de personas al año a nivel mundial, de las cuales casi tres cuartas partes tienen lugar en países de ingresos medianos y bajos. El objetivo de este estudio es evaluar las tasas de mortalidad y las tendencias relacionadas con las defunciones por ENT en el Caribe. Métodos. En el estudio se examinan las tasas de mortalidad ajustadas por edad y las tendencias a lo largo de diez años relacionadas con la muerte por cáncer, cardiopatías, enfermedades cerebrovasculares y diabetes en dos territorios de Estados Unidos (Puerto Rico e Islas Vírgenes), así como en otros veinte países o territorios de habla inglesa o neerlandesa, empleando la información disponible más reciente que corresponde a los diez años comprendidos entre 1999 y el 2014. Para el análisis, se utilizaron los programas informáticos JointPoint y SEER*Stat. Resultados. Estas cuatro ENT representan entre el 39 % y el 67 % del total de muertes en estos 22 países y territorios, y más de la mitad de las muertes en 17 de ellos. Las cardiopatías representan porcentajes mayores de muertes en la mayor parte de los países y territorios del Caribe (13 %-25 %), seguidos por el cáncer (8 %-25 %), la diabetes (4 %-21 %) y las enfermedades cerebrovasculares (1 %-13 %). Las tasas de mortalidad ajustadas por edad relacionadas con el cáncer y las cardiopatías son mayores en hombres que en mujeres, si bien no hubo en la región tendencias significativas relacionadas con la mortalidad en lo que concierne a ninguna ENT. Conclusiones. Las causas de la elevada mortalidad por ENT en estos países y territorios del Caribe siguen siendo un grave problema de salud pública que justifica una investigación en profundidad.

[RESUMO]. Objetivo. No período de 2006 a 2016, 70% das mortes na população mundial foram decorrentes de doenças não transmissíveis (DNTs). Cerca de 40 milhões de pessoas morrem por DNTs por ano em todo o mundo, com quase 75% das mortes ocorrendo nos países de baixa e média renda. O objetivo deste estudo foi avaliar as taxas e as tendências de mortalidade por DNTs no Caribe. Métodos. Foram examinadas as taxas de mortalidade padronizadas por idade e as tendências ao longo de 10 anos da mortalidade por câncer, doença cardíaca, doença cerebrovascular e diabetes em dois territórios dos Estados Unidos (Porto Rico e Ilhas Virgens Americanas) e em 20 países ou territórios do Caribe de língua inglesa ou holandesa, com base nos últimos dados de 10 anos para o período de 1999 a 2014. Os softwares SEER*Stat e Joinpoint foram usados na análise. Resultados. As quatro DNTs estudadas representaram 39% a 67% das causas de mortes nos 22 países e territórios, e foram responsáveis por mais da metade das mortes em 17 deles. A mortalidade na maioria dos países e territórios do Caribe foi maior por doença cardíaca (13% a 25%), seguida do câncer (8% a 25%), diabetes (4% a 21%) e doença cerebrovascular (1% a 13%). As taxas de mortalidade padronizadas pela idade por câncer e doença cardíaca foram maiores nos homens que nas mulheres, mas não se verificaram, na região, tendências de mortalidade significativas para qualquer uma das DNTs. Conclusões. A elevada mortalidade por DNTs nos países e territórios do Caribe é ainda um sério problema de saúde pública e os motivos devem ser investigados mais a fundo.