Ionic Liquid Modified Fe-Porphyrinic Metal-Organic Frameworks as Efficient and Selective Photocatalysts for CO2 Reduction.

Porphyrin-based metal-organic frameworks (MOFs) are ideal platforms for heterogeneous photocatalysts toward CO2 reduction. To further explore photocatalytic MOF systems, it is also necessary to consider their ability to fine-tune the microenvironments of the active sites, which affects their overall catalytic operation. Herein, a kind of ionic liquid (IL, here is 3-butyric acid-1-methyl imidazolium bromide, BAMeImBr) was anchored to iron-porphyrinic Zr-MOFs with different amounts to obtain ILx@MOF-526 (MOF-526 = Zr6O4(OH)4(FeTCBPP)3, FeTCBPP = iron 5,10,15,20-tetra[4-(4'-carboxyphenyl)phenyl]-porphyrin, x = 100, 200, and 400). ILx@MOF-526 series was designed to investigate the effects of the microenvironmental and electronic structural modification on the efficiency and selectivity of the photochemical reduction of CO2 after introducing IL fragments. Compared to parent MOF-526, the production and selectivity of CO were greatly improved in the absence of any photosensitizer under visible light by the ILx@MOF-526 series. Among them, the CO yield of IL200@MOF-526 was up to 14.0 mmol g-1 within 72 h with a remarkable CO selectivity of 97%, which is superior to that of MOF-526 without BAMeIm+ modification and other amounts of BAMeIm+ loaded. Furthermore, density functional theory calculations were performed to study the mechanism of the CO2 reduction.

Efficient Visible-Light-Driven Carbon Dioxide Reduction using a Bioinspired Nickel Molecular Catalyst.

Inspired by natural enzymes, this study presents a nickel-based molecular catalyst, [Ni‖(N2S2)]Cl2 (NiN2S2, N2S2=2,11-dithia[3,3](2,6)pyridinophane), for the photochemical catalytic reduction of CO2 under visible light. The catalyst was synthesized and characterized using various techniques, including liquid chromatography-high resolution mass spectrometry (LC-HRMS), UV-Visible spectroscopy, and X-ray crystallography. The crystallographic analysis revealed a slightly distorted octahedral coordination geometry with a mononuclear Ni2+ cation, two nitrogen atoms and two sulfur atoms. Photocatalytic CO2 reduction experiments were performed in homogeneous conditions using the catalyst in combination with [Ru(bpy)3]Cl2 (bpy=2,2'-bipyridine) as a photosensitizer and 1,3-dimethyl-2-phenyl-2,3-dihydro-1H-benzo[d]imidazole (BIH) as a sacrificial electron donor. The catalyst achieved a high selectivity of 89 % towards CO and a remarkable turnover number (TON) of 7991 during 8 h of visible light irradiation under CO2 in the presence of phenol as a co-substrate. The turnover frequency (TOF) in the initial 6 h was 1079 h-1, with an apparent quantum yield (AQY) of 1.08 %. Controlled experiments confirmed the dependency on the catalyst, light, and sacrificial electron donor for the CO2 reduction process. These findings demonstrate this bioinspired nickel molecular catalyst could be effective for fast and efficient photochemical catalytic reduction of CO2 to CO.

Photocatalytic antibacterial agents based on inorganic semiconductor nanomaterials: a review.

Microbial contamination and antibiotic pollution have threatened public health and it is important to develop a rapid and safe sterilization strategy. Among various disinfection strategies, photocatalytic antibacterial methods have drawn increasing attention due to their efficient disinfection performances and environment-friendly properties. Although there are some reviews about bacterial disinfection, specific reviews on photocatalysis focused on inorganic semiconductor nanomaterials are rarely reported. Herein, we present a systematic summary of recent disinfection developments based on inorganic nanomaterials (including metal oxides, sulfides, phosphides, carbon materials, and corresponding heterostructures) over the past five years. Moreover, key factors and challenges for inorganic nanomaterial-based photocatalytic disinfection are outlined, which holds great potential for future photocatalytic antibacterial applications.

Hollow structured CdS@ZnIn2S4 Z-scheme heterojunction for bifunctional photocatalytic hydrogen evolution and selective benzylamine oxidation.

Photocatalytic hydrogen evolution (PHE) is frequently constrained by inadequate light utilization and the rapid combination rate of the photogenerated electron-hole pairs. Additionally, conventional PHE processes are often facilitated by the addition of sacrificial reagents to consume photo-induced holes, which makes this approach economically unfavorable. Herein, we designed a spatially separated bifunctional cocatalyst decorated Z-scheme heterojunction of hollow structured CdS (HCdS) @ZnIn2S4 (ZIS), which was prepared by a sacrificial hard template method followed by photo-deposition. Consequently, PdOx@HCdS@ZIS@Pt exhibited efficient PHE (86.38 mmol·g-1·h-1) and benzylamine (BA) oxidation coupling (164.75 mmol·g-1·h-1) with high selectivity (97.34 %). The unique hollow core-shelled morphology and bifunctional cocatalyst loading in this work hold great potential for the design and synthesis of bifunctional Z-scheme photocatalysts.

Effect of birth asphyxia on neonatal blood glucose during the early postnatal life: A multi-center study in Hubei Province, China.

BACKGROUND: Birth asphyxia causes hypoxia or inadequate perfusion to the organs of newborns, leading to metabolism dysfunctions including blood glucose disorders. METHODS: Neonates with and without birth asphyxia were retrospectively recruited from 53 hospitals in Hubei Province from January 1 to December 31, 2018. In summary, 875, 1139, and 180 cases in the control group, the mild asphyxia group, and the severe asphyxia group were recruited, respectively. Neonatal blood glucose values at postnatal 1, 2, 6, and 12 h (time error within 0.5 h was allowed) were gathered from the medical records. RESULTS: The incidence rates of hyperglycemia in the control group, the mild asphyxia group and the severe asphyxia group were 2.97%, 7.90%, and 23.33%, respectively (p < 0.001). Additionally, the incidence rates of hypoglycemia in the three groups above were 3.66%, 4.13%, and 7.78%, respectively (p = 0.042). The blood glucose values of neonates with hypoglycemia in the asphyxia group were lower than in the control group (p = 0.003). Furthermore, the blood glucose values of neonates with hyperglycemia were highest in the severe asphyxia group (p < 0.001). There were 778 and 117 cases with blood glucose records at four predefined time points in the mild and severe asphyxia group, respectively. The incidence of blood glucose disorders in the mild asphyxia group significantly decreased from postnatal 6 h (p＜0.05). However, we found no obvious changes of the incidence of glucose disorders within postnatal 12 h in the severe asphyxia group (p = 0.589). CONCLUSION: Birth asphyxia is likely to cause neonatal blood glucose disorders, both hypoglycemia and hyperglycemia, during the early postnatal life. The neonates with severe asphyxia have higher incidence, worse severity and longer duration of blood glucose disorders than neonates with mild asphyxia.

The Impact of the Metabolic Syndrome and Its Components on Resting Energy Expenditure.

We determined whether metabolic syndrome (MetS) and the increasing number of its components influenced the resting energy expenditure (REE). Data on adult men (n = 72, 40%) and women (n = 108, 60%) from European (n = 154, 86%) and Sub-Saharan African (n = 26, 14%) ancestry were used. Ninety-five (53%) participants had MetS (MetS+), while 85 (47%) were without MetS (MetS-). REE was determined through indirect calorimetry, body composition by DEXA, and clinical biochemistry by standard laboratory techniques. MetS+ had a significantly higher REE (mean ± se: MetS+: 5995 ± 87.3 vs. MetS-: 5760 ± 86.3 kJ/d, p = 0.025) when adjusted for age, gender, fat mass (FM), fat-free mass (FFM), ethnicity, season, 25OHD, insulin sensitivity, and time of data collection. Within each MetS status group, an increase in the number of components (C) resulted in a stepwise increase in REE. Relative to zero components, those with 1C had adjusted REE higher by +526 ± 248.1 kJ/d (p = 0.037), while 2C were higher than 1C by +298 ± 140.8 kJ/d (p = 0.037). Similarly, relative to 3C, those with 4C had REE higher by +242 ± 120.7 kJ/d (p = 0.049). The higher REE of 5C over 4C by 132 ± 174.5 kJ/d did not achieve statistical significance. MetS was associated with a significantly higher REE. This greater energetic cost varied directly with the numbers of its components but was most evident in those not diagnosed with the syndrome.

Dual-Functional Photocatalysis for Cooperative Hydrogen Evolution and Benzylamine Oxidation Coupling over Sandwiched-Like Pd@TiO2 @ZnIn2 S4 Nanobox.

Photocatalytic hydrogen evolution (PHE) over semiconductor photocatalysts is usually constrained by the limited light-harvesting and separation of photogenerated electron-hole pairs. Most of the reported systems focusing on PHE are facilitated by consuming the photoinduced holes with organic sacrificial electron donors (SEDs). The introduction of the SEDs not only causes the environmental problem, but also increases the cost of the reaction. Herein, a dual-functional photocatalyst is developed with the morphology of sandwiched-like hollowed Pd@TiO2 @ZnIn2 S4 nanobox, which is synthesized by choosing microporous zeolites with sub-nanometer-sized Pd nanoparticles (Pd NPs) embedded as the sacrificial templates. The ternary Pd@TiO2 @ZnIn2 S4 photocatalyst exhibits a superior PHE rate (5.35 mmol g-1 h-1 ) and benzylamine oxidation conversion rate (>99%) simultaneously without adding any other SEDs. The PHE performance is superior to the reported composites of TiO2 and ZnIn2 S4 , which is attributed to the elevated light capture ability induced by the hollow structure, and the enhanced charge separation efficiency facilitated by the ultrasmall sized Pd NPs. The unique design presented here holds great potential for other highly efficient cooperative dual-functional photocatalytic reactions.

Time spent outdoors through childhood and adolescence - assessed by 25-hydroxyvitamin D concentration - and risk of myopia at 20 years.

PURPOSE: To investigate the relationship between time spent outdoors, at particular ages in childhood and adolescence, and myopia status in young adulthood using serum 25-hydroxyvitamin D [25(OH)D] concentration as a biomarker of time spent outdoors. METHODS: Participants of the Raine Study Generation 2 cohort had 25(OH)D concentrations measured at the 6-, 14-, 17- and 20-year follow-ups. Participants underwent cycloplegic autorefraction at age 20 years, and myopia was defined as a mean spherical equivalent -0.50 dioptres or more myopic. Logistic regression was used to analyse the association between risk of myopia at age 20 years and age-specific 25(OH)D concentrations. Linear mixed-effects models were used to analyse trajectory of 25(OH)D concentrations from 6 to 20 years. RESULTS: After adjusting for sex, race, parental myopia, body mass index and studying status, myopia at 20 years was associated with lower 25(OH)D concentration at 20 years (per 10 nmol/L decrease, odds ratio (aOR)=1.10, 95% CI: 1.02, 1.18) and a low vitamin D status [25(OH)D < 50 nmol/L] at 17 years (aOR = 1.71, 95% CI: 1.06, 2.76) and 20 years (aOR = 1.71, 95% CI: 1.14, 2.56), compared to those without low vitamin D status. There were no associations between 25(OH)D at younger ages and myopia. Individuals who were myopic at 20 years had a 25(OH)D concentration trajectory that declined, relative to non-myopic peers, with increasing age. Differences in 25(OH)D trajectory between individuals with and without myopia were greater among non-Caucasians compared to Caucasians. CONCLUSIONS: Myopia in young adulthood was most strongly associated with recent 25(OH)D concentrations, a marker of time spent outdoors.

Effect of minocycline on the changes in the sewage chemical index and microbial communities in sewage pipes.

With the increasing use of drugs in cities, the sewer is becoming the most suitable place for antibiotic accumulation and transfer. In order to reveal the occurrence and fate of antibiotic sewage during pipeline migration, we used an anaerobic reactor device to simulate the concentration change of minocycline in the sewer and its impact on the sewage quality. The results showed that 90.8 % of minocycline was removed during sewer transportation. In the presence of minocycline, although the consumption of Chemical Oxygen Demand and total nitrogen in the sewage did not change significantly, the consumption rate of total phosphorus, nitrate nitrogen and the growth rate of ammonia nitrogen at the front end of the pipeline were decreased from 29.4 %, 86.3 %, 60.3 % to 3.7 %, 81.5 %, 18.3 % respectively. Minocycline inhibited the reduction of SO42-, while also reducing the production of H2S gas and increasing the release of CH4 gas. Moreover, the decline in the abundance of functional bacteria such as phosphorus accumulating organisms was consistent with the consumption of sewage nutrients. This experiment provides data support for the risk of wastewater leakage of medical and pharmaceutical wastewater into domestic sewage, and will helps to maintain the safe operation of actual sewage pipes.

Metal-Organic Frameworks Based on Group 3 and 4 Metals.

Metal-organic frameworks (MOFs) based on group 3 and 4 metals are considered as the most promising MOFs for varying practical applications including water adsorption, carbon conversion, and biomedical applications. The relatively strong coordination bonds and versatile coordination modes within these MOFs endow the framework with high chemical stability, diverse structures and topologies, and interesting properties and functions. Herein, the significant progress made on this series of MOFs since 2018 is summarized and an update on the current status and future trends on the structural design of robust MOFs with high connectivity is provided. Cluster chemistry involving Y, lanthanides (Ln, from La to Lu), actinides (An, from Ac to Lr), Ti, and Zr is initially introduced. This is followed by a review of recently developed MOFs based on group 3 and 4 metals with their structures discussed based on the types of inorganic or organic building blocks. The novel properties and arising applications of these MOFs in catalysis, adsorption and separation, delivery, and sensing are highlighted. Overall, this review is expected to provide a timely summary on MOFs based on group 3 and 4 metals, which shall guide the future discovery and development of stable and functional MOFs for practical applications.

Spatially Separated Bifunctional Cocatalysts Decorated on Hollow-Structured TiO2 for Enhanced Photocatalytic Hydrogen Generation.

Efficient charge separation can promote photocatalysis of semiconductors. Herein, a hollow-structured TiO2 sphere decorated with spatially separated bifunctional cocatalysts was designed, which exhibited enhanced photocatalytic hydrogen generation. Ultrasmall-sized MOx (M = Pd, Co, Ni, or Cu) nanoparticles (NPs) were first introduced into a zeolite via confinement synthesis, and then, hollow TiO2 was fabricated by using the zeolite as a sacrificial template forming MOx@TiO2. Finally, Pt NPs were decorated on the outer shell, giving rise to MOx@TiO2@Pt, in which the MOx NPs and Pt NPs acted as hole capturers and electron sinks, respectively. Thanks to the enhanced light harvesting of the hollow structure and improved charge separation induced by the smaller-sized cocatalysts as well as spatially separated bifunctional cocatalysts, the as-prepared PdOx@TiO2@Pt catalyst exhibited a superior photocatalytic hydrogen-generation property (0.45 mmol h-1). This work demonstrates the advantage of the spatially separated bifunctional cocatalysts in enhancing the photocatalytic properties of semiconductors.

Increasing multimorbidity in an Australian street health service: A 10-year retrospective cohort study

Background and objectives: Street-based clinics provide general practice services to marginalised and homeless persons. The objective of this study was to examine prevalence, patterns and severity of multimorbidity in patients attending one such service. Method: A retrospective cohort study (2006­15), comprising medical record review of patients (n = 4285), was undertaken. A Cumulative Illness Rating Scale (CIRS) was used to assess multimorbidity. Results: Average age of patients was 38.2 ± 17.9 years. Of 31.5% Aboriginal patients, 50.8% were female (37.6% in non Aboriginal patients). Of all patients, 53% had multimorbidity. Aboriginal patients had higher rates of multimorbidity than non-Aboriginal patients (58.0% vs 50.6%, P <0.001). Psychiatric, musculoskeletal (especially skin) and respiratory conditions were most common. Disease severity was mild to moderate, with 26.8% having at least one severe or extremely severe condition. Multimorbidity and disease severity increased between 2006­11 and 2012­15. Aboriginality was the strongest predictor of multimorbidity (odds ratio [OR] = 2.1; 95% confidence interval [CI]: 1.8­2.4; P <0.001). Discussion: Street-based general practice services are critical to facilitate easy access to primary and secondary management of chronic multimorbid conditions in marginalised (especially Aboriginal) patients.

Bioinspired self-standing macroporous Au/ZnO sponges for enhanced photocatalysis.

A self-standing macroporous noble metal-zinc oxide (ZnO) sponge of robust 3D network has been fabricated through in-situ growth method. The key to the construction of the bioinspired sponge lies in the choice of commercial polyurethane sponge (CPS) with interconnected and junction-free macroporous structure as the skeleton to support Au/ZnO nanorods (Au/ZnONRs). The resultant Au/ZnO/CPS not only exhibits hierarchical structures representing physical features of CPS, but also demonstrates durable superior photocatalytic activity and hydrogen generation capability. In addition, we have adopted various irradiations to investigate the effect of UV light and visible light on the photocatalytic performance of Au/ZnO/CPS individually. In detail, the photocatalytic properties of Au/ZnO/CPS and ZnO/CPS have been monitored and compared under irradiations of different wavelengths (200-1100, 350-780, 200-420 and 420-780 nm) for 90 min to reveal the effect of irradiation wavelength on the activity of photocatalysts. A possible mechanism between irradiation wavelength and photocatalytic degradation efficiency is proposed. The facile in-situ growth approach presented herein can be easily scaled up, affording a convenient method for the preparation of self-standing 3D macroporous materials, which holds great potential for the application in both environmental purification and solar-to-hydrogen energy conversion.

One-pot synthesis of Au@TiO2 yolk-shell nanoparticles with enhanced photocatalytic activity under visible light.

Natural biological systems often use hollow structures to decrease reflection and achieve high solar light utilization. Herein, bio-inspired Au@TiO2 yolk-shell nanoparticles (NPs) have been designed to combine the advantages of noble metal coupling and hollow structures, and subsequently synthesized via a facile one-pot hydrothermal approach. The Au@TiO2 yolk-shell NPs not only exhibit reduced reflectance by multiple reflections and scattering within the hollow NPs, but also show enhanced photocatalytic activity in Rhodamine B (RhB) degradation by simultaneously improving light harvesting, charge separation and reaction site accessibility. Specifically, compared to the commercial TiO2 (P25), Au/TiO2 hybrid and Au@TiO2 core-shell NPs, the Au@TiO2 yolk-shell NPs demonstrate lower reflectance over a broader range and superior photocatalytic activity with more than 98.1% of RhB decomposed within 4h under visible light. The bio-inspired nanostructure, as well as the facile and scalable fabrication approach, will open a new avenue to the rational design and preparation of efficient photocatalysts for pollutant removal.

[Drug-Resistant Mechanism of Multiple Myeloma and Its Therapy Combined with HDACi -Review].

Drug resistance of multiple myeloma(MM) has become more and more common, and greatly decreased the survival rate of these patients. The occurence of drug-resistance involves in many factors such as bone marrow microenveronment, tumor cell self-metabolism, cytokines, specific targets and so on. In this review, the potential mechanisms of resistance to glucocorticoid/proteasome inhibitor/immunomodulatory druges are briefly expounded in the aspect of tumor cell self-metabolism, including the changes of heat slock protein expression, mRNA expression, related cytokine levels and down-regulation of thalidomid-effecting site CRBN expression. In this review, the researches on the effect of histone deacetylase inhibitors(HDACi) combined with glucocorticoid, proteasome inhibitors, immunomodulatory drugs and monoclonal antibodies on multiple myeloma, specially, drug-resistant multiple myeloma are also summarized.

Investigating the size effect of Au nanospheres on the photocatalytic activity of Au-modified ZnO nanorods.

Plasmonic nanostructures of semiconductors and noble metal nanospheres (NSs) hold great promise in the applications of solar energy conversion. Although it is known that the size of NSs plays a critical role in determining the photocatalytic performance of the resultant nanohybrids, the actual effects depend on multiple variables and needs to be elucidated for each specific scenario. Herein, ZnO nanorods (NRs) modified with AuNSs of diameters varying from 20 to 80nm have been prepared to investigate the size effect of AuNSs on the photocatalytic activity of Au-ZnO hybrids. Interestingly, the Au-ZnONRs with 40-nm AuNSs demonstrate higher photocatalytic activity than the nanohybrids with AuNSs of either smaller or larger sizes. A possible "trade-off" mechanism between efficient charge transfer for smaller NSs and stronger LSPR effect for larger ones is proposed.

Spiky TiO2/Au nanorod plasmonic photocatalysts with enhanced visible-light photocatalytic activity.

A facile approach for the preparation of spiky TiO2/Au nanorod (NR) plasmonic photocatalysts has been demonstrated, which is through in situ nucleation and growth of spiky TiO2 onto AuNRs. Different aspect ratios of AuNRs in 2.5, 2.7, 4.1 and 4.5 have been applied to prepare spiky TiO2/AuNR nanohybrids to achieve tunable and broad localized surface plasmon resonance (LSPR) bands. All spiky TiO2/AuNR nanohybrids exhibit enhanced light harvesting by extending visible light absorption range by both transverse and longitudinal LSPR bands and decreasing light reflectance by their unique spiky structures. Compared to the bare AuNRs, commercial TiO2 (P25) and spiky TiO2/Au nanosphere photocatalysts, the spiky TiO2/AuNR photocatalysts exhibit significantly enhanced visible light photocatalytic activity in Rhodamine B (RhB) degradation due to their simultaneous enhancement in the light harvesting, charge utilization efficiency, and substrate accessibility. In particular, the spiky TiO2/AuNR-685 photocatalysts show the best photocatalytic activity with ∼98.9% of the RhB degraded within 90 min under the irradiation of 420-780 nm, which could be ascribed to the most extended visible light absorption range and sufficient photon energy of TiO2/AuNR-685 photocatalysts within this irradiation region. The bio-inspired nanostructure, as well as the facile and scalable fabrication approach, will open a new avenue for the rational design and preparation of high-performance photocatalysts for pollutant removal and water splitting.

Drug-Resistant Mechanism of Multiple Myeloma and Its Therapy Combined with HDACi -Review / 中国实验血液学杂志

Drug resistance of multiple myeloma(MM) has become more and more common, and greatly decreased the survival rate of these patients. The occurence of drug-resistance involves in many factors such as bone marrow microenveronment, tumor cell self-metabolism, cytokines, specific targets and so on. In this review, the potential mechanisms of resistance to glucocorticoid/proteasome inhibitor/immunomodulatory druges are briefly expounded in the aspect of tumor cell self-metabolism, including the changes of heat slock protein expression, mRNA expression, related cytokine levels and down-regulation of thalidomid-effecting site CRBN expression. In this review, the researches on the effect of histone deacetylase inhibitors(HDACi) combined with glucocorticoid, proteasome inhibitors, immunomodulatory drugs and monoclonal antibodies on multiple myeloma, specially, drug-resistant multiple myeloma are also summarized.

Serum 25-hydroxyvitamin D concentrations and cardiometabolic risk factors in adolescents and young adults.

Evidence associating serum 25-hydroxyvitamin D (25(OH)D) concentrations and cardiometabolic risk factors is inconsistent and studies have largely been conducted in adult populations. We examined the prospective associations between serum 25(OH)D concentrations and cardiometabolic risk factors from adolescence to young adulthood in the West Australian Pregnancy Cohort (Raine) Study. Serum 25(OH)D concentrations, BMI, homoeostasis model assessment for insulin resistance (HOMA-IR), TAG, HDL-cholesterol and systolic blood pressure (SBP) were measured at the 17-year (n 1015) and 20-year (n 1117) follow-ups. Hierarchical linear mixed models with maximum likelihood estimation were used to investigate associations between serum 25(OH)D concentrations and cardiometabolic risk factors, accounting for potential confounders. In males and females, respectively, mean serum 25(OH)D concentrations were 73·6 (sd 28·2) and 75·4 (sd 25·9) nmol/l at 17 years and 70·0 (sd 24·2) and 74·3 (sd 26·2) nmol/l at 20 years. Deseasonalised serum 25(OH)D3 concentrations were inversely associated with BMI (coefficient -0·01; 95 % CI -0·03, -0·003; P=0·014). No change over time was detected in the association for males; for females, the inverse association was stronger at 20 years compared with 17 years. Serum 25(OH)D concentrations were inversely associated with log-HOMA-IR (coefficient -0·002; 95 % CI -0·003, -0·001; P<0·001) and positively associated with log-TAG in females (coefficient 0·002; 95 % CI 0·0008, 0·004; P=0·003). These associations did not vary over time. There were no significant associations between serum 25(OH)D concentrations and HDL-cholesterol or SBP. Clinical trials in those with insufficient vitamin D status may be warranted to determine any beneficial effect of vitamin D supplementation on insulin resistance, while monitoring for any deleterious effect on TAG.

A new electronic screening tool for identifying risk of familial hypercholesterolaemia in general practice.

OBJECTIVE: To evaluate the performance of a new electronic screening tool (TARB-Ex) in detecting general practice patients at potential risk of familial hypercholesterolaemia (FH). METHODS: Medical records for all active patients seen between 2012 and 2014 (n=3708) at a large general practice in Perth, Western Australia were retrospectively screened for potential FH risk using TARB-Ex. Electronic extracts of medical records for patients identified with potential FH risk (defined as Dutch Lipid Clinic Network Criteria (DLCNC) score ≥5) through TARB-Ex were reviewed by a general practitioner (GP) and lipid specialist. High-risk patients were recalled for clinical assessment to determine phenotypic FH diagnosis. Performance was evaluated against a manual record review by a GP in the subset of 360 patients with high blood cholesterol (cholesterol ≥7 mmol/L or low-density lipoprotein cholesterol ≥4.0 mmol/L). RESULTS: Thirty-two patients with DLCNC score ≥5 were identified through electronic screening compared with 22 through GP manual review. Sensitivity was 95.5% (95% CI 77.2% to 99.9%), specificity was 96.7% (95% CI 94.3% to 98.3%), negative predictive accuracy was 99.7% (95% CI 98.3% to 100%) and positive predictive accuracy was 65.6% (95% CI 46.9% to 8%). Electronic screening was completed in 10 min compared with 60 h for GP manual review. 10 of 32 patients (31%) were considered high risk and recalled for clinical assessment. Six of seven patients (86%) who attended clinical assessment were diagnosed with phenotypic FH on examination. CONCLUSIONS: TARB-Ex screening is a time-effective and cost-effective method of systematically identifying potential FH risk patients from general practice records for clinical follow-up.