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Automatic segmentation of skin lesion is an important step in computer‐aided diagnosis. However, due to the significant variations in the size and shape of the lesion areas, as well as the low contrast with normal skin tissue, the boundaries are not clearly distinguishable, leading to a high possibility of incorrect segmentation. Therefore, this task is highly challenging. To overcome these difficulties, this paper proposes a medical image segmentation architecture named dual branch encoder and multi‐scale cross attention fusion network, which includes a dual‐branch encoder based on convolutional neural network and an improved channel‐enhanced Mamba to comprehensively extract local and global information from dermoscopy images. Additionally, to enhance the feature interaction and fusion of local and global information, a multi‐scale cross attention fusion module is adopted to cross‐merge features in different directions and at different scales, maximizing the advantages of the dual‐branch encoder and achieving precise segmentation of skin lesions. Extensive experiments are conducted on three public skin lesion datasets: ISIC‐2018, ISIC‐2017, and ISIC‐2016, to verify the effectiveness and superiority of the proposed method. The dice similarity coefficient scores on the three datasets reached 81.77%, 81.68% and 85.60%, respectively, surpassing most state‐of‐the‐art methods. [ABSTRACT FROM AUTHOR]

Photocatalytic ozonation is considered to be a promising approach for the treatment of refractory organic pollutants, but the design of efficient catalyst remains a challenge. Surface modification provides a potential strategy to improve the activity of photocatalytic ozonation. In this work, density functional theory (DFT) calculations were first performed to check the interaction between O3 and TiO2−OH (surface hydroxylated TiO2) or TiO2−F (surface fluorinated TiO2), and the results suggest that TiO2−OH displays better O3 adsorption and activation than does TiO2−F, which is confirmed by experimental results. The surface hydroxyl groups greatly promote the O3 activation, which is beneficial for the generation of reactive oxygen species (ROS). Importantly, TiO2−OH displays better performance towards pollutants (such as berberine hydrochloride) removal than does TiO2−F and most reported ozonation photocatalysts. The total organic carbon (TOC) removal efficiency reaches 84.4 % within two hours. This work highlights the effect of surface hydroxylation on photocatalytic ozonation and provides ideas for the design of efficient photocatalytic ozonation catalysts. [ABSTRACT FROM AUTHOR]

Solar‐driven CO2 reduction into value‐added C2+ chemical fuels, such as C2H4, is promising in meeting the carbon‐neutral future, yet the performance is usually hindered by the high energy barrier of the C─C coupling process. Here, an efficient and stabilized Cu(I) single atoms‐modified W18O49 nanowires (Cu1/W18O49) photocatalyst with asymmetric Cu─W dual sites is reported for selective photocatalytic CO2 reduction to C2H4. The interconversion between W(V) and W(VI) in W18O49 ensures the stability of Cu(I) during the photocatalytic process. Under light irradiation, the optimal Cu1/W18O49 (3.6‐Cu1/W18O49) catalyst exhibits concurrent high activity and selectivity toward C2H4 production, reaching a corresponding yield rate of 4.9 µmol g−1 h−1 and selectivity as high as 72.8%, respectively. Combined in situ spectroscopies and computational calculations reveal that Cu(I) single atoms stabilize the *CO intermediate, and the asymmetric Cu─W dual sites effectively reduce the energy barrier for the C─C coupling of two neighboring CO intermediates, enabling the highly selective C2H4 generation from CO2 photoreduction. This work demonstrates leveraging stabilized atomically‐dispersed Cu(I) in asymmetric dual‐sites for selective CO2‐to‐C2H4 conversion and can provide new insight into photocatalytic CO2 reduction to other targeted C2+ products through rational construction of active sites for C─C coupling. [ABSTRACT FROM AUTHOR]

Photoconversion of CO2 and H2O into ethanol is an ideal strategy to achieve carbon neutrality. However, the production of ethanol with high activity and selectivity is challenging owing to the less efficient reduction half‐reaction involving multi‐step proton‐coupled electron transfer (PCET), a slow C−C coupling process, and sluggish water oxidation half‐reaction. Herein, a two‐dimensional/two‐dimensional (2D/2D) S‐scheme heterojunction consisting of black phosphorus and Bi2WO6 (BP/BWO) was constructed for photocatalytic CO2 reduction coupling with benzylamine (BA) oxidation. The as‐prepared BP/BWO catalyst exhibits a superior photocatalytic performance toward CO2 reduction, with a yield of 61.3 μmol g−1 h−1 for ethanol (selectivity of 91 %).In situ spectroscopic studies and theoretical calculations reveal that S‐scheme heterojunction can effectively promote photogenerated carrier separation via the Bi−O−P bridge to accelerate the PCET process. Meanwhile, electron‐rich BP acts as the active site and plays a vital role in the process of C−C coupling. In addition, the substitution of BA oxidation for H2O oxidation can further enhance the photocatalytic performance of CO2 reduction to C2H5OH. This work opens a new horizon for exploring novel heterogeneous photocatalysts in CO2 photoconversion to C2H5OH based on cooperative photoredox systems. [ABSTRACT FROM AUTHOR]

Photoconversion of CO2 and H2O into ethanol is an ideal strategy to achieve carbon neutrality. However, the production of ethanol with high activity and selectivity is challenging owing to the less efficient reduction half‐reaction involving multi‐step proton‐coupled electron transfer (PCET), a slow C−C coupling process, and sluggish water oxidation half‐reaction. Herein, a two‐dimensional/two‐dimensional (2D/2D) S‐scheme heterojunction consisting of black phosphorus and Bi2WO6 (BP/BWO) was constructed for photocatalytic CO2 reduction coupling with benzylamine (BA) oxidation. The as‐prepared BP/BWO catalyst exhibits a superior photocatalytic performance toward CO2 reduction, with a yield of 61.3 μmol g−1 h−1 for ethanol (selectivity of 91 %).In situ spectroscopic studies and theoretical calculations reveal that S‐scheme heterojunction can effectively promote photogenerated carrier separation via the Bi−O−P bridge to accelerate the PCET process. Meanwhile, electron‐rich BP acts as the active site and plays a vital role in the process of C−C coupling. In addition, the substitution of BA oxidation for H2O oxidation can further enhance the photocatalytic performance of CO2 reduction to C2H5OH. This work opens a new horizon for exploring novel heterogeneous photocatalysts in CO2 photoconversion to C2H5OH based on cooperative photoredox systems. [ABSTRACT FROM AUTHOR]

Background: The atherogenic index of plasma (AIP) is a novel biomarker associated with atherosclerosis, and an important risk factor for atherosclerosis, but its relation with cardiovascular prognosis in prediabetic patients with unstable angina pectoris (UAP) is still uncertain. Methods: This study included 1096 prediabetic patients with UAP who were subjected to follow-up for a maximum of 30 months, with cardiac death, refractory angina, and non-fatal myocardial infarction (MI) being the primary cardiovascular endpoints. Results: A significantly increased AIP was observed for the group with primary cardiovascular endpoints. Kaplan–Meier curves corresponding to these endpoints revealed pronounced differences between these two AIP groups (Log-rank P < 0.001). Multivariate Cox proportional hazards analyses highlighted AIP as being independent related to this primary endpoint (HR 1.308, 95% CI: 1.213–1.412, P < 0.001). AIP addition to the baseline risk model improved the prediction of the primary endpoint (AUC: baseline model, 0.622, vs. baseline model + AIP, 0.739, P < 0.001). Conclusions: AIP could be used to predict cardiovascular events in prediabetic individuals with UAP. [ABSTRACT FROM AUTHOR]

Visible and even infrared (IR) light-initiated hot electrons of graphene (Gr) catalysts are a promising driven power for green, safe, and sustainable H2O2 synthesis and organic synthesis without the limitation of bandgap-dominated narrow light absorption to visible light confronted by conventional photocatalyst. However, the life time of photogenerated hot electrons is too short to be efficiently used for various photocatalytic reactions. Here, we proposed a straightforward method to prolong the lifetime of photogenerated hot electrons from graphene by tuning the Schottky barrier at Gr/rutile interface to facilitate the hot electron injection. The rational design of Gr-coated TiO2 heterojunctions with interface synergy-induced decrease in the formation energy of the rutile phase makes the phase transfer of TiO2 support proceed smoothly and rapidly via ball milling. The optimized Gr/rutile dyad could provide a H2O2 yield of 1.05 mM·g−1·h−1 under visible light irradiation (λ ≥ 400 nm), which is 30 times of the state-of-the-art noble-metal-free titanium oxide-based photocatalyst, and even achieves a H2O2 yield of 0.39 mM·g−1·h−1 on photoexcitation by near-infrared-region light (∼ 800 nm). [ABSTRACT FROM AUTHOR]

Selective CO2 photoreduction to hydrocarbon fuels such as CH4 is promising and sustainable for carbon‐neutral future. However, lack of proper binding strengths with reaction intermediates makes it still a challenge for photocatalytic CO2 methanation with both high activity and selectivity. Here, low‐coordination single Au atoms (Au1‐S2) on ultrathin ZnIn2S4 nanosheets was synthesized by a complex‐exchange route, enabling exceptional photocatalytic CO2 reduction performance. Under visible light irradiation, Au1/ZnIn2S4 catalyst exhibits a CH4 yield of 275 μmol g−1 h−1 with a selectivity as high as 77 %. As revealed by detailed characterizations and density functional theory calculations, Au1/ZnIn2S4 with Au1‐S2 structure not only display fast carrier transfer to underpin its superior activity, but also greatly reduce the energy barrier for protonation of *CO and stabilize the *CH3 intermediate, thereby leading to the selective CH4 generation from CO2 photoreduction. [ABSTRACT FROM AUTHOR]

Selective CO2 photoreduction to hydrocarbon fuels such as CH4 is promising and sustainable for carbon‐neutral future. However, lack of proper binding strengths with reaction intermediates makes it still a challenge for photocatalytic CO2 methanation with both high activity and selectivity. Here, low‐coordination single Au atoms (Au1‐S2) on ultrathin ZnIn2S4 nanosheets was synthesized by a complex‐exchange route, enabling exceptional photocatalytic CO2 reduction performance. Under visible light irradiation, Au1/ZnIn2S4 catalyst exhibits a CH4 yield of 275 μmol g−1 h−1 with a selectivity as high as 77 %. As revealed by detailed characterizations and density functional theory calculations, Au1/ZnIn2S4 with Au1‐S2 structure not only display fast carrier transfer to underpin its superior activity, but also greatly reduce the energy barrier for protonation of *CO and stabilize the *CH3 intermediate, thereby leading to the selective CH4 generation from CO2 photoreduction. [ABSTRACT FROM AUTHOR]

To combat groundwater pollution, in situ chemical oxidation (ISCO) has been extensively adopted to degrade groundwater pollutants. A critical factor associated with the success of ISCO is the stability (or persistence) of the chemical oxidant. A higher oxidant stability can result in a higher integrity and a sustained oxidation capacity for the oxidants. Both potassium permanganate (KMnO4) and persulfate (PS) are two most commonly employed chemical oxidants for ISCO operations. Although a number of experimental studies have been conducted to evaluate the persistence of these two oxidants, systematic investigations of the persistence of KMnO4 and PS and especially the impact of different subsurface materials on oxidant stability are still limited. To fill these knowledge gaps, the stability of both KMnO4 and PS oxidants has been systemically evaluated in this study. For each type of oxidant, the impact of solution pH and the presence of matrix anions on oxidant stability were evaluated. Furthermore, the persistence of these oxidants was examined in the presence of a number of soils and subsurface minerals with the natural oxidant demand value of each subsurface material being determined. It is found that KMnO4 can directly react with the reducing constituents in the soils via chemical oxidation where PS requires to be activated first in order to produce sulfate radical to react with reducing species. This study provides the essential information of the stability of KMnO4 and PS under different physiochemical conditions and in the presence of different subsurface materials for groundwater ISCO treatment. The conclusions from this study can substantially facilitate the ISCO operations by use of KMnO4 and PS in a more efficient and cost-effective manner. [ABSTRACT FROM AUTHOR]

Groundwater pollution is a significant threat to the public health and environment. Existing groundwater remedial approaches include ex situ treatment and conventional in situ chemical oxidation methods. Although these two methods are widely adopted for groundwater cleanup, continual treatment effectiveness is not satisfactory due to several physicochemical challenges, such as tailing, back diffusion, and concentration rebound. Moreover, these two methods require significant energy and chemical inputs. As an alternative to conventional approaches, controlled release materials are able to discharge chemical oxidants in a continual manner with a substantially prolonged release longevity and treatment time. Thus, these materials are characterized as cost-effective and low-maintenance. In this study, controlled release bead (CRB) materials composed of potassium permanganate (KMnO4)-paraffin were synthesized and evaluated for their performance in degrading alkylbenzene organics. Both batch and dynamic degradation studies indicate that the fabricated CRBs can gradually release KMnO4 into the aqueous phase to degrade alkylbenzenes and the eventual effectiveness in pollutant degradation is on par with the aqueous KMnO4 solution. Furthermore, KMnO4-cement CRBs were fabricated and tested for KMnO4 release kinetics from the CRB surface. It shows that system temperature can considerably influence KMnO4 release longevity and hence treatment lifetime. This study provides the essential information of the novel CRB materials for groundwater pollution remediation with a reduced energy and chemical consumption and a lower environmental footprint. This study expands our capacity in designing, laboratory testing, and modeling these novel materials to facilitate their potential field remedial application. [ABSTRACT FROM AUTHOR]

Background and aims: although an association between metabolic syndrome (MS) and cardiovascular disease risk has been documented, the relationship in patients with complex calcified coronary lesions undergoing rotational atherectomy (RA) and drug-eluting stent(DES) insertion remains controversial. Here, the influence of MS on outcomes was assessed. Methods and results: we retrospectively included 398 patients who underwent RA and DES insertion for complex calcified coronary lesions in our institution between June 2015 and January 2019. The modified Adult Treatment Plan III was used to diagnose MS. The endpoint was major adverse cardiovascular events (MACEs), comprising mortality from all causes, myocardial infarction, and target vessel revascularization (TVR). In all, 173 (43.5%) patients had MS. MS was significantly associated with MACE over the 28.32 ± 6.79-month follow-up period (HR 1.783, 95% CI from 1.122 to 2.833) even after adjustment for other possible confounders. Conclusion: MS was frequently observed in patients treated with RA with DES insertion for complex calcified coronary lesions. MS independently predicted MACE in these patients. [ABSTRACT FROM AUTHOR]

Benzothiazole (BTH) is an aromatic heterocyclic compound with wide industrial applications. In view of its toxicity and wide environmental presence, previous efforts have been made to decompose BTH via different degradation pathways. However, due to its recalcitrant nature, conventional biological treatment methods cannot completely degrade BTH in the wastewater. In this study, sulfate radical-based advanced oxidation process (AOP) technique has been adopted to degrade BTH in aqueous phase. Persulfate (PS) was employed as radical promotor to generate sulfate radical via heat activation. Degradation of BTH by thermally activated persulfate via AOP has been experimentally evaluated in a systematic manner. Laboratory efforts have been made to examine the impact of a number of physiochemical parameters including the type of oxidants, reaction temperature, initial concentrations of PS and BTH, solution pH, and the presence of anionic species. It shows that a higher BTH degradation rate can be achieved by lowering BTH initial concentration or increasing PS concentration. Increasing solution pH or the presence of 10 mM of Cl−, Br−, CO 3 2 − , or HCO 3 − species can decrease BTH degradation rate. Furthermore, the primary radical(s) responsible for BTH degradation have been identified as sulfate radical at an acidic aqueous condition, and hydroxyl radical and sulfate radical combined at a basic condition. This study provides the necessary theoretical and technical foundations for BTH degradation via sulfate radical-based AOP technique. The conclusions from this study can substantially promote the field application of AOP, especially sulfate radical-based AOP technique, for BTH degradation in wastewater treatment process. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease and insulin resistance are closely related. The triglyceride-glucose (TyG) index is frequently used as an indicator of insulin resistance. However, there is scant information on the TyG index in the prediabetic population, nor is the prognostic significance of the index known for prediabetes and acute coronary syndrome (ACS) patients. Methods: The clinical endpoint was a major adverse cardiovascular and cerebrovascular event (MACCEs), including cardiac-related death, non-fatal myocardial infarction, ischemia-driven revascularization, and stroke. The TyG index was calculated as = ln [(triglyceride level, mg/dL) × (glucose level, mg/dL)÷2] under fasting conditions. Results: The study included 2,030 prediabetic patients with ACS. Patients were followed up for 2.5 years, during which the total incidence of MACCEs was 12%. After adjustment for covariates, the TyG index was found to be predictive of prediabetes with ACS (HR 4.942, 95%CI: 3.432-6.115, P<0.001). Using propensity score matching, 574 pairs were successfully matched, and the two groups were analyzed in terms of survival. This showed that there was a significantly greater incidence of MACCEs in patients with high TyG indices (HR 3.526, 95%CI: 2.618-4.749, P<0.001), mainly due to ischemia-driven revascularization and stroke. Conclusions: The TyG index independently predicts future MACCEs and may be an important prognostic indicator for patients with prediabetes and ACS. [ABSTRACT FROM AUTHOR]

Aims: To identify risk factors for cardiac death of elderly and severe chronic kidney disease (CKD) patients with coronary atherosclerotic heart disease (CAHD) after percutaneous coronary intervention (PCI). Methods: 1010 CAHD-CKD patients over 60 years old who had CKD stage 3 or above and underwent PCI were followed up for at least 3 years. Cases of cardiac death were divided into groups. After univariate analysis of all variables, the variables with P <.2 were selected for further logistic regression. Results: For logistic regression single-vessel disease (SVD) PCI OR = 0.612, 95%CI: 0.416–0.899, P =.012, it is the protective factor. There are four risk factors, stable angina pectoris (SAP) OR = 4.723, 95%CI: 1.098∼20.322, P =.037, combined with lower extremity arteriosclerosis obliterans (LEASO) OR = 2.631, 95%CI: 1.272∼5.440, P =.009, K > 4.285 mmol/L OR = 1.44, 95%CI: 1.002∼2.069, P =.049, without statins OR = 2.015, 95%CI: 1.072∼3.789, P =.030. Conclusion: In elderly and serious CAHD-CKD patients after PCI, SVD PCI was a protective factor against cardiac death. However, SAP, CAHD-CKD combined with LEASO, K > 4.285 mmol/L, and no statins were independent risk factors of cardiac death for elderly patients with severe CKD after PCI. [ABSTRACT FROM AUTHOR]

Aim: There is no model for predicting the outcomes for coronary heart disease (CHD) patients with chronic kidney disease (CKD) after percutaneous coronary intervention (PCI). To develop and validate a model to predict major adverse cardiovascular events (MACEs) in patients with comorbid CKD and CHD undergoing PCI. Methods: We enrolled 1714 consecutive CKD patients who underwent PCI from January 1, 2008 to December 31, 2017. In the development cohort, we used least absolute shrinkage and selection operator regression for data dimension reduction and feature selection. We used multivariable logistic regression analysis to develop the prediction model. Finally, we used an independent cohort to validate the model. The performance of the prediction model was evaluated with respect to discrimination, calibration, and clinical usefulness. Results: The predictors included a positive family history of CHD, history of revascularization, ST segment changes, anemia, hyponatremia, transradial intervention, the number of diseased vessels, dose of contrast media >200 ml, and coronary collateral circulation. In the validation cohort, the model showed good discrimination (area under the receiver operating characteristic curve, 0.612; 95% confidence interval: 0.560, 0.664) and good calibration (Hosmer-Lemeshow test, P = 0.444). Decision curve analysis demonstrated that the model was clinically useful. Conclusions: We created a nomogram that predicts MACEs after PCI in CHD patients with CKD and may help improve the screening and treatment outcomes. [ABSTRACT FROM AUTHOR]

It has been discovered that both inflammation and platelet aggregation could cause crucial effect on the occurrence and development of cardiovascular diseases. As a combination of platelet and lymphocyte, platelet-lymphocyte ratio (PLR) was proved to be correlated with the severity as well as prognosis of cardiovascular diseases. Exploring the relationship between PLR and in-hospital mortality in cardiac intensive care unit (CICU) patients was the purpose of this study. PLR was calculated by dividing platelet count by lymphocyte count. All patients were grouped by PLR quartiles and the primary outcome was in-hospital mortality. The independent effect of PLR was determined by binary logistic regression analysis. The curve in line with overall trend was drawn by local weighted regression (Lowess). Subgroup analysis was used to determine the relationship between PLR and in-hospital mortality in different subgroups. We included 5577 CICU patients. As PLR quartiles increased, in-hospital mortality increased significantly (Quartile 4 vs. Quartile 1: 13.9 vs. 8.3, P < 0.001). After adjusting for confounding variables, PLR was proved to be independently associated with increased risk of in-hospital mortality (Quartile 4 vs. Quartile 1: OR 95% CI 1.55, 1.08–2.21, P = 0.016, P for trend < 0.001). The Lowess curves showed a positive relationship between PLR and in-hospital mortality. The subgroup analysis revealed that patients with low Acute Physiology and Chronic Health Evaluation IV (APACHE IV) or with less comorbidities had higher risk of mortality for PLR. Further, PLR quartiles had positive relation with length of CICU stay (Quartile 4 vs. Quartile 1: 2.7, 1.6–5.2 vs. 2.1, 1.3–3.9, P < 0.001), and the length of hospital stay (Quartile 4 vs. Quartile 1: 7.9, 4.6–13.1 vs. 5.8, 3.3–9.8, P < 0.001). PLR was independently associated with in-hospital mortality in CICU patients. [ABSTRACT FROM AUTHOR]

Background: As metabolic molecules, bile acids (BAs) not only promote the absorption of fat-soluble nutrients, but they also regulate many metabolic processes, including the homeostasis of glucose and lipids. Although total serum BA (TBA) measurement is a readily available clinical test related to coronary artery disease (CAD), myocardial infarction (MI), and type 2 diabetes mellitus (T2DM), the relationship between TBA and these pathological conditions remain unclear, and research on this topic is inconclusive. Methods: This study enrolled 20,255 menopausal women aged over 50 years, including 6,421 T2DM patients. The study population was divided into different groups according to the median TBA level in order to explore the clinical characteristics of menopausal women with different TBA levels. Spline analyses, generalized additive model (GAM) model and regression analyses based on TBA level were used to explore the relationship between TBA and different diseases independently, including CAD and MI, or in combination with T2DM. Results: Both in the general population and in the T2DM subgroup, the TBA level was significantly lower in CAD patients than in non-CAD patients. Spline analyses indicated that within normal clinical range of TBA concentration (0–10 µmol/L), the presence of CAD and MI showed similar trends in total and T2DM population. Similarly, the GAM model indicated that within the 0–10 μmol/L clinical range, the predicted probability for CAD and MI alone and in combination with T2DM was negatively correlated with TBA concentration. Multivariate regression analysis suggested that low TBA level was positively associated with the occurrence of CAD combined with T2DM (OR: 1.451; 95%CI: 1.141–1.847). Conclusions: In menopausal women, TBA may represent a valuable clinical serum marker with negative correlation for CAD and MI in patients with T2DM. [ABSTRACT FROM AUTHOR]

Quadruped robots have superior terrain adaptability and flexible movement capabilities than traditional robots. In this article, we innovatively apply it in person-following tasks, and propose an efficient motion planning scheme for quadruped robots to generate a flexible and effective trajectory in confined spaces. The method builds a real-time local costmap via onboard sensors, which involves both static and dynamic obstacles. And we exploit a simplified kinodynamic model and formulate the friction pyramids formed by ground reaction forces’ inequality constraints to ensure the executable of the optimized trajectory. In addition, we obtain the optimal following trajectory in the costmap completely based on the robot's rectangular footprint description, which ensures that it can walk through the narrow spaces avoiding collision. Finally, a receding horizon control strategy is employed to improve the robustness of motion in complex environments. The proposed motion planning framework is integrated on the quadruped robot JueYing and tested in simulation as well as real scenarios. It shows that the execution success rates in various scenes are all over 90%. [ABSTRACT FROM AUTHOR]

Ni/TiO2 as a classic system has been widely studied in the traditional catalysis field including the water-gas shift reaction and selective oxidation/hydrogenation. However, in terms of the electrocatalytic hydrogen evolution reaction (HER), there is still a lack of systematic research on the actual synergistic promotion effect on the performance, and the influence of the host material on the electronic interaction between Ni and TiO2 is still unclear. Herein, we synthesized a series of Ni/TiO2 composites with different forms and tested the relevant HER performance. The results show that Ni/TiO2 exhibits much better HER performance than pure Ni and there is one type of electronic interaction between Ni and TiO2 in the composite with different forms, that is, electrons transfer from Ni to TiO2. However, the interaction strength is host dependent, and the composite with Ni as the host displays the strongest interaction, and therefore the best HER performance (46 mV at 10 mA cm−2). [ABSTRACT FROM AUTHOR]

Background. Neutrophil percentage-to-albumin ratio (NPAR) has been proved to be associated with clinical outcome of many diseases. This study was aimed at exploring the independent effect of NPAR on all-cause mortality of critically ill patients with coronary artery disease (CAD). Method. NPAR was calculated as neutrophil percentage numerator divided by serum albumin concentration. Clinical endpoints were 30-day, 90-day, and 365-day all-cause mortality. Multivariable Cox proportional hazard models were performed to confirm the association between NPAR and all-cause mortality. Result. 3106 patients with CAD were enrolled. All-cause mortality rates of 30 days (P < 0.001), 90 days (P < 0.001), and 365 days (P < 0.001) increased as NPAR tertiles increased. And after adjusting for possible confounding variables, NPAR was still independently associated with 30-day (third tertile group versus first tertile group: HR, 95% CI: 1.924, 1.471-2.516; P for trend < 0.001), 90-day (third tertile group versus first tertile group: HR, 95% CI: 2.053, 1.646-2.560; P for trend < 0.001), and 365-day (third tertile group versus first tertile group: HR, 95% CI: 2.063, 1.717-2.480; P for trend < 0.001) all-cause mortality in patients with CAD. Subgroup analysis did not find obvious interaction in most subgroups. Conclusion. NPAR was independently correlated with 30-day, 60-day, and 365-day all-cause mortality in critically ill patients with CAD. [ABSTRACT FROM AUTHOR]

We conducted a meta-analysis of 13 randomized trials comparing the efficacy of rosuvastatin versus atorvastatin in reducing concentrations of C-reactive protein (CRP). We searched PubMed, Ovid, and Elsevier databases until June 2014. Search terms included C-reactive protein or CRP, rosuvastatin, atorvastatin, randomized, randomly, and randomization; 13 trials (3798 patients) were included. Funnel plots for CRP were inspected to assess publication bias. The pooled analysis demonstrated the benefit of rosuvastatin over atorvastatin therapy for all 13 trials (mean difference [MD] = −0.11, which is standardized mean with no unit although the raw data before pooling is mg/L, 95% confidence interval −0.15 to −0.07, P < .0001) with no evidence of significant publication bias (I2 = 6.9%, P = .377). Subgroup analysis indicated a significant benefit of rosuvastatin over atorvastatin regarding the 1/1 dose ratio (MD = −0.14, 95% CI −0.21 to −0.06) and 1/2 dose ratio (MD= −0.11, 95% CI −0.16 to −0.05). Cumulative and influence analyses showed accuracy and stability for the estimation mentioned earlier. Our meta-analysis shows that rosuvastatin produces better reduction in CRP concentrations than atorvastatin at a dose ratio of 1/1 and 1/2 (rosuvastatin/atorvastatin), respectively. [ABSTRACT FROM AUTHOR]

Background: Combining low-dose statin and ezetimibe reduces the low-density lipoprotein cholesterol (LDL-C) similar to high-dose statin. However, whether there is a difference in the effect of these 2 lipid-lowering regimes on endothelial function is still controversial. Methods: We performed a systematic search of databases (MEDLINE [1950 to September 2011], EMBASE [1966 to September 2011]) and references of identified studies. Completely published randomized controlled trials comparing the effect of high-dose statin with low-dose stain plus ezetimibe on endothelial function (flow-mediated dilation [FMD] method) were included in this study. Results: Six trials with a total of 213 participants were included in the meta-analysis. The pooled weighted mean difference of FMD did not differ between the 2 lipid-lowering regimes (0.22%; 95% confidence interval [CI]: --0.85%-1.29%, P = .68). Furthermore, no significant reduction in LDL-C and C-reactive protein (CRP) occurred with high-dose statin versus low-dose statin plus ezetimibe (pooled weighted mean differences of LDL-C and CRP were -4.12 mg/dL, 95% CI: -9.54-1.12 mg/dL, P = .12, and -0.02 mg/L, 95% CI: -0.31-0.27 mg/L, P =.89, respectively). Conclusions: Based on the currently available evidence, combining a low-dose statin with ezetimibe may provide similar beneficial effects on endothelial function as high-dose statin. [ABSTRACT FROM PUBLISHER]