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Background: The cardiac resynchronization therapy (CRT) non‐response rate can reach 30% in heart failure (HF) patients with left bundle branch block (LBBB). This study aimed to evaluate the value of baseline q waves in leads I, V5, or V6 in predicting response to CRT in patients with HF and LBBB. Methods: Patients with HF (left ventricular ejection fraction ≤35%) and LBBB receiving CRT implantation were retrospectively enrolled. Baseline characteristics and electrocardiogram parameters, including lateral and left precordial q waves were evaluated. Non‐response to CRT was defined as the improvement of left ventricular ejection fraction (LVEF) < 5% at a 6‐month follow‐up. Results: A total of 132 patients (mean age 63.0 ± 10.4 years, 94 [71.2%] male) were included. Among them, 32 patients with q waves in leads I, V5, or V6 were classified into the qLBBB (+) group, and the rest without q waves in these leads were defined as the qLBBB (‐) group. The CRT non‐response rate in the qLBBB (+) group was markedly higher than that in the qLBBB (‐) group (68.8% vs. 33.3%, p <.001). Multivariable logistic regression analysis revealed that the presence of baseline q waves in leads I, V5, or V6 remained significantly associated with a higher rate of CRT non‐response in patients with HF and LBBB (odds ratio: 4.8, 95% confidence interval: 1.5–15.0, p =.007). Conclusion: Any q wave in leads I, V5, or V6 was an independent predictive factor for CRT non‐response in patients with HF and LBBB. [ABSTRACT FROM AUTHOR]

Objective: No study has systematically investigated the quality of long-term care delivered to the rural older people with chronic diseases, such as atrial fibrillation (AF) in China. This study aims to provide contemporary data on the prevalence and awareness of AF among the older population in rural China and to evaluate healthcare knowledge and delivery by village doctors., Design: A cross-sectional study., Setting: Rural villages in Daqiao and Xiaoji towns of Jiangsu Province, China., Participants: Rural population aged ≥65 years., Outcome Measures: AF was identified using 12-lead electrocardiography in the first-step (government-led health examination) and single-lead electrocardiography in the second-step (in-house AF screening). Questionnaire surveys were designed for the AF patients and their village doctors., Results: Among 31,342 permanent residents, 12,630 (40.3 %) declined, 7,956 (25.3 %) participated in the first-step and 10,756 (34.3 %) in the second-step. The overall AF detection rate was 4.3 % (810/18,712). Of the 810 AF patients (mean age 76.1±5.9 years; 51.4 % female), 51.5 % were illiterate, only 2.6 % could use smartphone applications, and 8.1 % lived with their children. Common risk factors were older age, men, hypertension, diabetes, prior stroke, vascular disease, and congestive heart failure. Among the 402 patients with known AF, 367 were at high risk of stroke and 10.9 % (40/367) were anticoagulated. Only 17.6 % patients with known hypertension had blood pressure level <140/90 mmHg, and 6.0 % with known diabetes had a fasting blood glucose level ≤6.1 mmol/L. Only 7.3 % (9/122) village doctors reported having the knowledge of integrated care AF management., Conclusions: This study identified AF in 4.3 %, but AF management was suboptimal in rural China. The current village doctor-dominant rural healthcare system is far from delivering standardized AF management for older patients in rural China. There is an urgent need to empower the village doctors in optimising the care of AF patients., Competing Interests: Declaration of competing interest MLC reported receiving lecture fee from Boehringer Ingelheim. All other authors declare no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The main challenge for immune checkpoint blockade (ICB) therapy lies in immunosuppressive tumor microenvironment (TME). Repolarizing M2-like tumor-associated macrophages (TAMs) into inflammatory M1 phenotype is a promising strategy for cancer immunotherapy. Here, this study shows that the tumor suppressive protein SHISA3 regulates the antitumor functions of TAMs. Local delivery of mRNA encoding Shisa3 enables cancer immunotherapy by reprogramming TAMs toward an antitumoral phenotype, thus enhancing the efficacy of programmed cell death 1 (PD-1) antibody. Enforced expression of Shisa3 in TAMs increases their phagocytosis and antigen presentation abilities and promotes CD8 + T cell-mediated antitumor immunity. The expression of SHISA3 is induced by damage/pathogen-associated molecular patterns (DAMPs/PAMPs) in macrophages via nuclear factor-κB (NF-κB) transcription factors. Reciprocally, SHISA3 forms a complex with heat shock protein family A member 8 (HSPA8) to activate NF-κB signaling thus maintaining M1 polarization of macrophages. Knockout Shisa3 largely abolishes the antitumor efficacy of combination immunotherapy with Toll-like receptor 4 (TLR4) agonist monophosphoryl lipid A (MPLA) and PD-1 antibody. It further found that higher expression of SHISA3 in antitumoral TAMs is associated with better overall survival in lung cancer patients. Taken together, the findings describe the role of SHISA3 in reprogramming TAMs that ameliorate cancer immunotherapy., (© 2024 The Author(s). Advanced Science published by Wiley‐VCH GmbH.)

Aqueous zinc metal batteries are a viable candidate for next-generation energy storage systems, but suffer from poor cycling efficiency of the Zn anode. Emerging approaches aim to regulate zinc plating behavior to suppress uncontrolled dendrites, while the stripping process is seldom considered. Herein, an oriented metal stripping strategy is demonstrated to stabilize the Zn anode by removing high-index facets for exposing the (002) plane through the addition of anionic additive sodium citrate (SC). Consequently, high-index facets that coordinate strongly with SC are preferentially stripped out due to a reduced stripping barrier, rendering stable (002) facet preponderant in epitaxial plating. After repeat stripping/plating, the ultra-high proportion of 93% for (002) and large-size grains of ≈100 µm (six times larger than before) can be obtained. Zn anode shows continuous 25 000 cycles with low overpotential at 100 mA cm -2 in symmetric cells and more than 70 h of stable operation even at an ultra-high depth of discharge of 92.3%. Moreover, an extremely long lifespan of 12 000 cycles at 10 A g -1 with a high capacity retention of 89% is achieved by the assembled Zn//I 2 battery. This work provides a distinctive approach to improving the stripping process to design highly efficient zinc anodes for promising aqueous zinc metal batteries., (© 2024 Wiley‐VCH GmbH.)