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INTRODUCTION AND OBJECTIVES: The DECADE cooperation is a pooled analysis of individual patient data from drug-eluting stent (DES) trials with a 10-year follow-up. This analysis reports the risk of definite stent thrombosis (ST) through to 10 years after percutaneous coronary intervention (PCI) in patients treated with early- and new-generation DES.METHODS: Individual patient data from 5 DES trials with a 10-year follow-up were pooled. The primary endpoint was definite ST up to 10 years after PCI. Patients were divided into 2 groups as per the generation of DES implanted (early and new DES). Individual participant data were analyzed using a 1-stage approach.RESULTS: We included 9700 patients, 6866 in the new DES group and 2834 in the early DES group. Through to 10 years, definite ST occurred in 69 of 6866 patients treated with new DES and in 91 of 2834 patients treated with early DES (1.0% vs 3.5%, adjusted hazard ratio, 0.32; 95%CI, 0.23-0.45). The rate of definite ST was lower in the new DES group than in the early DES group from 1 to 5 years (rate ratio, 0.14; 95%CI, 0.08-0.26) and from 5 to 10 years (rate ratio, 0.23; 95%CI, 0.08-0.61) after PCI.CONCLUSIONS: The incidence of definite ST through to 10 years after PCI with new-generation DES was 1%. New-generation DES are associated with a lower 10-year incidence of definite ST than early-generation DES, particularly beyond 1 year after PCI.

INTRODUCTION AND OBJECTIVES The DECADE cooperation is a pooled analysis of individual patient data from drug-eluting stent (DES) trials with a 10-year follow-up. This analysis reports the risk of definite stent thrombosis (ST) through to 10 years after percutaneous coronary intervention (PCI) in patients treated with early- and new-generation DES. METHODS Individual patient data from 5 DES trials with a 10-year follow-up were pooled. The primary endpoint was definite ST up to 10 years after PCI. Patients were divided into 2 groups as per the generation of DES implanted (early and new DES). Individual participant data were analyzed using a 1-stage approach. RESULTS We included 9700 patients, 6866 in the new DES group and 2834 in the early DES group. Through to 10 years, definite ST occurred in 69 of 6866 patients treated with new DES and in 91 of 2834 patients treated with early DES (1.0% vs 3.5%, adjusted hazard ratio, 0.32; 95%CI, 0.23-0.45). The rate of definite ST was lower in the new DES group than in the early DES group from 1 to 5 years (rate ratio, 0.14; 95%CI, 0.08-0.26) and from 5 to 10 years (rate ratio, 0.23; 95%CI, 0.08-0.61) after PCI. CONCLUSIONS The incidence of definite ST through to 10 years after PCI with new-generation DES was 1%. New-generation DES are associated with a lower 10-year incidence of definite ST than early-generation DES, particularly beyond 1 year after PCI.

Purpose: Anticholinergic (AC) drugs are associated with various determinantal outcomes. Data regarding the effect of AC drugs on mortality among geriatric hip fracture patients are limited and inconsistent.Methods: Using Danish health registries, we identified 31,443 patients aged ≥65 years undergoing hip fracture surgery. AC burden was assessed 90 days before surgery by the Anticholinergic Cognitive Burden (ACB) score and number of AC drugs. Logistic and Cox regression producing odds ratios (OR) and hazard ratios (HR) for 30- and 365- day mortality, adjusting for age, sex, and comorbidities were computed.Results: AC drugs were redeemed by 42% of patients. The 30-day mortality increased from 7% for patients with ACB score of 0 to 16% for patients with ACB score of ≥5, corresponding to an adjusted OR 2.5 (CI: 2.0-3.1). The equivalent adjusted HR for 365-mortality was 1.9 (CI: 1.6-2.1). Using count of AC drugs as exposure we found a stepwise increase in ORs and HRs with increased number of AC drugs; Compared to non-users, adjusted ORs for 30-days mortality were 1.6 (CI: 1.4-1.7), 1.9 (CI: 1.7-2.1), and 2.3 (CI: 1.9-2.7) for users of 1, 2 and 3+ AC drugs. HRs for 365-day mortality were 1.4 (CI: 1.3-1.5), 1.6 (CI: 1.5-1.7) and 1.8 (CI: 1.7-2.0).Conclusion: Use of AC drugs was associated with increased 30-day and 365-day mortality among older adults with hip fracture. Simply counting the number of AC drugs may be a clinically relevant and easy AC risk assessment tool. Continued effort to reduce AC drug-use is relevant. Purpose: Anticholinergic (AC) drugs are associated with various determinantal outcomes. Data regarding the effect of AC drugs on mortality among geriatric hip fracture patients are limited and inconsistent.Methods: Using Danish health registries, we identified 31,443 patients aged ≥65 years undergoing hip fracture surgery. AC burden was assessed 90 days before surgery by the Anticholinergic Cognitive Burden (ACB) score and number of AC drugs. Logistic and Cox regression producing odds ratios (OR) and hazard ratios (HR) for 30- and 365- day mortality, adjusting for age, sex, and comorbidities were computed.Results: AC drugs were redeemed by 42% of patients. The 30-day mortality increased from 7% for patients with ACB score of 0 to 16% for patients with ACB score of ≥5, corresponding to an adjusted OR 2.5 (CI: 2.0-3.1). The equivalent adjusted HR for 365-mortality was 1.9 (CI: 1.6-2.1). Using count of AC drugs as exposure we found a stepwise increase in ORs and HRs with increased number of AC drugs; Compared to non-users, adjusted ORs for 30-days mortality were 1.6 (CI: 1.4-1.7), 1.9 (CI: 1.7-2.1), and 2.3 (CI: 1.9-2.7) for users of 1, 2 and 3+ AC drugs. HRs for 365-day mortality were 1.4 (CI: 1.3-1.5), 1.6 (CI: 1.5-1.7) and 1.8 (CI: 1.7-2.0).Conclusion: Use of AC drugs was associated with increased 30-day and 365-day mortality among older adults with hip fracture. Simply counting the number of AC drugs may be a clinically relevant and easy AC risk assessment tool. Continued effort to reduce AC drug-use is relevant.

Context The long-term somatic and psychiatric consequences of Cushing’s syndrome are well-described, but the socioeconomic consequences are largely unknown. Objective We studied employment status, educational level, risk of depression, and other socioeconomic outcomes of Cushing’s syndrome in the years before diagnosis and after surgery. Design Nationwide register-based cohort study. Methods We used a validated algorithm to identify 424 patients operated for adrenal (n = 199) or pituitary Cushing’s syndrome (n = 225) in Denmark from January 1, 1986 to December 31, 2017. We obtained socioeconomic registry data from 10 years before diagnosis (year −10) to 10 years after surgery (year +10) and included a sex- and age-matched reference population. We identified prognostic factors for returning to work using modified Poisson regression. Results Compared to the reference population, the patients’ employment was permanently reduced from year −6 [relative risk (RR) 0.92, 95% CI 0.84-0.99] to year +10 (RR 0.66, 95% CI 0.57-0.76). Sick leave (RR 2.15, 95% CI 1.40-3.32) and disability pension (RR 2.60, 95% CI 2.06-3.27) were still elevated in year +10. Annual income, education, parenthood, relationship status, and risk of depression were also negatively impacted, but parenthood and relationship status normalized after surgery. Among patients, negative predictors of full-time employment after surgery included female sex, low education, comorbidity, and depression. Conclusion Cushing’s syndrome negatively affects a wide spectrum of socioeconomic variables many years before diagnosis of which only some normalize after treatment. The data underpin the importance of early diagnosis and continuous follow-up of Cushing’s syndrome and, not least, the pervasive health threats of glucocorticoid excess.

Jeppe Damgren Vesterager, Morten Madsen, Thomas Johannesson Hjelholt, Pia Kjær Kristensen, Alma Becic Pedersen Department of Clinical Epidemiology, Aarhus University Hospital and Department of Clinical Medicine, Aarhus University, Aarhus, DenmarkCorrespondence: Alma Becic Pedersen, Tel +45 87167212, Fax +45 87167215, Email abp@clin.au.dkObjective: Comorbidity has an important role in risk prediction and risk adjustment modelling in observational studies. However, it is unknown which comorbidity index is most accurate to predict mortality in hip fracture patients. We aimed to evaluate the prediction ability, including discrimination and calibration of Charlson comorbidity index (CCI), Elixhauser comorbidity index (ECI) and Rx-risk index for 30 day- and 1 year mortality in a population-based cohort of hip fracture surgery patients.Methods: Using the Danish Multidisciplinary Hip Fracture Registry in the period 2014– 2018, 31,443 patients were included. CCI and ECI were based on discharge diagnoses, while Rx-Risk index was based on pharmacy dispensings. We used logistic regression to assess discrimination of the different indices, individually and in combinations, by calculating c-statistics and the contrast in c-statistic to a base model including only age and gender with 95% confidence intervals (CI).Results: The study cohort were primarily female (69%) and older than 85 years (42%). The 30-day mortality was 10.1% and the 1-year mortality was 26.6%. Age and gender alone had a good discrimination ability for 30-day and 1-year mortality (c-statistic=0.70, CI: 0.69– 0.71 and c-statistic=0.68, CI: 0.67 − 0.69, respectively). By adding indices individually to the base model, Rx-risk index had the best 30-day and 1-year mortality discrimination ability (c-statistic=0.73, CI: 0.72– 0.74 and 0.71 CI: 0.71– 0.72, respectively). By adding combination of indices to the base model, a combination of CCI and the Rx-risk index had a 30-day and 1-year mortality discrimination ability of c-statistic=0.74, CI: 0.73– 0.75 and c-statistic=0.73, CI: 0.73– 0.74, respectively. Calibration of indices was similar.Conclusion: The highest discrimination ability was achieved by combining CCI and Rx-risk index in addition to age and gender. However, age and gender alone had a fair mortality discrimination ability.Keywords: Charlson comorbidity index, elixhauser index, Rx-risk index, multimorbidity, discrimination, calibration

This study aimed to examine the 30-day risk of myocardial infarction (MI) and death in patients who underwent noncardiac surgery within 1 year after coronary drug-eluting stent implantation for acute coronary syndrome (ACS) or stable angina pectoris (SAP) and to compare it with the risk in surgical patients without known coronary artery disease. Patients with drug-eluting stent implantation for ACS (n = 2,291) or SAP (n = 1,804) who underwent noncardiac surgery were compared with a cohort from the general population without known coronary artery disease matched on the surgical procedure, hospital contact type, gender, and age. In patients with ACS, the 30-day MI risk was markedly increased when surgery was performed within 1 month after stenting (10% vs 0.8%; adjusted odds ratio [ORadj] 20.1, 95% confidence interval [CI] 8.85 to 45.6), whereas mortality was comparable (10% vs 8%, ORadj 1.17, 95% CI 0.76 to 1.79). When surgery was performed between 1 and 12 months after stenting, the 30-day absolute risk for MI was low but higher than in the comparison cohort (0.6% vs 0.2%, ORadj 2.18, 95% CI 0.89 to 5.38), whereas the mortality risks were similar (2.0% vs 1.8%, ORadj 1.03, 95% CI 0.69 to 1.55). In patients with SAP, the 30-day MI risk was low but higher than in the comparison cohort (0.4% vs 0.2%, ORadj 1.90, 95% CI 0.70 to 5.14), whereas the mortality risks were similar (2.2% vs 2.1%, ORadj 0.91, 95% CI 0.61 to 1.37). In conclusion, patients with ACS and SAP who underwent surgery between 1 and 12 months after stent implantation had a risk for MI and death that was similar to the risk observed in surgical patients without coronary artery disease.

In recent years, the power conversion efficiency of perovskite solar cells has increased substantially, reaching today's values of above 25%. This has also placed an increased focus on device stability, which still limits commercial use. Electron transport layers (ETL) are critical for both factors in perovskite solar cells and have received much attention since the research focus boomed for this technology. In this chapter, requirements on ideal ETL are first provided, including electronic and photonic properties, energy band alignment, morphology, defect states, and chemical stability. Different metal oxide and organic electron transport materials used for perovskite solar cells are reviewed, focusing on optimizing ETL using various doping strategies to improve the cells' efficiency. Finally, the progress made on electron transport materials used in mesoscopic perovskite solar cells, as well as normal (n–i–p) and inverted (p–i–n) planar perovskite solar cells is briefly discussed, highlighting device architecture considerations. This chapter reviews the ETL used in perovskite solar cells, emphasizing the considerations needed when embedding such layers inside perovskite solar cells.

The introduction of nonfullerene acceptors (NFAs) has pushed the power conversion efficiency and organic photovoltaics (OPV) device stability to new standards. In this aspect, removal of trace impurities from one purification stage to the next is frequently stressed throughout the synthesis of photoactive OPV materials and NFAs to obtain the highest-purity material. However, detailed studies of the effect of purification on device performance are less reported. Herein, the role of NFA trace impurities on the optoelectronic characteristics and lifetime of resulting OPV devices is studied. The optimization of PBDB-T:ITIC-X devices, with various ITIC purity levels (X), has been thoroughly studied via a combination of photophysical, chemical, morphological, electrical, and optical characterization techniques, to shine light on the role of these impurities on device performance and lifetime. The findings suggest that, even in materials with larger concentrations of trace impurities, careful tuning can produce high efficiencies. Interestingly, the less-pure materials lead to longer device lifetimes along with an enhancement in accumulative power generation by a factor 3, compared to the purest ITIC-based devices. This demonstrates that selecting a material with the highest purity may not always be the best option for NFA OPV and that any positive effects of NFA purification must be carefully considered in light of both the device efficiency and stability.

Aims Using Scandinavian population-based registries, we assessed risk of stroke/systemic embolism (SE) and bleeding with non-vitamin K antagonist oral anticoagulants compared with warfarin in anticoagulation-naïve patients with atrial fibrillation (AF). Methods and results This historical cohort study included 219 545 AF patients [median age 74 years; 43% women; mean CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke or transient ischaemic attack, vascular disease, age 65–74 years, sex category) score 3.3] initiating apixaban, dabigatran, rivaroxaban, or warfarin in Denmark, Norway, and Sweden (1 January 2013 to 31 December 2016). The primary endpoints were stroke/SE and major bleeding. The median follow-up times were 9.7 (3.9–21.5) months for stroke/SE and 9.6 (3.8–21.3) months for bleeding. Apixaban and warfarin initiators were older and had higher CHA2DS2-VASc scores compared with dabigatran and rivaroxaban initiators. After 1:1 propensity score matching, three cohorts were created: apixaban–warfarin (n = 111 162), dabigatran–warfarin (n = 56 856), and rivaroxaban–warfarin (n = 61 198). Adjusted hazard ratios (HRs) were estimated using a Cox regression. For stroke/SE, adjusted HRs against warfarin were 0.96 [95% confidence interval (CI): 0.87–1.06] for apixaban, 0.89 (95% CI: 0.80–1.00) for dabigatran, and 1.03 (95% CI: 0.92–1.14) for rivaroxaban. For major bleeding, the HRs against warfarin were 0.73 (95% CI: 0.67–0.78) for apixaban, 0.89 (95% CI: 0.82–0.97) for dabigatran, and 1.15 (95% CI: 1.07–1.25) for rivaroxaban. The results in the dabigatran cohort did not hold in all dose-defined subgroups. Conclusion In this large Scandinavian study among AF patients initiating oral anticoagulation, those initiating dabigatran, apixaban, and rivaroxaban had similar rates of stroke/SE to patients initiating warfarin. Rates of major bleeding were lower with apixaban and dabigatran and higher with rivaroxaban, each compared with warfarin.

Organic photovoltaics (OPVs) technology now offers power conversion efficiency (PCE) of over 18% and is one of the main emerging photovoltaic technologies. In such devices, titanium dioxide (TiOx) has been vastly used as an electron extraction layer, typically showing unwanted charge-extraction barriers and the need for light-soaking. In the present work, using advanced photoemission spectroscopies, we investigate the electronic interplay at the interface between low-temperature-sputtered TiOx and C70 acceptor fullerene molecules. We show that defect states in the band gap of TiOx are quenched by C70 while an interfacial state appears. This new interfacial state is expected to support the favorable energy band alignment observed, showing a perfect match of transport levels, and thus barrier-free extraction of charges, making low-temperature-sputtered TiOx a good candidate for the next generation of organic solar cells.

We compared 10-year clinical outcomes in diabetes and nondiabetes patients treated with Endeavor zotarolimus-eluting (ZES) or Cypher sirolimus-eluting coronary stents (SES). A total of 1,162 patients were randomized to ZES (169 with diabetes) and 1,170 patients were randomized to SES (168 with diabetes). Patients were further stratified by diabetes status at the time of inclusion. A subgroup of patients with diabetes (n = 88) underwent angiographic re-evaluation 10 months after stent implantation. End points included a combined end point of death or myocardial infarction, and the individual end points of death, myocardial infarction, and revascularization. In patients with diabetes, we found no difference in the combined end point (odds ratio [OR] 0.81, 95% confidence interval [CI] 0.53 to 1.24), death (OR 0.80, 95% CI 0.51 to 1.25), or in MI (OR 1.07, 95% CI 0.60 to 1.91). However, diabetics with ZES more frequently underwent coronary revascularization compared with SES patients (OR 1.93, 95% CI 1.05 to 3.66). In patients without diabetes, ZES and SES had similar 10-year rates of all end points (death: OR 1.13, 95% CI 0.93 to 1.39; MI: OR 0.80, 95% CI 0.61 to 1.05; revascularization: OR 0.81, 95% CI 0.61 to 1.09). Landmark analysis from 5 to 10 years showed no difference in outcomes between SES and ZES in either subgroup. In conclusion, at 10 years, SES and ZES performed similarly in patients with and without diabetes. Although coronary revascularization was more prevalent in diabetes patients with ZES, this may, in part, have been related to the angiographic follow-up that was offered to a subgroup of diabetes patients.

The performance of organic solar cells has improved significantly in recent years due to the use of non-fullerene acceptors (NFA). While processing additives are typically added to the active layer blends to enhance device performance in NFA organic solar cells, their impact on device degradation remains unclear. In this work we have compared the performance, in pristine and degraded state, between air-processed slot-die coated NFA ITO-free organic solar cells with and without the processing additive DIO, using a structure of PET/Ag/ZnO/PBDB-T:ITIC/FHC PEDOT:PSS. We observed an improvement in the power conversion efficiency of the devices when adding DIO, from 4.03% up to 4.97%. The evolution of the performance for both devices under ISOS-L1 life testing protocol reveals that the drop in efficiency is mainly due to a decay of JSC for both cells. In the short time scale the efficiency of non-DIO cells decays faster than the DIO cells, whereas in the long time scale the efficiency of non-DIO cells tends to stabilize sooner. Carrier mobilities estimated from impedance measurements decrease with time at similar rate for both degraded samples. Besides, DIO devices present a steep increase of the series resistance with time causing a decrease of the FF and thus of the efficiency. Moreover, in both degraded devices, the open-circuit voltage saturates with increasing illumination intensity. Numerical simulations reveal that a reduced anode work function of 5 eV is needed to fit experimental data.

Thin-film organic and perovskite solar cells have attracted the interest of research and industry. The main reason behind this is the low price, high tunability, and great potential of these technologies. Lightweight, color tunability, translucence, flexibility, and ease and low cost of processing are a few of the excellent characteristics of these technologies. However, they have a high sensitivity to light, oxygen, temperature, and humidity, which are common environmental conditions. Upon exposure to these environmental stresses, the chemical structure and morphological arrangement undergo complex changes that result in dramatic reduction of device functionalities over time. This chapter collects the approaches currently reported in the field of additive-assisted stabilization, a method in which solar cells’ active layers are blended with additives that promote their stability (e.g., hydrogen donors, radical scavengers, hydroperoxide decomposers, quenchers, UV absorbers).

The energy carried by sunlight has an enormous potential to provide humanity with all the energy it needs while limiting the catastrophic consequences of climate change caused to a large extent by current combustion of fossil fuels. A convenient way to harvest solar energy is by making use of the photovoltaic effect of certain semiconducting materials. When a solar photon interacts with such a material, its energy can be converted into electronic energy, which can be extracted to an external electrical circuit, providing both a photovoltage and a photocurrent. The material absorbing the sunlight imposes certain boundary conditions on its electrons which allow electronic states to have only specific distinct energies. Importantly, there will always be a certain minimum energy needed to promote a “resting” electron in a material to a higher electronic state. Therefore, all materials used for the absorption of sunlight will have a requirement on the minimal energy that must be carried by a photon in order for that photon to be absorbed by the material. Photons with energies lower than this absorption threshold will be transmitted by the material. In a solar cell, this portion of solar energy will be lost. This loss of solar photons, known as a transmission loss, restricts the photocurrent achievable from sunlight (see Fig. 1.1a). In a hypothetical solar cell with an optimal absorption threshold (also known as band gap) of 1.3 eV, the fraction of incident solar energy lost by transmission is ∼25%. Open image in new window Fig. 1.1 (a) The two main loss mechanisms responsible for the internal power conversion efficiency limit of single threshold solar cells. (b) General depiction of strategies to overcome thermalization and transmission losses, respectively

The power conversion efficiency of thin film solar cells based on organic and perovskite materials has improved dramatically in recent years, currently reaching above 18% for organic photovoltaics and above 25% for perovskite solar cells. Combined with their appealing properties, such as mechanical flexibility, light weight, semi-transparency, and low-cost large-scale roll-to-roll (R2R) processing compatibility, the high conversion efficiencies have placed organic and perovskite solar cells at the center of attention in terms of promising PV technologies. In this context, 2D materials are, due to their unique properties such as high charge carrier mobility, high optical transparency and especially tunable electronic structure, ideal contact layer materials in thin film solar cell devices. They can be applied as electrodes, hole (HTL) and electron (ETL) transport layers, and additives in active layers. This review paper focuses on the integration of 2D graphene and its derivatives, and 2D materials beyond graphene, i.e. transitional metal dichalcogenides (TMD), MXene, black phosphorous (BP) and boron nitrides in organic and perovskite solar cells, and discusses the positive influence these material systems have shown on both the fundamental photophysical processes, as well as on device stability and lifetime. Furthermore, this review addresses the future potential of 2D materials for the development of lightweight, eco-friendly, high performance and cost-effective flexible solar cells, provided by the high mechanical flexibility, high environmental stability, low electrical resistivity, and low environmental impact of these 2D material systems.

ObjectivesTo characterise and quantify possible patient-related disparities in hip fracture care including temporal changes.DesignPopulation-based cohort study.SettingAll Danish hospitals treating patients with hip fracture.Participants60 275 hip fracture patients from 2007 to 2016.InterventionsQuality of care was defined as fulfilment of eligible care process measures for the individual patient recommended by an expert panel. Using yearly logistic regression models, we predicted the individual patient’s probability for receiving high-quality care, resulting in a distribution of adjusted probabilities based on age, sex, comorbidity, fracture type, education, family mean income, migration status, cohabitation status, employment status, nursing home residence and type of municipality. Based on the distribution, we identified best-off patients (ie, the 10% of patients with the highest probability) and worst-off patients (ie, the 10% of patients with the lowest probability). We evaluated disparities in quality of care by measuring the distance in fulfilment of outcomes between the best-off and worst-off patients.Primary and secondary outcome measuresThe primary outcome was fulfilment of all-or-none, defined as receiving all relevant process measures. Secondary outcomes were fulfilment of the individual process measures including preoperative optimisation, early surgery, early mobilisation, assessment of pain, basic mobility, nutritional risk and need for antiosteoporotic medication, fall prevention and a postdischarge rehabilitation programme.ResultsThe proportion of patients receiving high-quality care varied over time for both best-off and worst-off patients. The absolute difference in percentage points between the best-off and worst-off patients for receiving all-or-none of the eligible process measures was 12 (95% CI 6 to 18) in 2007 and 23 (95% CI 19 to 28) in 2016. Disparities were consistent for a range of care processes, including assessment of pain, mobilisation within 24 hours, assessment of need for antiosteoporotic medication and nutritional risk assessment.ConclusionsDisparity of care between best-off and worst-off patients remained substantial over time.

In this study, we observe near-infrared-to-visible photon upconversion via sensitized triplet-triplet annihilation in a solid-state film based on neat palladium(II) 1,4,8,11,15,18,22,25-octa-n-butoxyphthalocyanine [PdPc(OBu)8] and 5,6,11,12-tetraphenylnapthacene (rubrene). By continuous excitation at 730 nm, the system reaches a maximum upconversion quantum yield of 3.6 × 10-2% at power densities below 0.2 W cm-2. Although the observed upconversion quantum yield is most likely negatively affected by efficient singlet exciton fission in the films, a quantum yield of upconverted states of 1.3% confirms the potential for this system if the upconverted state is harvested via electron or energy transfer. By doping the films with a dibenzotetraphenylperiflanthene emitter, the energy transfer strategy shows to effectively raise the upconversion quantum yield by three times, which is promising for the use of this solid-state upconverter for power conversion efficiency enhancement of emerging high-energy band gap solar cells.

Aims: In 2010, the European Society of Cardiology Guidelines on atrial fibrillation (AF) introduced the CHA2DS2-VASc score to guide initiation of oral anticoagulation. In patients with AF undergoing percutaneous coronary intervention (PCI), triple therapy with oral anticoagulation and dual antiplatelet therapy was recommended to reduce ischaemic risk. We examined how the CHA2DS2-VASc score impacted oral anticoagulation use and risks of ischaemic and hospitalized bleeding events in patients with AF undergoing PCI. Methods: We included 6,014 patients with AF undergoing first-time PCI in Western Denmark between 2003 and 2017. We divided patients into four groups based on year of PCI and estimated 1-year risks of major adverse cardiac events (MACE) and hospitalization for bleeding. Results: The proportion of oral anticoagulation users was 48% in 2003–2006 and 49% in 2006–2010. Following the CHA2DS2-VASc score implementation, the proportion increased to 59% in 2011–2014 and 77% in 2015–2017. Using 2003–2006 as reference, risks of MACE were similar in 2007–2010 (adjusted relative risk [RRadj] 0.99, 95% confidence interval [CI] 0.83–1.18) and 2011–2014 (RRadj 0.92, 95% CI 0.78–1.09), but declined by 23% in 2015–2017 (RRadj 0.77, 95% CI 0.65–0.92). Hospitalizations for bleeding did not increase despite wider use of triple therapy. Conclusion: Implementation of the CHA2DS2-VASc score in the 2010 European guidelines on AF was associated with an increased utilization of oral anticoagulation and triple therapy among AF patients undergoing PCI. These changes were associated with a gradual decline in the risk of MACE, while the risk of hospitalized bleeding remained unchanged.

In 2010, the European Society of Cardiology Guidelines on atrial fibrillation (AF) introduced the CHAWe included 6,014 patients with AF undergoing first-time PCI in Western Denmark between 2003 and 2017. We divided patients into four groups based on year of PCI and estimated 1-year risks of major adverse cardiac events (MACE) and hospitalization for bleeding.The proportion of oral anticoagulation users was 48% in 2003-2006 and 49% in 2006-2010. Following the CHAImplementation of the CHA

Light-trapping nanostructures have for decades been researched as a route to enhance the performance of organic solar cells (OSCs). Whereas the power conversion efficiencies (PCEs) of OSCs have reached above 18 %, industrially compatible devices made by scalable processing in air, using only nontoxic solvents and materials, have shown significantly lower performance values. Although light-trapping nanostructures may improve this, the methods for integrating the nanostructures are typically not compatible with industrial scale up. In this work, scalable, industrially compatible, nonfullerene-based OSCs are developed with integrated light-trapping nanostructures at the back electrodes in the devices. The OSCs are made by using scalable roll-to-roll (R2R) and sheet-to-sheet (S2S) processes and the nanostructures are made by using roll-to-plate (R2P) nanoimprint lithography. A fully scalable solution is thereby developed for industrially compatible nanostructured OSCs. The nanostructured devices show enhancements in PCE up to 25 % compared to reference cells, owing to an enhancement in the short-circuit current density (15 %) by enhanced absorption, and improved charge carrier extraction leading to an enhancement in the fill factor (7 %). Optical modeling is utilized to verify the optical effect of the nanostructures. The best devices attain a PCE of 6.5 %, which is the highest reported efficiency for air-processed slot-die coated ITO-free flexible PBDB-T : ITIC devices, here using nontoxic solvents.

Photochemical and mechanical stability are critical in the production and application of organic solar cells. While these factors can individually be improved using different additives, there is no example of studies on the combined effects of such additive-assisted stabilization. In this study, the properties of PTB7:[70]PCBM organic solar cells are studied upon implementation of two additives: the carotenoid astaxanthin (AX) for photochemical stability and the silicone polydimethylsiloxane (PDMS) for improved mechanical properties. A newly designed additive, AXcPDMS, based on astaxanthin covalently bonded to PDMS was also examined. Lifetime tests, produced in ISOS-L-2 conditions, reveal an improvement in the accumulated power generation (APG) of 10% with pure AX, of 90% when AX is paired with PDMS, and of 140% when AXcPDMS is added in the active layer blend, as compared to the control devices. Singlet oxygen phosphorescence measurements are utilized to study the ability of AX and AXcPDMS to quench singlet oxygen and its precursors in the films. The data are consistent with the strong stabilization effect of the carotenoids. While AX and AXcPDMS are both efficient photochemical stabilizers, the improvement in device stability observed in the presence of AXcPDMS is likely due to a more favorable localization of the stabilizer within the blend. The mechanical properties of the active layers were investigated by tensile testing and cohesive fracture measurements, showing a joint improvement of the photooxidative stability and the mechanical properties, thus yielding organic solar cell devices that are promising for flexible photovoltaic applications.

Objective: We examined the risk of myocardial infarction associated with glucose-lowering therapy among diabetes patients with and without obstructive coronary artery disease. Methods: A cohort of patients with type 1 or type 2 diabetes (n = 12,030), who underwent coronary angiography from 2004 to 2012, were stratified by presence of obstructive (any stenosis ⩾50%) coronary artery disease and by type of diabetes treatment: diet, non-insulin treatment and insulin (±oral anti-diabetics). The primary endpoint was myocardial infarction. Adjusted hazard ratios were calculated using diet-treated patients without coronary artery disease as reference. Results: In patients without coronary artery disease, risk of myocardial infarction was similar in patients treated with non-insulin medication (adjusted hazard ratio 0.70, 95% confidence interval 0.27–1.81) and insulin (adjusted hazard ratio 0.76, 95% confidence interval 0.27–2.08) as compared to diet only. In patients with coronary artery disease, the risk of myocardial infarction was higher than in the reference group and an incremental risk was observed being lowest in patients treated with diet (adjusted hazard ratio 3.79, 95% confidence interval 1.61–8.88), followed by non-insulin medication (adjusted hazard ratio 5.42, 95% confidence interval 2.40–12.22), and highest in insulin-treated patients (adjusted hazard ratio 7.91, 95% confidence interval 3.51–17.82). Conclusion: The presence of obstructive coronary artery disease defines the risk of myocardial infarction in diabetes patients. Glucose-lowering therapy, in particular insulin, was associated with risk of myocardial infarction only in the presence of coronary artery disease.

Degradation of perovskite solar cells (PSCs) is often found to be partially or fully reversible when the cells are allowed to recover in the dark. Unlike the dynamics of degradation, knowledge about the dynamics of PSC cell recovery is very limited. Here, we demonstrate that the PSC recovery strongly depends on the electrical bias conditions during the light-induced degradation and that it can be manipulated by applying an external electrical bias during the recovery phase. Investigation of the recovery dynamics allows us to analyze the degradation mechanisms in detail. More specifically, we aged a mixed-cation mixed-halide PSC with a n-i-p structure under illumination in open-circuit (OC) or short-circuit (SC) conditions, and periodically measured their characteristics during the recovery. PSCs aged in SC degrade faster and fully recover after the light is switched off, while the performance of the cells aged in OC does not recover but instead further decreases after the light is switched off (“drop-in-dark” effect). With the use of transient photoluminescence, secondary ion mass spectrometry, and drift-diffusion-based simulations, we hypothesize that extrinsic ion migration causes the drop-in-dark effect, by forming an electron extraction barrier at the metal oxide electron transport layer. The applied bias alleviates this effect. Our results are relevant for gaining a deeper understanding of the multiple degradation mechanisms present in perovskite solar cells, and for finding a practical way to assist their recovery.

Organic photovoltaics (OPVs) technology now offers power conversion efficiency (PCE) of over 18% and is one of the main emerging photovoltaic technologies. In such devices, titanium dioxide (TiO