Prolonged dual antiplatelet therapy in patients with non-ST-segment elevation myocardial infarction: 2-year findings from EPICOR Asia.

BACKGROUND: Patients with non-ST-segment elevation myocardial infarction (NSTEMI) have a generally poor prognosis and antithrombotic management patterns (AMPs) used post-acute coronary syndrome (ACS) remain unclear. Duration of dual antiplatelet therapy (DAPT) and patient characteristics was evaluated in NSTEMI patients enrolled in EPICOR Asia. HYPOTHESIS: Patients stopping DAPT early may benefit from more intensive monitoring. METHODS: EPICOR Asia was a prospective, real-world, primary data collection, cohort study in adults with an ACS, conducted in eight countries/regions in Asia, with 2 year follow-up. Eligible patients were hospitalized within 48 hours of symptom onset and survived to discharge. We describe AMPs and baseline characteristics in NSTEMI patients surviving ≥12 months with DAPT duration ≤12 and > 12 months post-discharge. Clinical outcomes (composite of death, myocardial infarction, and stroke; and bleeding) were also explored. RESULTS: At discharge, 90.8% of patients were on DAPT (including clopidogrel, 99%). At 1- and 2-year follow-up, this was 79.2% and 60.0%. Patients who stopped DAPT ≤12 months post-discharge tended to be older, female, less obese, have prior cardiovascular disease, and have renal dysfunction. While causality cannot be inferred, the incidence of the composite endpoint over the subsequent 12 months was 10.6% and 3.1% with shorter vs longer use of DAPT, and mortality risk over the same period was 8.4% and 1.6%. CONCLUSIONS: Over 90% of NSTEMI patients were discharged on DAPT, with 60% on DAPT at 2 years. Patients stopping DAPT early were more likely to have higher baseline risk and may therefore benefit from more intensive monitoring during long-term follow-up

Intervention-induced enhancement in intrinsic brain activity in healthy older adults

This study examined the effects of a multimodal intervention on spontaneous brain activity in healthy older adults. Seventeen older adults received a six-week intervention that consisted of cognitive training, Tai Chi exercise, and group counseling, while 17 older adults in a control group attended health knowledge lectures. The intervention group demonstrated enhanced memory and social support compared to the control group. The amplitude of low frequency fluctuations (ALFF) in the middle frontal gyrus, superior frontal gyrus, and anterior cerebellum lobe was enhanced for the intervention group, while the control group showed reduced ALFF in these three regions. Moreover, changes in trail-making performance and well-being could be predicted by the intervention-induced changes in ALFF. Additionally, individual differences in the baseline ALFF were correlated with intervention-related changes in behavioral performance. These findings suggest that a multimodal intervention is effective in improving cognitive functions and well-being and can induce functional changes in the aging brain. The study extended previous training studies by suggesting resting-state ALFF as a marker of intervention-induced plasticity in older adults

A Variable Ionized Disk Wind in the Black Hole Candidate EXO 1846–031

After 34 yr, the black hole candidate EXO 1846–031 went into outburst again in 2019. We investigate its spectral properties in the hard intermediate and the soft states with NuSTAR and Insight-HXMT. A reflection component has been detected in the two spectral states but possibly originating from different illumination spectra: in the intermediate state, the illuminating source is attributed to a hard coronal component, which has been commonly observed in other X-ray binaries, whereas in the soft state, the reflection is probably produced by disk self-irradiation. Both cases support EXO 1846–031 as a low-inclination system of ~40°. An absorption line is clearly detected at ~7.2 keV in the hard intermediate state, corresponding to a highly ionized disk wind (log} ξ > 6.1) with a velocity of up to 0.06c. Meanwhile, quasi-simultaneous radio emissions have been detected before and after the X-rays, implying the coexistence of disk winds and jets in this system. If only the high-flux segment of the NuSTAR observation is considered, the observed wind appears to be magnetically driven. The absorption line disappeared in the soft state and a narrow emission line appeared at ~6.7 keV on top of the reflection component, which may be evidence for disk winds, but data with higher spectral resolution are required to examine this

Detection of the Diffuse Supernova Neutrino Background with JUNO

As an underground multi-purpose neutrino detector with 20 kton liquid scintillator, Jiangmen Underground Neutrino Observatory (JUNO) is competitive with and complementary to the water-Cherenkov detectors on the search for the diffuse supernova neutrino background (DSNB). Typical supernova models predict 2-4 events per year within the optimal observation window in the JUNO detector. The dominant background is from the neutral-current (NC) interaction of atmospheric neutrinos with 12C nuclei, which surpasses the DSNB by more than one order of magnitude. We evaluated the systematic uncertainty of NC background from the spread of a variety of data-driven models and further developed a method to determine NC background within 15\% with {\it{in}} {\it{situ}} measurements after ten years of running. Besides, the NC-like backgrounds can be effectively suppressed by the intrinsic pulse-shape discrimination (PSD) capabilities of liquid scintillators. In this talk, I will present in detail the improvements on NC background uncertainty evaluation, PSD discriminator development, and finally, the potential of DSNB sensitivity in JUNO

The Relative Body Weight Gain From Early to Middle Life Adulthood Associated With Later Life Risk of Diabetes: A Nationwide Cohort Study

AimTo determine the effect of decade-based body weight gain from 20 to 50 years of age on later life diabetes risk.Methods35,611 non-diabetic participants aged ≥ 50 years from a well-defined nationwide cohort were followed up for average of 3.6 years, with cardiovascular diseases and cancers at baseline were excluded. Body weight at 20, 30, 40, and 50 years was reported. The overall 30 years and each 10-year weight gain were calculated from the early and middle life. Cox regression models were used to estimate risks of incident diabetes.ResultsAfter 127,745.26 person-years of follow-up, 2,789 incident diabetes were identified (incidence rate, 2.18%) in 25,289 women (mean weight gain 20-50 years, 7.60 kg) and 10,322 men (7.93 kg). Each 10-kg weight gain over the 30 years was significantly associated with a 39.7% increased risk of incident diabetes (95% confidence interval [CI], 1.33-1.47); weight gain from 20-30 years showed a more prominent effect on the risk of developing diabetes before 60 years than that of after 60 years (Hazard ratio, HR = 1.084, 95% CI [1.049-1.121], P <0.0001 vs. 1.015 [0.975-1.056], P = 0.4643; PInteraction=0.0293). It showed a stable effect of the three 10-year intervals weight gain on risk of diabetes after 60 years (HR=1.055, 1.038, 1.043, respectively, all P < 0.0036).ConclusionsThe early life weight gain showed a more prominent effect on developing diabetes before 60 years than after 60 years; however, each-decade weight gain from 20 to 50 years showed a similar effect on risk developing diabetes after 60 years

Experimental and Numerical Kinetic Study of OME1 and OME2 Combustion in Low-Pressure Laminar Flame

The combustion chemistry of OME1 and OME2 was studied in stoichiometric laminar flames at low pressure, 50 mbar, by carrying out flame structure measurements with molecular-beam mass spectrometry (MBMS). The kinetic modeling has been performed under the same conditions and the simulated results were compared with experimental results. A new detailed kinetic sub-mechanism for OME2 will be developed and added to the previous UCL mechanism

Experimental kinetics study in low-pressure laminar flamers of OME1 and OME2

The emergency of reducing the emission of greenhouse gases and achieving a circular carbon economy has encouraged research on renewable energy systems. For long-distance transportation and long-term storage, electricity can be converted into liquid and gaseous fuels (called e-fuels) benefiting from their high energy density. Oxymethylene ethers (OMEs) are regarded as one of the valuable candidates for e-fuels and potential asset to the current energy transition. A detailed knowledge of the chemical kinetics of OMEs is necessary to optimize their combustion properties. Moreover, few detailed studies have been conducted on longer chain species (OMEn, n>1) [1-3]. The purpose of this work is to refine the kinetics of OME1 and to study the combustion chemistry of OME2 in laminar low-pressure flames, under stoichiometric conditions, by carrying out experimental studies with molecular-beam mass spectrometry (MBMS) and kinetic modeling studies. A new detailed kinetic mechanism including OME1 and OME2 will be established and validated against these experimental flame structures

Experimental and numerical kinetics study of OME1 and OME2 combustion in stoichiometric low-pressure laminar flame

The combustion chemistry of OME1 and OME2 was studied in stoichiometric laminar flames at low pressure, 50 mbar, by carrying out flame structure measurements with molecular-beam mass spectrometry (MBMS). The kinetic modeling has been performed under the same conditions, and the simulated results were compared with experimental results. A new detailed kinetic sub-mechanism for OME2 will be developed and added to the previous UCL mechanism

Mitochondrial Genomes of the Genus Claassenia (Plecoptera: Perlidae) and Phylogenetic Assignment to Subfamily Perlinae

Mitochondrial genomes of three stoneflies, e.g., Claassenia magna Wu, 1948, Claassenia sp. 2 and Claassenia xucheni Chen, 2019 were sequenced in this study with 15,774, 15,777 and 15,746 bp in length, respectively. Each mitogenome contained 37 genes including 22 tRNAs, two ribosomal RNAs, 13 protein-coding genes (PCGs), and a noncoding control region (CR). In general, standard ATN start and TAN termination codons were evident in the PCGs. Although the dihydrouridine arm was absent in trnSer, the remaining 21 tRNAs displayed the characteristic cloverleaf secondary structure. Stem-loop structures were identified in the CRs of all three mitogenomes, but tandem repeats were only apparent in Claassenia xucheni. The mitogenomes of three Claassenia species were analyzed and compared with mitogenomes in 21 other stoneflies from the Perlidae and three Euholognatha species (Rhopalopsole bulbifera, Capnia zijinshana and Amphinemura longispina) as outgroups. Phylogenetic analyses using maximum likelihood and Bayesian inference. Phylogenetic analysis supported that Claassenia was recovered as the sister group of other Perlinae and Claassenia+Perlinae emerged from the paraphyletic Acroneuriinae. The final results supported that Claassenia was classified into subfamily Perlinae and proposed Claassenia represent a transitional group of the subfamilies Acroneuriinae and Perlinae. This study provided new molecular evidence for exploring the debatable taxonomic position of the genus Claassenia in Perlidae