Abstract Background Optical coherence tomography (OCT) guided percutaneous coronary intervention (PCI) has been demonstrated to improve short and long-term outcomes compared with standard angiography-guided PCI. However, little is known about the impact of cholesterol crystals on the prognosis of patients with acute coronary syndrome (ACS) in the setting of receiving OCT-guided PCI. Purpose This study aims to investigate the association between cholesterol crystals and 6-month outcomes in ACS patients who underwent OCT-guided PCI. Methods Patients with ACS who underwent OCT-guided PCI in a high-volume PCI center between July 2020 and June 2022 were retrospectively enrolled and were further divided into two groups according to the presence or absence of cholesterol crystals. OCT imaging characteristics including plaque morphology before the PCI procedure in target lesions were assessed. The primary outcome was a composite of all-cause death, ischemia-driven revascularization, or readmission for heart failure in a 6-month follow-up period. The association between cholesterol crystals and 6-month outcomes was evaluated using Kaplan-Meier curves. Independent predictors for cholesterol crystals and 6-month outcomes were evaluated by the logistic regression and Cox proportional hazards regression analyses, respectively. Results 403 patients were enrolled in this study. The mean age was 61 years old and 79.4% were men. Cholesterol crystals were presented in 224 (55.6%) target lesions in patients with ACS. Baseline characteristics were not statistically different between the two groups in age, sex, smoke, previous hyperlipidemia, and other clinical features, except for diabetes, multivessel disease, and ACS classification (p <0.05). In the multivariable logistic regression analysis, cholesterol crystals were associated with diabetes, plaque rupture, lipid length, calcification, macrophage infiltration, and thin-capped fibroatheroma (all p <0.05). Patients with cholesterol crystals had higher risks of poor 6-month composite outcomes when compared to those without cholesterol crystals (13.4% vs. 6.7%, HR 2.09, 95%CI 1.07-4.09, p = 0.031), even after confounders adjustment for age, sex, diabetes, multivessel disease and ACS classification using inverse probability of treatment weighting (p = 0.027). Subgroup analysis showed significant interactions between cholesterol crystals and 6-month outcomes with respect to the male (HR 2.82, 95%CI 1.22-6.51, p = 0.015), target lesions in LAD (HR 4.47, 95%CI 1.29-15.44, p = 0.018), and incomplete revascularization (HR 3.08, 95%CI 1.04-8.98, p = 0.042). The Cox regression analysis identified cholesterol crystal as an independent predictor for 6-month composite outcomes (HR 2.12, 95%CI 1.08-4.19, p = 0.030). Conclusions The presence of cholesterol crystals was associated with a poor 6-month prognosis in patients with ACS, even in the setting of receiving OCT-guided PCI.
BACKGROUND: Circulating metals from both the natural environment and pollution have been linked to cardiovascular disease.However, few prospective studies have investigated the associations between exposure to multiple metals and incident coronary heart disease (CHD).OBJECTIVES: We conducted a nested case-control study in the prospective Dongfeng-Tongji cohort, to investigate the prospective association between plasma metal concentrations and incident CHD.METHODS: A total of 1,621 incident CHD cases and 1,621 controls free of major cardiovascular disease at baseline and follow-up visits were matched on age ( ± 5 years) and sex.We measured baseline fasting plasma concentrations of 23 metals and used conditional logistic regression models to estimate odds ratios (ORs) of CHD for metal concentrations categorized according to quartiles in controls.RESULTS: Five metals (titanium, arsenic, selenium, aluminum, and barium) were significantly associated with CHD based on trend tests from singlemetal multivariable models adjusted for established cardiovascular risk factors.When all five were included in the same model, adjusted ORs for barium and aluminum were close to the null, whereas associations with titanium, arsenic, and selenium were similar to estimates from single-metal models, and ORs comparing extreme quartiles were 1.32 (95% CI: 1.03, 1.69; p-trend = 0:04), 1.78 (95% CI: 1.29, 2.46; p-trend = 0:001), and 0.67 (95% CI: 0.52, 0.85; p-trend = 0:001), respectively.CONCLUSIONS: Our study suggested that incident CHD was positively associated with plasma levels of titanium and arsenic, and inversely associated with selenium.Additional research is needed to confirm these findings in other populations.
Scholarship examining public service motivation (PSM) in multi-incentive settings is still insufficient. Though previous studies have extensively tested the nomological networks of PSM, they paid less attention to differences between individual preferences. Drawing on latent class analysis (LCA), this study addresses this gap by focusing on these differences in a multi-incentive setting instead of merely investigating relationships between variables. The analysis established a four-class model that classified 1286 Chinese respondents into four groups based on their PSM level and responses to three types of rewards (i.e., intrinsic, intangible extrinsic, and tangible extrinsic rewards). Results demonstrated that: among the respondents, (1) 32.49% with low PSM preferred tangible extrinsic rewards; (2) 19.3% with moderate PSM showed a preference for intangible extrinsic rewards; (3) 35.94% with high PSM reported a desire for tangible extrinsic rewards; and (4) 12.26% with high PSM showed a preference for all three types of rewards. Findings support the argument that PSM may be compatible with tangible and intangible extrinsic rewards.
at present, the physical education and health course in primary and secondary schools in China is faced with the dilemma of failing to strengthen the body and bring health and vitality to the students. Through the method of literature review and comparative analysis, this paper studies the physical education curriculum of primary and secondary schools in China, finds that there are some problems in the curriculum of primary and secondary school sports, and explores the social impact of these problems from multiple perspectives. From the perspective of “healthy China 2030”, this paper puts forward the following suggestions: 1. Adjusting measures to local conditions, vigorously promoting the development of school-based physical education curriculum; 2. Paying attention to the clarity of curriculum objectives, reflecting the gradual and targeted of curriculum objectives; 3. Constructing the primary, junior high and high school integrated physical education curriculum teaching content system, hoping that this study could provide a certain theoretical support for Chinese primary and secondary school physical education and health courses so that physical education could become an important position for young people to civilize their spirit and savage their physique, and provide help for the early realization of sports power and healthy China.
Acute myelomagakaryocytic leukemia is a diagnostic and therapeutic challenge owing to its heterogeneity and overlapping features with other types of acute leukemia. In order to build a diagnostic profile, we analyzed the biological, clinical and hematologic characteristics of acute myelomagakaryocytic leukemia. We found that, in three patients diagnosed with acute myelomagakaryocytic leukemia, there were two types of leukemia cells. One type was myeloblastic with positive peroxidase (POX) stainig and the expression of antigens CD13 and CD33. The other type was megakaryoblastic with negative POX staining and the expression of antigens CD36, CD41, CD42a and CD61. Three patients displayed the same cytogenetic abnormality, a (9: 22) translocation. Among the three patients with RT-PCR, two patients displayed BCR-ABL fusion gene amplification and one patient showed a previously undescribed OTT-MAL fusion gene amplification.
Much has been written on how an increasingly assertive China has sought to challenge the incumbent players in the global and regional arenas. Japan, as East Asia’s regional hegemon, is said to be throwing its weight behind the US because it has much to lose in an era of China rising. Nevertheless, how much of this resembles reality? This article seeks to unpack some commonly held assumptions, focusing on the political/security as well as economic choices facing Japan. It argues that the Japanese have seemingly forged a rather strong alignment with the US in the sphere of politics/security, often with an eye to limit the influence of China. However, the situation is less clear cut when it comes to opportunities and challenges in the economic realm. Indeed, in some of Japan’s most prominent industries, one observes complementarity effects and close interdependence with the Chinese economy. These findings illustrate that China-Japan competition is more complex than commonly portrayed, in addition to raising questions about the complicating effects that economic interdependence can have in a nation’s “strategic” policies.
Rugby Sevens is gaining popularity in Asia as evidenced by the increase in number of tournaments and participants of the sport. Currently, there are limited studies that look at injury statistics for Rugby Sevens, especially at the amateur level. This study aims to assess injury patterns among amateur Rugby Sevens players participating in the annual Singapore Cricket Club Rugby Sevens International tournament from 2012 to 2017. A retrospective review was made of recorded injury data of all players participating in the 2012 to 2017 Singapore Cricket Club Rugby Sevens Internationals tournament. Main outcome measures include incidence rate of injuries expressed per 1000 player hours, injury rate according to anatomical location, and comparative injury incidence between successive days within each tournament. 343 injuries were recorded over the 6 tournaments, with an injury incidence of 348 per 1000 player hours. The lower limb was the most commonly injured region (46%, 159 per 1000 paying hours), followed by head and neck injuries (24%, 82 per 1000 playing hours), upper limb injuries (21%, 74 per 1000 playing hours) and trunk injuries (9%, 32 per 1000 playing hours). There was a greater incidence of injuries on day 3 of competition compared to day 1 for the 2013 and 2016 tournaments (2013: 541 per 1000 player hours vs. 520 per 1000 player hours; 2016: 191 per 1000 player hours vs. 767 per 1000 player hours). Being the first study of injuries in Asian Rugby Sevens, this serves to inform of the background risk of injuries, which is much higher than is currently reported in the literature. A well-designed, prospective injury surveillance study will be necessary to investigate if injury rates are indeed higher at the amateur level in Asia, and whether there are modifiable risk factors unique to this part of the world which should be considered to guide injury prevention programmes.
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