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Hyung-Lae Kim and colleagues report a genome-wide association study of quantitative traits of biomedical importance in Koreans. Although some loci were previously detected in European populations, others are new. To identify genetic factors influencing quantitative traits of biomedical importance, we conducted a genome-wide association study in 8,842 samples from population-based cohorts recruited in Korea. For height and body mass index, most variants detected overlapped those reported in European samples. For the other traits examined, replication of promising GWAS signals in 7,861 independent Korean samples identified six previously unknown loci. For pulse rate, signals reaching genome-wide significance mapped to chromosomes 1q32 (rs12731740, P = 2.9 × 10 −9 ) and 6q22 (rs12110693, P = 1.6 × 10 −9 ), with the latter ∼400 kb from the coding sequence of GJA1 . For systolic blood pressure, the most compelling association involved chromosome 12q21 and variants near the ATP2B1 gene (rs17249754, P = 1.3 × 10 −7 ). For waist-hip ratio, variants on chromosome 12q24 (rs2074356, P = 7.8 × 10 −12 ) showed convincing associations, although no regional transcript has strong biological candidacy. Finally, we identified two loci influencing bone mineral density at multiple sites. On chromosome 7q31, rs7776725 (within the FAM3C gene) was associated with bone density at the radius ( P = 1.0 × 10 −11 ), tibia ( P = 1.6 × 10 −6 ) and heel ( P = 1.9 × 10 −10 ). On chromosome 7p14, rs1721400 (mapping close to SFRP4 , a frizzled protein gene) showed consistent associations at the same three sites ( P = 2.2 × 10 −3 , P = 1.4 × 10 −7 and P = 6.0 × 10 −4 , respectively). This large-scale GWA analysis of well-characterized Korean population-based samples highlights previously unknown biological pathways.

BackgroundThe association of physical activity with the development and progression of coronary artery calcium (CAC) scores has not been studied. This study aimed to evaluate the prospective association between physical activity and CAC scores in apparently healthy adults.MethodsProspective cohort study of men and women free of overt cardiovascular disease who underwent comprehensive health screening examinations between 1 March 2011 and 31 December 2017. Baseline physical activity was measured using the International Physical Activity Questionnaire Short Form (IPAQ-SF) and categorised into three groups (inactive, moderately active and health-enhancing physically active (HEPA)). The primary outcome was the difference in the 5-year change in CAC scores by physical activity category at baseline.ResultsWe analysed 25 485 participants with at least two CAC score measurements. The proportions of participants who were inactive, moderately active and HEPA were 46.8%, 38.0% and 15.2%, respectively. The estimated adjusted average baseline CAC scores (95% confidence intervals) in participants who were inactive, moderately active and HEPA were 9.45 (8.76, 10.14), 10.20 (9.40, 11.00) and 12.04 (10.81, 13.26). Compared with participants who were inactive, the estimated adjusted 5-year average increases in CAC in moderately active and HEPA participants were 3.20 (0.72, 5.69) and 8.16 (4.80, 11.53). Higher physical activity was association with faster progression of CAC scores both in participants with CAC=0 at baseline and in those with prevalent CAC.ConclusionWe found a positive, graded association between physical activity and the prevalence and the progression of CAC, regardless of baseline CAC scores.

Atomically precise fabrication methods are critical for the development of next-generation technologies. For example, in nanoelectronics based on van der Waals heterostructures, where two-dimensional materials are stacked to form devices with nanometer thicknesses, a major challenge is patterning with atomic precision and individually addressing each molecular layer. Here we demonstrate an atomically thin graphene etch stop for patterning van der Waals heterostructures through the selective etch of two-dimensional materials with xenon difluoride gas. Graphene etch stops enable one-step patterning of sophisticated devices from heterostructures by accessing buried layers and forming one-dimensional contacts. Graphene transistors with fluorinated graphene contacts show a room temperature mobility of 40,000 cm 2  V −1  s −1 at carrier density of 4 × 10 12  cm −2 and contact resistivity of 80 Ω·μm. We demonstrate the versatility of graphene etch stops with three-dimensionally integrated nanoelectronics with multiple active layers and nanoelectromechanical devices with performance comparable to the state-of-the-art. Fabrication methods to pattern thin materials are a critical tool to build molecular scale devices. Here the authors report a selective etching method using XeF 2 gas to pattern graphene based heterostructures with multiple active layers and achieve 1D contacts with low contact resistivity of 80 Ω·µm

Background and Objectives: Few comparative studies have evaluated wearable single-lead electrocardiogram (ECG) devices and standard multi-lead ECG devices during exercise testing. This study aimed to validate the accuracy of a wearable single-lead ECG monitor for recording heart rate (HR) metrics during graded exercise tests (GXTs). Methods: A cohort of 50 patients at a tertiary hospital underwent GXT while simultaneously being equipped with wearable single- and conventional multi-lead ECGs. The concordance between these modalities was quantified using the intraclass correlation coefficient and Bland–Altman plot analysis. Results: The minimum and average HR readings between the devices were generally consistent. Parameters such as ventricular ectopic beats and supraventricular ectopic beats showed strong agreement. However, the agreement for the Total QRS and Maximum RR was not sufficient. HR measurements across different stages of the exercise test showed sufficient agreement. Although not statistically significant, the standard multi-lead ECG devices exhibited higher noise levels compared to the wearable single-lead ECG devices. Conclusions: Wearable single-lead ECG devices can reliably monitor HR and detect abnormal beats across a spectrum of exercise intensities, offering a viable alternative to traditional multi-lead systems.

There are conflicting data regarding the benefit of intravascular ultrasound (IVUS)–guided percutaneous coronary intervention (PCI) over angiography-guided PCI. Since the last meta-analysis was published, several new studies have been reported. We performed a comprehensive meta-analysis to evaluate the clinical impact of IVUS-guided PCI with drug-eluting stent compared with conventional angiography-guided PCI. This meta-analysis included 26,503 patients from 3 randomized and 14 observational studies; 12,499 patients underwent IVUS-guided PCI and 14,004 underwent angiography-guided PCI. Main outcome measures were total mortality, myocardial infarction (MI), stent thrombosis, and target lesion revascularization (TLR). IVUS-guided PCI was significantly associated with more stents, longer stents, and larger stents. Regarding clinical outcomes, IVUS-guided PCI was associated with a significantly lower risk of TLR (odds ratio [OR] 0.81, 95% confidence interval [CI] 0.66 to 1.00, p = 0.046). In addition, the risk of death (OR 0.61, 95% CI 0.48 to 0.79, p <0.001), MI (OR 0.57, 95% CI 0.44 to 0.75, p <0.001), and stent thrombosis (OR 0.59, 95% CI 0.47 to 0.75, p <0.001) were also decreased. In conclusion, our meta-analysis demonstrated that IVUS-guided PCI was associated with lower risk of death, MI, TLR, and stent thrombosis after drug-eluting stent implantation.

Patients with unprotected left main coronary artery stenosis were assigned to either CABG or PCI with sirolimus-eluting stents. At 1 year, with a wide prespecified noninferiority margin, PCI was found to be noninferior to CABG. Anumber of registry reports, as well as a substudy from a large, randomized trial, have indicated that percutaneous coronary intervention (PCI) may be an acceptable alternative to coronary-artery bypass grafting (CABG) in some patients with unprotected left main coronary artery stenosis. 1 – 11 Recent clinical guidelines have accordingly stated that elective PCI can be considered for patients who have unprotected left main coronary artery disease, although they suggest that the aggregated evidence favors CABG. 12 , 13 Whether the outcomes after PCI are similar to those after CABG remains uncertain, however, owing to the lack of large, randomized clinical trials. Registry results have . . .

Polyamide66 (PA66) hydrolysis affects the mechanical properties of Polyamide66/glass fiber (PA66/GF) composites. We investigated the effects of monoethylene glycol (MEG) on the degree of hydrolysis and mechanical properties of four different commercial PA66/glass fiber composites. Using pyrolysis-gas chromatography/mass spectrometry (py-GC/MS), we identified the byproducts of PA66 composite hydrolysis: carboxylic acid and alkylamine substances. The degree of hydrolysis increased as the immersion time in MEG increased. However, the tensile and flexural properties decreased due to hydrolysis. The tensile strength decreased by 42–45%; however, elongation increased by 23–63%. When PA66 absorbs MEG at 130 °C, the materials molecular chains’ bonding force decreased, resulting in increased elongation.

Structural symmetry-breaking is a key strategy to modify the physical and chemical properties of two-dimensional transition metal dichalcogenides. However, little is known about defect formation during this process. Here, with atomic-scale microscopy, we investigate the evolution of defect formation in monolayer MoS 2 exposed indirectly to hydrogen plasma. At the beginning of the treatment only top-layer sulfur atoms are removed, while vacancies and the molybdenum atomic layer are maintained. As processing continues, hexagonal-shaped nanocracks are generated along the zigzag edge during relaxation of defect-induced strain. As defect density increases, both photoluminescence and conductivity of MoS 2 gradually decreases. Furthermore, MoS 2 showed increased friction by 50% due to defect-induced contact stiffness. Our study reveals the details of defect formation during the desulfurization of MoS 2 and helps to design the symmetry-breaking transition metal dichalcogenides, which is of relevance for applications including photocatalyst for water splitting, and Janus heterostructures. Desulfurization of MoS 2 alters its chemical and physical properties by breaking structural symmetry. Here, the atomic-scale mechanistic pathway by which this occurs is investigated during plasma etching, and changes in chemical structure and physical properties are revealed.

Collateral channel wiring (CCW) is important in a retrograde chronic total occlusion (CTO) procedure. However, the guidance is insufficient. To investigate the optimal CCW time, patients who had received retrograde CTO procedures were enrolled. The optimal CCW time was derived by Receiver Operating Characteristic curves regarding success rates or complications. The clinical outcomes in terms of success and complication rates were addressed by cutoff value of optimal CCW time. With cutoff values of 25 min, 191 (54.9%) had shorter CCW times and 157 (45.1%) had longer CCW times. The success rates were significantly higher in the group with shorter CCW times than in the group with longer CCW times ( p  < 0.05). Procedure-related myocardial infarction (MI) and collateral channel (CC) related complications were more frequently observed in longer CCW times group than shorter group. The CCW time less than 25 min was more likely to result in a technical success (adjusted odds ratio [aOR]: 3.69) and the odds of CC perforation decreased by approximately 80% (aOR: 0.20). A CCW time of less than 25 min may facilitate the success results and minimize the risk of complications in retrograde CTO procedures.

Background The impact of rosuvastatin versus atorvastatin on new-onset diabetes mellitus (NODM) among patients treated with high-intensity statin therapy for coronary artery disease (CAD) remains to be clarified. This study aimed to evaluate the risk of NODM in patients with CAD treated with rosuvastatin compared to atorvastatin in the randomized LODESTAR trial. Methods In the LODESTAR trial, patients with CAD were randomly assigned to receive either rosuvastatin or atorvastatin using a 2-by-2 factorial randomization. In this post-hoc analysis, the 3-year incidence of NODM was compared between rosuvastatin and atorvastatin treatment in the as-treated population with high-intensity statin therapy as the principal population of interest. Results Among 2932 patients without diabetes mellitus at baseline, 2377 were included in the as-treated population analysis. In the as-treated population with high-intensity statin therapy, the incidence of NODM was not significantly different between the rosuvastatin and atorvastatin groups (11.4% [106/948] versus 8.8% [73/856], hazard ratio [HR] = 1.32, 95% confidence interval [CI] = 0.98 to 1.77, P  = 0.071). When the risk of NODM with rosuvastatin versus atorvastatin was assessed according to the achieved low-density lipoprotein cholesterol (LDL-C) level, the risk of NODM began to increase at a LDL-C level below 70 mg/dL. The incidence of NODM was significantly greater in the rosuvastatin group than it was in the atorvastatin group when the achieved LDL-C level was < 70 mg/dL (13.9% versus 8.0%; HR = 1.79, 95% CI 1.18 to 2.73, P  = 0.007). Conclusions Among CAD patients receiving high-intensity statin therapy, the incidence of NODM was not significantly different between rosuvastatin and atorvastatin. However, a drug effect of the statin type on NODM was observed when the achieved LDL-C level was < 70 mg/dL. Trial registration ClinicalTrials.gov, Identifier: NCT02579499. Graphical abstract