Self-reported risk of stroke and factors associated with underestimation of stroke risk among older adults with atrial fibrillation: the SAGE-AF study

Background Though engaging patients with atrial fibrillation(AF) in understanding their stroke risk is encouraged by guidelines, little is known regarding AF patients' perceived stroke risk or its relationship with oral anticoagulation(OAC) use. We aim to identify factors associated with underestimation of stroke risk among older patients with AF and relate this to OAC use. Methods Data are from the ongoing SAGE(Systematic Assessment of Geriatric Elements)-AF study, which included older patients(> 65 years) with non-valvular AF and a CHA2 DS2-VASc score of ≥ 2. Participants reported their perceived risk of having a stroke without OAC. We compared the perceived risk to CHA2 DS2-VASc predicted stroke risk and classified participants as "over" or "under" estimators, and identified factors associated with underestimation of risk using multiple logistic regression. Results The average CHA2 DS2-VASc score of 915 participants(average age: 75 years, 47% female, 86% white) was 4.3 ± 1.6, 43% of participants had discordant predicted and self-reported stroke risks. Among the 376 participants at highest risk(CHA2 DS2-VASc score ≥ 5), 46% of participants underestimated their risk. Older participants(≥ 85 years) were more likely and OAC treated patients less likely to underestimate their risk of developing a future stroke than respective comparison groups. Conclusions A significant proportion of study participants misperceived their stroke risk, mostly by overestimating. Almost half of participants at high risk of stroke underestimated their risk, with older patients more likely to do so. Patients on OAC were less likely to underestimate their risk, suggesting that successful efforts to educate patients about their stroke risk may influence treatment choices.

Two-telescope-based solar seeing profile measurement simulation

Measurements of the daytime seeing profile of the atmospheric turbulence are crucial for evaluating a solar astronomical site so that research on the profile of the atmospheric turbulence as a function of altitude C_(n)^(2)(h_(n))becomes more and more critical for performance estimation and optimization of future adaptive optics(AO)including the multi-conjugate adaptive optics(MCAO)systems.Recently,the S-DIMM+method has been successfully used to measure daytime turbulence profiles above the New Solar Telescope(NST)on Big Bear Lake.However,such techniques are limited by the requirement of using a large solar telescope which is not realistic for a new potential astronomical site.Meanwhile,the AMASP(advanced multiple-aperture seeing profiler)method is more portable and has been proved that can reliably retrieve the seeing profile up to 16 km with the Dunn Solar Telescope(DST)on the National Solar Observatory(Townson,Kellerer et al.).But the turbulence of the ground layer is calculated by combining A-MASP and S-DIMM+(Solar Differential Image Motion Monitor+)due to the limitation of the twoindividual-telescopes structure.To solve these problems,we introduce the two-telescope seeing profiler(TTSP)which consists of two portable individual telescopes.Numerical simulations have been conducted to evaluate the performance of TTSP.We find our TTSP can effectively retrieve seeing profiles of four turbulence layers with a relative error of less than 4%and is dependable for actual seeing measurement.

Process evaluation of E-learning in continuing medical education:evidence from the China-Gates Foundation Tuberculosis Control Program

Background:E-learning is a growing phenomenon which provides a unique opportunity to address the challenges in continuing medical education(CME).The China-Gates Foundation Tuberculosis(TB)Control Program implemented online training forTB health workers in three provinces of China.We aim to evaluate the implementation of E-learning CME programs,analyse the barriers and facilitators during the implementation process,and to provide policy recommendations.

The effectiveness of E-learning in continuing medical education for tuberculosis health workers: a quasi-experiment from China

Background:Given the context of rapid technological cha nge and COIVD-19 pan demies,E-lear ning may provide a unique opportunity for addressing the challenges in traditional face-to-face continuing medical education(CME).However,the effectiveness of E-learning in CME interventions remains unclear.This study aims to evaluate whether E-learning training program can improve TB health personnel's knowledge and behaviour in China.

Copper-Free Click Chemistry-Mediated Assembly of Single Quantum Dot Nanosensor for Accurately Monitoring Locus-Specific m^(6)A in Cancer Cells

N6-methyladenosine(m^(6)A)plays an important role in embryogenesis,nuclear export,transcription splicing,and protein translation control.Herein,we demonstrate a copper-free click chemistry-mediated assembly of single quantum dot(QD)nanosensor for accurately monitoring locus-specific m^(6)A in cancer cells.The m^(6)A-sensitive endoribonuclease MazF can digest the unmethylated A-RNA,and the intact m^(6)A-RNA then hybridizes with DNA probes a and b to produce a sandwich hybrid,initiating the click chemistry to generate probe a–b ligation product via first tandem ligation detection reaction(LDR)cycle.Subsequently,DNA probes c and d can hybridize with the probe a–b ligation product to generate the probe c–d ligation product via second LDR cycle.Both LDR cycles can be repeated through denaturation and annealing reaction to generate abundant biotin-/fluorophore-modified probe c–d ligation products that can easily assemble on the QD surface to induce distinct fluorescence resonance energy transfer(FRET)between QD and Cy5.This assay can be homogenously performed without the involvement of copper catalyst,m^(6)A-specific antibody,radioactive labeling,ligase enzyme,enzymatic reverse transcription,and next-generation sequencing.Moreover,it can discriminate even 0.01% m^(6)A level in complex samples and accurately measure cellular m^(6)A-RNA expression,providing a promising avenue for clinical diagnostics and biomedical research.