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Adapting to climate change is critical to building sustainable and resilient agricultural systems. Understanding farmers' perceptions of climate change has become the key to the effective implementation of climate change adaptation policies. This research draws multidisciplinary attention to how farmers participate in decision-making on adaptation behaviors and provides useful insights for realizing synergies between environmental change and agricultural production. In this work, we conducted a meta-analysis of 63 quantitative studies on Chinese farmers' adaptation to climate change to assess the relationship between motivational factors and adaptation behavior. Our analysis highlights that farmers' perceptions of precipitation changes are often inaccurate; however, other psychological factors, such as perception, experience, and risk attitude, significantly positively impact their adaptation behavior. In addition, different climate regions are the main source of high heterogeneity in inter-study comparisons of climate change perception, and the effect of climate regions may therefore constitute a moderating factor that weakens the positive relationship between climate change perception and adaptive behavior. Furthermore, this study highlights the need to intervene at the household level to enhance farmers' adaptability to climate change, which includes providing support through income diversification, early warning information services, training, assistance, credit, subsidies, and other resources. In the future, research on how perception, experience, and risk interact to affect adaptive behavior should be strengthened. • Provides a quantitative summary of the literature on smallholders' climate change adaptation behavior. • Farmers' perceptions of precipitation changes were often inaccurate. • Paying attention to farmers' psychological characteristics is important to explain climate change adaptation behavior. • Both informal and formal institutional interventions can exert positive effects on smallholder adaptation to climate change. [ABSTRACT FROM AUTHOR]

Fine particulate matter (PM 2.5) exposure is associated with stroke incidence and mortality. However, the global distribution and trends of stroke burden and mortality attributable to PM 2.5 are rarely studied. We estimated the spatial patterns and temporal trends of PM 2.5 -attributable stroke burden in 195 countries and territories from 1990 to 2017. Detailed data on stroke burden attributable to PM 2.5 were extracted from the Global Burden of Disease Study (GBD) 2017. The numbers and age-standardized rates of stroke disability-adjusted life years (DALYs) and mortality (ASDR and ASMR) were estimated by age, sex, subtype, region, and country. Temporal trends in ASDR and ASMR were analyzed using estimated annual percentage change (EAPC). Globally, in 2017, 10.5 million DALYs and 0.4 million deaths related to stroke were attributable to PM 2.5. The corresponding ASDR and ASMR increased with age, were highest in males and for intracerebral hemorrhage, and varied greatly across countries, with the largest burden in high-middle sociodemographic index (SDI) regions and East Asia. The global ASDR and ASMR decreased by 7.2% and 12.2% from 1990 to 2017, with EAPCs of −0.42 (95% confidence interval [CI]: -0.55, −0.28) and −0.57 (95% CI: -0.72, −0.42), respectively. Age-specific stroke burden rates declined significantly, except in the middle-aged population. The decrease was more pronounced in women and for subarachnoid hemorrhage, while proportions of ischemic stroke burden increased globally and in all SDI regions. Most geographic regions achieved significant declines in ASDR and ASMR since 1990; however, Asia and approximately 30% of countries and territories, especially in low-income countries, showed undesirable increasing trends. The patterns and trends were heterogeneous across countries. Strengthened and tailored approaches for stroke prevention and air pollution management are still needed to reduce the disease burden associated with PM 2.5 , particularly in males, middle-age populations, and low-income countries and for ischemic stroke. • Stroke burden attributable to PM 2.5 varied greatly across countries. • The age-standardized rate (ASR) of PM 2.5 -attributable stroke burden were decreased in most regions. • The reduction in the ASR was more pronounced in women and for subarachnoid hemorrhage. • Ischemic stroke burden attributable to PM 2.5 significantly increased since 1990. • Asia and about 30% of countries showed increased trends in ASR, especially in low-income countries. [ABSTRACT FROM AUTHOR]

Smoking is a well-defined modifiable risk factor for dementia. Understanding national temporal trends of dementia deaths due to smoking is critical for prioritizing action for the global prevention of dementia, as well as smoking prevention. We aimed to estimate the patterns and temporal trends of smoking-attributable dementia-related deaths for 195 countries from 1990 to 2017. Detailed data on dementia deaths attributable to smoking were obtained from the Global Burden of Disease Study 2017. The estimated annual percentage change (EAPC) was used to quantify the temporal trends in the age-standardized mortality rate (ASMR) of dementia attributable to smoking by age, sex, region, and country. In 2017, approximately 2.51 million deaths attributable to dementia occurred globally; among them, 317,747 dementia-related deaths were attributable to smoking. The corresponding ASMR decreased by 31.1% from 6.33 per 100,000 population in 1990 to 4.36 per 100,000 population in 2017, with an EAPC of −1.43 (95% CI -1.48, −1.37). The reduction in the ASMR in women (EAPC = −2.13; 95% CI -2.18, −2.08) was more pronounced than that in men (EAPC = −1.26; 95% CI -1.32, −1.20). Most geographic region have achieved significant declines in ASMRs since 1990; however, Central Asia and 24 countries and territories showed increased trends in ASMRs over the same period. Despite large reductions in the ASMRs of dementia attributable to smoking over the past three decades, the corresponding number of deaths has steadily increased due to population growth and aging. The ASMR trend patterns were heterogeneous across countries, and there were undesirable increases in the dementia ASMR in some countries. Strengthened efforts for tobacco prevention are still needed to reduce the disease burden due to smoking, particularly in countries where the dementia ASMR is increasing. • Trends of dementia deaths attributable to smoking for 195 countries were estimated. • Globally, the ASMR of dementia attributable to smoking were decreased. • The reduction in the ASMR in women was more pronounced than that in men. • Most geographic region have achieved significant declines in ASMRs since 1990. • Central Asia and 24 countries and territories showed increased trends in ASMRs. [ABSTRACT FROM AUTHOR]

Limited research explores the impact of body mass index (BMI) change on osteoporosis, regarding the role of lipid metabolism. We aimed to cross-sectionally investigate these relationships in 820 Chinese participants aged 55–65 from the Taizhou Imaging Study. We used the baseline data collected between 2013 and 2018. T-score was calculated by standardizing bone mineral density and was used for osteoporosis and osteopenia diagnosis. Multinomial logistic regression was used to examine the effect of BMI change on bone health status. Multivariable linear regression was employed to identify the metabolites corrected with BMI change and T-score. Exploratory factor analysis (EFA) and mediation analysis were conducted to ascertain the involvement of the metabolites. BMI increase served as a protective factor against osteoporosis (OR = 0.79[0.71–0.88], P -value<0.001) and osteopenia (OR = 0.88[0.82–0.95], P -value<0.001). Eighteen serum metabolites were associated with both BMI change and T-score. Specifically, high-density lipoprotein (HDL) substructures demonstrated negative correlations (β = −0.08 to −0.06 and − 0.12 to −0.08, respectively), while very low-density lipoprotein (VLDL) substructions showed positive correlations (β = 0.09 to 0.10 and 0.10 to 0.11, respectively). The two lipid factors (HDL and VLDL) extracted by EFA acted as mediators between BMI change and T-score (Prop. Mediated = 8.16% and 10.51%, all P -value<0.01). BMI gain among Chinese aged 55–65 is beneficial for reducing the risk of osteoporosis. The metabolism of HDL and VLDL partially mediates the effect of BMI change on bone loss. Our research offers novel insights into the prevention of osteoporosis, approached from the perspective of weight management and lipid metabolomics. • BMI gain during midlife serves as a protective factor against osteoporosis. • BMI gain protects mainly women and those with normal and overweight BMI. • BMI change and BMD are linked to various lipid metabolism. • BMI change may affect elderly BMD via lipid metabolism, especially HDL and VLDL. [ABSTRACT FROM AUTHOR]

The gut microbiota is reportedly involved in neurodegenerative disorders, and exploration of differences in the gut microbiota in different cognitive status could provide clues for early detection and intervention in cognitive impairment. Here, we used data from the Taizhou Imaging Study (N = 516), a community-based cohort, to compare the overall structure of the gut microbiota at the species level through metagenomic sequencing, and to explore associations with cognition. Interestingly, bacteria capable of producing short-chain fatty acids (SCFAs), such as Bacteroides massiliensis , Bifidobacterium pseudocatenulatum , Fusicatenibacter saccharivorans and Eggerthella lenta , that can biotransform polyphenols, were positively associated with better cognitive performance (p < 0.05). Although Diallister invisus and Streptococcus gordonii were not obviously related to cognition, the former was dominant in individuals with mild cognitive impairment (MCI), while the later was more abundant in cognitively normal (CN) than MCI groups, and positively associated with cognitive performance (p < 0.05). Functional analysis further supported a potential role of SCFAs and lactic acid in the association between the gut microbiota and cognition. The significant associations persisted after accounting for dietary patterns. Collectively, our results demonstrate an association between the gut microbiota and cognition in the general population, indicating a potential role in cognitive impairment. The findings provide clues for microbiome biomarkers of dementia, and insight for the prevention and treatment of dementia. • Associations between gut microbiota and cognition were assessed in a community population. • Six gut taxonomic features are associated with cognition. • SCFAs and lactic acid may correlate with better cognitive performance. • The significant associations persisted after accounting for dietary patterns. [ABSTRACT FROM AUTHOR]