Search

Aims: To identify the trajectories of body mass index (BMI) and waist circumference (WC), and assess the associations of BMI trajectory, WC trajectory, or the two combined, with type 2 diabetes mellitus (T2DM) risk in Chinese adults. Materials and Methods: This study was based on a prospective project—the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China‐PAR). A total of 54 434 participants (39.21% men) who were measured on at least two occasions were included. Three slowly increasing trajectory patterns were identified for BMI, and four for WC, by latent mixed modelling. A nine‐category variable was derived by combining the WC trajectory (low, moderate, moderate‐high/high) and the BMI trajectory (low, moderate, high). Logistic regression models were applied to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). Results: The risk of developing T2DM increased with elevated BMI or WC trajectory levels (all ptrend <0.001). The risks were 2.85 (2.59–3.14) for high BMI trajectory and 4.34 (3.78–4.99) for high WC trajectory versus low trajectory groups, respectively. The association was more pronounced among younger individuals (pinteraction <0.001). In the joint analysis, compared to participants with low WC and BMI trajectory, those with moderate‐high/high WC combined with high BMI trajectory had the highest risk of T2DM (OR 3.96, 95% CI 3.48–4.50); even those who maintained moderate‐high/high WC but low BMI trajectory showed a higher T2DM risk (OR 3.00, 95% CI 2.31–3.91). Conclusions: This study suggests that simultaneous dynamic and continuous monitoring of BMI and WC may contribute more than single measurements to predicting T2DM risk and determining preventive strategies. [ABSTRACT FROM AUTHOR]

We aimed to investigate the association of metabolic obesity phenotypes with all-cause mortality risk in a rural Chinese population. This prospective cohort study enrolled 15 704 Chinese adults (38·86 % men) with a median age of 51·00 (interquartile range: 41·00–60·00) at baseline (2007–2008) and followed up during 2013–2014. Obesity was defined by waist circumference (WC: ≥ 90 cm for men and ≥ 80 cm for women) or waist-to-height ratio (WHtR: ≥ 0·5). The hazard ratio (HR) and 95 % CI for the risk of all-cause mortality related to metabolic obesity phenotypes were calculated using the Cox hazards regression model. During a median follow-up of 6·01 years, 864 deaths were identified. When obesity was defined by WC, the prevalence of participants with metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO) and metabolically unhealthy obesity (MUO) at baseline was 12·12 %, 2·80 %, 41·93 % and 43·15 %, respectively. After adjusting for age, sex, alcohol drinking, smoking, physical activity and education, the risk of all-cause mortality was higher with both MUNO (HR = 1·20, 95 % CI 1·14, 1·26) and MUO (HR = 1·20, 95 % CI 1·13, 1·27) v. MHNO, but the risk was not statistically significant with MHO (HR = 0·99, 95 % CI 0·89, 1·10). This result remained consistent when stratified by sex. Defining obesity by WHtR gave similar results. MHO does not suggest a greater risk of all-cause mortality compared to MHNO, but participants with metabolic abnormality, with or without obesity, have a higher risk of all-cause mortality. These results should be cautiously interpreted as the representation of MHO is small. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to identify common COVID-19 symptoms and asymptomatic infection rates during the epidemic in China. We also introduce the concepts of "Time-point asymptomatic rate" and "Period asymptomatic rate".Object and Methods: A questionnaire survey was conducted online from December 2022 to January 5, 2023, collecting demographic characteristics, laboratory results, clinical symptoms, lifestyle and vaccination history. Statistical methods were used to analyze symptom characteristics, associated factors, and patterns during an 8-day observation period. Numerical variables were described by median M (Q1-Q3) or mean and standard deviation (). Categorical variables are described by frequency (N), ratio (%) or rate (%). The influencing factors were studied by Wilcoxon or Kruskal-Willis H rank sum test or logistic regression analysis, and the trend of symptom incidence by Spearman rank correlation. P value being ≤ 0.05 was statistically significant.Results: Out of 536 participants, 493 (91.98%) were infected, with 3 asymptomatic cases and 490 symptomatic cases within 8 days. The time-point asymptomatic rate increased from 0.61% on day 1 to 15.42% on day 8. Fever, cough, and fatigue were the main symptoms, with additional symptoms such as vomiting, diarrhea, and hyposmia reported. Symptom durations varied, with cough and expectoration lasting longer and vomiting and diarrhea lasting shorter. Several symptoms showed a downward trend over time.Conclusion: Our online survey highlighted that most COVID-19 patients experienced symptoms, and the time-point asymptomatic rate showed a dynamic change among the infected population. Onset patterns and demographic factors influence symptom occurrence and duration. These findings have implications for clinical practitioners and decision-makers in public health measures and strategies. [ABSTRACT FROM AUTHOR]

Background and Purpose: Some cheap and easily used operated indexes of insulin resistance (IR) were currently available. We aimed to evaluate the association of six surrogate indexes of IR with incident stroke and to compare their predictive capacity.Methods: We analysed data from 14,595 eligible study participants from the Rural Chinese Cohort Study. Modified Poisson regression models were used to estimate relative risks (RRs) and 95% confidence intervals (95% CIs) of incident stroke associated with the visceral adiposity index (VAI), the Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), triglyceride-glucose (TyG), TyG-body mass index, and TyG-waist circumference. The receiver operator characteristic curve was used to compare the ability of the abovementioned IR indexes to predict stroke.Results: During a median follow-up of 6 years, 786 newly diagnosed stroke cases were identified. The levels of six surrogate indexes of IR were all significantly higher in the stroke population than in the non-stroke population (p < 0.001). Compared with quartile 1, the multivariable adjusted RRs (95% CIs) of incident stroke for quartile 4 were 2.01 (1.47-2.76), 1.62 (1.28, 2.04), 1.64 (1.28-2.09), and 1.92 (1.50-2.45) for CVAI, VAI, LAP, and TyG, respectively. Significant dose-response associations were also found between surrogate IR indexes and risk of stroke. The area under the curves|areas under the curves for CVAI (0.674) was significantly greater than for other indexes (TyG-WC:0.622, TyG:0.614, LAP:0.606, TyG-BMI:0.598, and VAI:0.577) (p < 0.001).Conclusions: Six surrogate indexes of IR were independently associated with incident stroke. The CVAI may be the most suitable index for stroke prediction. [ABSTRACT FROM AUTHOR]

The study compared the level of physical activity (PA) between older people living with HIV (PLWH) and their HIV-negative counterparts in China and tested the mediational roles of self-compassion, attitudes toward aging, and perceived stress in the between-group difference in PA. From December 2017 to August 2018, face-to-face interviews were conducted among 337 and 363 HIV-positive and –negative people aged ≥ 50 in Yongzhou City, Hunan, China. Path analysis was performed. The proportions of low, moderate, and high levels of PA in the HIV-positive and -negative groups were 18.9% versus 6.7%, 43.1% versus 32.0%, and 38.0% versus 61.3%, respectively, yielding a statistically significant difference. The path analysis showed that older PLWH reported less self-compassion and positive attitudes toward aging, which was in turn associated with more perceived stress and ultimately associated with less PA. Chinese older PLWH were more sedentary than their HIV-negative counterparts. Future PA interventions may modify the mediators. [ABSTRACT FROM AUTHOR]

Introduction: Lactate dehydrogenase (LDH) is an important oxidoreductase in the anaerobic metabolic pathway. The role of LDH in arterial stiffness (AS) and 10-year cardiovascular disease (CVD10) risk has not been established. Methods: This retrospective, cross-sectional, and observational study evaluated the relationships between the LDH level and AS and CVD10 risk in 12,597 health-examined people (6988 men and 5609 women; mean age, 49.49 years) in China. Brachial–ankle pulse wave velocity (baPWV) was used to estimate AS. The Framingham CVD 10-year risk prediction model was used to calculate the CVD10 risk score. Results: In both sexes, an increased LDH level was associated with increased AS and CVD10 (men: β = 0.032, P < 0.001; women: β = 0.025, P < 0.001). Half of the population with a high LDH level (≥ 172 U/L) showed significantly increased AS and CVD10 risk score. Men and women with baPWV ≥ 1400 cm/s had a higher LDH level, and the latter was significantly different from that of the group with baPWV < 1400 cm/s (men: 176.93± 30.99 vs 173.00± 33.36, P < 0.001; women: 189.10± 34.20 vs 171.39± 31.08, P < 0.001). In both sexes, a higher level of LDH was noted in groups with higher CVD10 risk score (men: 176.65± 32.51 vs 172.94± 32.46, P < 0.001; women: 202.51± 44.05 vs 175.73± 32.39, P < 0.001). Discussion: An increased LDH level may be associated with AS and CVD10 risk. The LDH level could be a new predictor of AS and CVD10 risk in health-examined populations. [ABSTRACT FROM AUTHOR]

Objective: The impact of baseline hypertension status on the BMI-mortality association is still unclear. We aimed to examine the moderation effect of hypertension on the BMI-mortality association using a rural Chinese cohort.Design: In this cohort study, we investigated the incident of mortality according to different BMI categories by hypertension status.Setting: Longitudinal population-based cohort.Participants: 17 262 adults ≥18 years were recruited from July to August of 2013 and July to August of 2014 from a rural area in China.Results: During a median 6-year follow-up, we recorded 1109 deaths (610 with and 499 without hypertension). In adjusted models, as compared with BMI 22-24 kg/m2, with BMI ≤ 18, 18-20, 20-22, 24-26, 26-28, 28-30 and >30 kg/m2, the hazard ratios for mortality in normotensive participants were 1·92 (95% CI 1·23, 3·00), 1·44 (95% CI 1·01, 2·05), 1·14 (95% CI 0·82, 1·58), 0·96 (95% CI 0·70, 1·31), 0·96 (95% CI 0·65, 1·43), 1·32 (95% CI 0·81, 2·14) and 1·32 (95% CI 0·74, 2·35), respectively, and in hypertensive participants were 1·85 (95% CI 1·08, 3·17), 1·67 (95% CI 1·17, 2·39), 1·29 (95% CI 0·95, 1·75), 1·20 (95% CI 0·91, 1·58), 1·10 (95% CI 0·83, 1·46), 1·10 (95% CI 0·80, 1·52) and 0·61 (95% CI 0·40, 0·94), respectively. The risk of mortality was lower in individuals with hypertension with overweight or obesity v. normal weight, especially in older hypertensives (≥60 years old). Sensitivity analyses gave consistent results for both normotensive and hypertensive participants.Conclusions: Low BMI was significantly associated with increased risk of all-cause mortality regardless of hypertension status in rural Chinese adults, but high BMI decreased the mortality risk among individuals with hypertension, especially in older hypertensives. [ABSTRACT FROM AUTHOR]

Background: Mental health is affected by both genetic and environmental factors. However, previous studies have showed conflict findings about the role of lifestyle and little is known about the situation of the Chinese population. The purpose of this study was to explore the relationship between the frequency of food consumption, physical exercise condition and mental health, as well as factors related to mental stress in Chinese.Methods: We recruited 8160 residents who had health examinations in a public hospital during June 2016 to May 2018. Demographic characteristics, the frequency of food consumption, physical exercise condition and mental health status was collected by a questionnaire. We estimated the association using the odds ratio (OR) and 95% confidence interval (CI) based on Binary or ordinal logistic regression models. A classification and regression tree (CART) demonstrated the prediction of the value of a target variable based on other values.Results: The logistic regression model and classification tree model both found that the frequency of fresh vegetables or fruit and fried foods consumption and the current state of drinking alcohol were related to mental stress. The degree of mental stress reduced significantly with increasing consumption of fish (OR = 0.80, 95% CI: 0.71-0.90) and regular exercise (OR = 0.55, 95% CI:0.48-0.64) in females and increased consumption of fish (OR = 0.55, 95% CI: 0.48-0.64) and cereal crop (OR = 0.77, 95% CI: 0.68-0.89), fish (OR = 0.87, 95%CI:0.77-0.96) and regular exercise (OR = 0.61, 95%CI:0.53-0.70) in males. On the contrary, the frequency of consumption of desserts (OR = 1.43, 95% CI: 1.26-1.62) and the current of drinking alcohol (OR = 1.47, 95%CI:1.21-1.79) in females and meat (OR = 1.47, 95%CI: 1.31-1.65), pickled and smoked food (OR = 1.18, 95%CI:1.05-1.32) and the current state of drinking alcohol (OR = 1.25, 95%CI:1.12-1.40) in males were related to an increased risk of mental health.Conclusions: Our study showed that both the frequency of some food consumption and physical exercise condition were associated with mental health and affected the degree of stress, which provided novel insights into interventions. [ABSTRACT FROM AUTHOR]

Two new species of Fulvifomes are described from specimens collected in rainforests of Nonggang Nature Reserve of southern China, based on morphological characteristics and molecular phylogenetic analysis of the internal transcribed spacer (ITS) and nuclear large subunit ribosomal DNA (nLSU) sequences. Fulvifomes nonggangensis sp. nov. is characterized by perennial, sessile and solitary basidiocarps, applanate pileus, small cystidioles of 9.9–15.4 × 2.9–3.5 μm, large pores of 5–6 per mm, a dimitic hyphal system, and broadly ellipsoid basidiospores of 4.3–5.3 × 3.3–4.2 μm. F. tubogeneratus sp. nov. is characterized by perennial, sessile, and imbricate basidiocarps, a duplex context, small pores of 7–8 per mm, a dimitic hyphal system, and ovoid to subglobose basidiospores of 5.72 × 5.00 μm. [ABSTRACT FROM AUTHOR]

Background: The association of ratio of triglycerides to high‐density lipoprotein cholesterol (TG/HDL‐C ratio) change trajectory with risk of type 2 diabetes mellitus (T2DM) remains unknown. The aim of this study was to evaluate the association between risk of T2DM and TG/HDL‐C ratio change trajectory. Methods: A total of 18 444 participants aged 18‐80 years old were included in this cohort study. Linear regression and quadratic regression models were used to determine the TG/HDL‐C ratio change trajectory. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between TG/HDL‐C ratio change trajectory and probability of T2DM. Results: T2DM developed in 714 participants during a median follow‐up of 5.74 years (92 076.23 person‐years of follow‐up). After adjusting for baseline potential confounders, odds of T2DM were greater for participants with the increasing, U‐shape, bell‐shape, and other shape change vs decreasing change (adjusted OR [aOR] 2.01, 95% CI 1.42‐2.81; 1.56, 1.15‐2.13; 1.60, 1.17‐2.20; and 1.49, 1.13‐2.00, respectively). The results were robust in the sensitivity analyses on excluding baseline participants with T2DM. Moreover, the associations remained significant with male sex, age <60 years and body mass index <24 kg/m2. Conclusions: This retrospective study revealed increased probability of T2DM with increasing, U‐shape, bell‐shape, and other‐shape TG/HDL‐C ratio change trajectories, especially with male sex, age <60 years and body mass index <24 kg/m2. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate the sex‐specific association between the ZJU index and risk of fatty liver disease in a large Chinese cohort. Methods: A total of 28 729 adults without fatty liver disease at baseline and who completed at least one follow‐up of annual examinations between 2009 and 2016 were included in this study. The Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for fatty liver disease risk associated with the ZJU index. Results: During a median follow‐up of 3.01 years, 7373 developed fatty liver disease. There were significant associations between the ZJU index and fatty liver disease for women and men with increasing HRs as the quartiles increase across Q2–Q4, corresponding HRs (95% CIs) in M3 were 2.28 (1.98–2.64), 3.52 (3.07–4.04), and 4.87 (4.24–5.59) for women and 2.44 (2.17–2.75), 4.18 (3.73–4.68), and 6.23 (5.56–6.98) for men. The association between the ZJU index and fatty liver disease risk remained significant in all the subgroups except that of T2DM and abdominal obesity subgroups for men. However, the association became nonsignificant when comparing Q3 and Q2 of the ZJU index with reference in the subgroups of T2DM for men, and nonsignificant when comparing Q3 of the ZJU index with reference in the subgroups of participants with T2DM and abdominal obesity for women. Conclusion: The ZJU index was significantly associated with the risk of fatty liver disease in Chinese population. It will be better to keep body mass index, alanine aminotransferase, aspartate aminotransferase, triglyceride, and fasting plasma glucose at a normal level for preventing fatty liver disease. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine whether perioperative breathing training reduces the incidence of postoperative pulmonary complications in patients undergoing laparoscopic colorectal surgery. Design: A randomized controlled trial. Setting: University hospital. Subjects: A total of 240 patients undergoing laparoscopic colorectal surgery participated in this study. Intervention: The enrolled patients were randomized into an intervention or control group. Patients in the intervention group received perioperative breathing training, including deep breathing and coughing exercise, balloon-blowing exercise, and pursed lip breathing exercise. The control group received standard perioperative care without any breathing training. Main measures: The primary endpoint was the incidence of postoperative pulmonary complications. The secondary objectives were to evaluate the effect of perioperative breathing training on arterial oxygenation, incidence of other postoperative complications, patient satisfaction, length of stay, and hospital charges. Results: The incidence of postoperative pulmonary complications in the breathing training group was lower than that in the control group (5/120 [4%] vs 14/120 [12%]; RR 0.357, 95%CI 0.133–0.960; P = 0.031). In addition, PaO2 and arterial oxygenation index on the first and fourth days after surgery were significantly higher in the breathing training group than in the control group (P < 0.001). In addition, patients with breathing training had shorter length of stay (6d [IQR 5–7] vs 8d [IQR 7–9]), lower hospital charges (7761 ± 1679 vs 8212 ± 1326), and higher patient satisfaction (9.46 ± 0.65 vs 9.21 ± 0.47) than those without. Conclusion: Perioperative breathing training may reduce the incidence of postoperative pulmonary complications and preserve of arterial oxygenation after laparoscopic colorectal surgery. [ABSTRACT FROM AUTHOR]

Background. Conflicting findings have been reported regarding the sex-specific association between serum uric acid (SUA) level and type 2 diabetes mellitus (T2DM) risk, and no study has explored the association between the change in hyperuricemia status and T2DM risk. The study was aimed at exploring the sex-specific association of baseline SUA and changes in hyperuricemia status with T2DM risk. Methods. We included 37,296 eligible adults without T2DM at the first examination who attended the baseline examination and at least one follow-up annual examination. Cox and logistic regression models were used to calculate hazard ratios (HRs) and odds ratios (ORs) with their 95% confidence intervals (CIs) for T2DM risk associated with baseline SUA and the change in hyperuricemia status, respectively. Results. During a median follow-up of 3.09 years, of 37,296 eligible adults, 2,263 developed T2DM. Compared with the first SUA quartile, higher quartiles were associated with an increased risk of T2DM in women (HR 1.78, 95% CI 1.17-2.71 for Q3 and 1.93, 1.27-2.93 for Q4; P trend < 0.001) but not in men. Compared with women with a persistent normal SUA level at baseline and the last follow-up, T2DM risk increased significantly among those whose SUA status changed from normal at baseline to hyperuricemia at the last follow-up (OR 1.71, 95% CI 1.12-2.55) and those with persistent hyperuricemia at baseline and the last follow-up (OR 2.37, 95% CI 1.60-3.46). However, for men, a nonsignificant association was found between the change in hyperuricemia status and T2DM risk. Conclusions. Baseline SUA and the change in hyperuricemia status were associated with T2DM risk only among women. The findings suggest the importance of monitoring SUA levels and maintaining them within a normal range for preventing or reducing incident T2DM in Chinese women. [ABSTRACT FROM AUTHOR]

A comprehensive understanding of the relationship between arbuscular mycorrhizal (AM) fungi and coastal saline soil organic carbon (SOC) is crucial for analysis of the function of coastal wetlands in soil carbon sequestration. In a field experiment, the temporal and spatial dynamics of AM fungi, glomalin-related soil protein (GRSP) – which is described as a N-linked glycoprotein and the putative gene product of AM fungi, SOC, and soil aggregates were investigated in halophyte Kosteletzkya virginica rhizosphere soil of coastal saline areas of North Jiangsu, China. Soil samples were collected from a depth of up to 30 cm in two plantation regions from August 2012 to May 2013. Results showed K. virginica formed a strong symbiotic relationship to AM fungi. AM colonization and spore density were the highest in the 10–20 cm soil layer of Jinhai farm in August 2012, because of the presence of numerous fibrous roots in this soil layer. The total GRSP and SOC were the highest in the 0–10 cm soil layer in May 2013 and November 2012, respectively. Correlation coefficient analysis revealed that AM colonization and spore density were positively correlated with total GRSP. Meanwhile, total GRSP was significantly positively correlated with large macroaggregates (>3 mm), SOC, total P, Olsen P, and soil microbial biomass carbon (SMBC), but negatively correlated with microaggregates (<0.25 mm), soil EC, total N, and pH. SOC was positively correlated with spore density, large macroaggregates, small macroaggregates (2–0.25 mm), alkaline N, and SMBC and negatively correlated with microaggregates, EC, pH, and total K. Although it may be a statistical artifact, we found an interesting phenomenon that there was no significant correlation between soil aggregates and AM colonization or spore density. Hence, total GRSP is a vital source of saline soil C pool and an important biological indicator for evaluating coastal saline SOC pool and soil fertility, while AM colonization or spore density may not be. [ABSTRACT FROM AUTHOR]

Background: The discordance of the low-density lipoprotein cholesterol-to-high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio with alterative lipid parameters may explain the inconsistent association of CIMT with the LDL-C/HDL-C ratio. Therefore, this study aimed to explore the associations between LDL-C/HDL-C ratio discordance with alternative lipid parameters and elevated carotid intima-media thickness (CIMT) risk in a large cohort in Beijing, China. Methods: In total, 13,612 adults who didn't have elevated CIMT at baseline and who participated in at least one follow-up of annual examination between 2009 and 2016 were included in this cohort study. A multivariable Cox regression model was utilized to evaluate the associations of discordance of the LDL-C/HDL-C ratio with TC, TGs, LDL-C and HDL-C with elevated CIMT risk. Results: During 37,999 person-years of follow-up, 2004 individuals (1274 men and 730 women) developed elevated CIMT. Among individuals with normal TC and TGs, 16.6 and 15.2% individuals had a discordantly high LDL-C/HDL-C ratio, respectively, and the risk of elevated CIMT increased by 1.54 (95% CI 1.33, 1.77) and 1.53 (95% CI 1.33, 1.76), respectively, comparing to individuals with a concordantly low LDL-C/HDL-C ratio. A high LDL-C/HDL-C ratio could significantly increase elevated CIMT risk regardless of discordance/concordance with LDL-C and HDL-C (P < 0.001). A low LDL-C/HDL-C ratio with discordantly normal HDL-C and high LDL-C (13.2% of individuals) had a 32% (HR = 1.32, 95% CI 1.11, 1.57) higher risk of elevated CIMT than concordantly low LDL-C and normal HDL-C. Sensitivity analysis by excluding CIMT developed in the first 2 years follow-up further confirmed the above results. Conclusions: A high LDL-C/HDL-C ratio could significantly increase elevated CIMT risk regardless of discordance/concordance with TC, TGs, LDL-C and HDL-C Even a low LDL-C/HDL-C ratio with discordantly high LDL-C and normal HDL-C could also significantly increase CIMT risk. Individuals should maintain both the LDL-C/HDL-C ratio and LDL-C at normal levels to prevent elevated CIMT. [ABSTRACT FROM AUTHOR]

Metabolically healthy obesity refers to a subset of obese people with a normal metabolic profile. We aimed to explore the association between metabolically healthy and obesity status and risk of hypertension among Chinese adults from The Rural Chinese Cohort Study. This prospective cohort study enrolled 9137 Chinese adults without hypertension, type 2 diabetes or treatment for lipid abnormality at baseline (2007–2008) and followed up during 2013–2014. Modified Poisson regression models were used to examine the risk of hypertension by different metabolically healthy and obesity status, estimating relative risks (RR) and 95 % CI. During 6 years of follow-up, we identified 1734 new hypertension cases (721 men). After adjusting for age, sex, smoking and other confounding factors, risk of hypertension was increased with metabolically healthy general obesity (MHGO) defined by BMI (RR 1·75, 95 % CI 1·02, 3·00) and metabolically healthy abdominal obesity (MHAO) defined by waist circumference (RR 1·51, 95 % CI 1·12, 2·04) as compared with metabolically healthy non-obesity. The associations between metabolically healthy and obesity status and hypertension outcome were consistent after stratifying by sex, age, smoking, alcohol drinking and physical activity. Both MHGO and MHAO were associated with increased risk of hypertension. Obesity control programmes should be implemented to prevent or delay the development of hypertension in rural China. [ABSTRACT FROM AUTHOR]

This study was to compare global and domain-specific neurocognitive performance between older people living with HIV (PLWH) taking/not taking efavirenz (EFV) and HIV-negative controls. A cross-sectional study was conducted in Yongzhou city, China. All PLWH older than 50 years listed on the registry of Centres for Disease Control and Prevention were invited to join the study. Frequency matching was used to sample HIV-negative controls according to the distribution of age, sex, and years of formal education of older PLWH. A total of 308 older PLWH and 350 HIV-negative controls completed the face-to-face interview and neurocognitive assessment using the comprehensive neuropsychological test battery. After adjusting for significant confounders, older PLWH taking EFV showed poorer performance in memory (p = 0.020), verbal fluency (p = 0.002), and poorer global neurocognitive performance (p = 0.032) than those without EFV use. Compared to HIV-negative controls, older PLWH taking EFV had poorer performance in all neurocognitive domains (p values: <0.001–0.003) and poorer global neurocognitive performance (p < 0.001). Similar trends were observed when comparing older PLWH without using EFV versus HIV-negative controls, with the exception of verbal fluency (p = 0.560). Health care workers should monitor the neuropsychological performance of older PLWH, epically those who were taking EFV. Longitudinal studies are warranted. [ABSTRACT FROM AUTHOR]

The next generation of public health professionals requires rigorous training in behavioral health, in order to design effective behavioral interventions to respond effectively to the epidemiological transition in China. This study aimed to investigate issues in training in social and behavioral sciences in public health in China. A cross-sectional survey was conducted among 1285 and 835 last-year undergraduate and graduate public health students in 2013. The results showed that (1) majority of undergraduate students but a minority of graduate students had enrolled in psychology, social medicine, and health promotion courses; (2) very few had enrolled in other social and behavioral sciences courses; (3) high percentages of students perceived significance, needs, and interests related to social sciences courses; (4) very few were familiar with commonly used behavioral health theories and constructs, or had applied such theories/constructs to their thesis. The situation deviates from international accreditation requirement. A timely review and benchmarking are warranted. [ABSTRACT FROM AUTHOR]

Trollius chinensis Bunge is a traditional edible and medicinal plant utilized popularly in north China. This study is intended to evaluate the antioxidant and antimicrobial properties of extracts obtained with different processing methods from Trollius chinensis Bunge. The results showed that all extract displayed moderate or great potential of antioxidant and antibacterial activity, especially ultrasound-assisted ethanol extracts (UAE). It exhibited the highest 2, 2-diphenyl-1-picrylhydrazyl (DPPH; EC50 0.215 ± 1.10 mg/mL), 2, 2-azino-bis (3-ethylbenzo-thiazoline-6-sulfonic acid) (ABTS; EC50 < 10 μg/mL) and reducing power (RP; EC50 0.25 ± 0.02 mg/mL) with the highest level of flavonoids content (71.56 ± 0.35 mg/g) and total phenolic (35.75 ± 0.35 mg/g). In addition, the UAE had high antibacterial activity against Staphylococcus aureus (19.7 ± 0.6 mm inhibition zone) , Bacillus subtilis (16.4 ± 0.3 mm inhibition zone), Escherichia coli (15.3 ± 0.2 mm inhibition zone), respectively. The HPLC analysis show that the main flavonoids components in T. chinensis Bunge were revealed to be 2″-O-β-L-galactopyranosylorientin, orientin, vitexin, hyperin. These results suggested the extracts of T. chinensis Bunge could be potentially used as a promising source of antioxidant and antibacterial agents for using in the food or drug industries. [ABSTRACT FROM AUTHOR]

Over the past 20 years since its introduction, Kosteletzkya virginica has proved to be one of the optimal halophytes for saline land restoration in China. In six seashore mallow plantations, its well-developed perennial root system promoted the growth of arbuscular mycorrhizal fungus in the rhizosphere, where the fungus’s activity produced total glomalin (TG, ranging from 0.85 to 2.43 mg g −1 soil), with a high ratio of TG/SOC (soil organic carbon) up to 53.29% in six-year-old seashore mallow plantation. K. virginica ameliorated the condition of saline soils, promoted native species growth, and increased plant diversity in the plantation sites. Seashore mallow contains many bioactive compounds, e.g., polysaccharides, saponins, flavonoids, etc. which have high bioactivity, and could be used as a fodder additive or for the development of health foods. The leaf, flower, stem and root of K. virginica , serve as raw materials for hierachical development of useful products according to their different properties. This study reviews and summarizes research on K. virginica in China during the past 20 years since its introduction from the USA. Also, we present guidelines for the planting and use of seashore mallow in China, in terms of an ecological engineering roadmap, which illustrates the process and strategy for the restoration of saline soils and designs for biomass industries based on its production. [ABSTRACT FROM AUTHOR]

Abstract: Spartina alterniflora Loisel (S. alterniflora) is native to the Atlantic and Gulf Coasts of North America and was introduced to China in 1979. Over the years, S. alterniflora played an important role in protecting coastal banks, accelerating sediment deposition, improving local economies, and alleviating natural disasters. As an exotic species, S. alterniflora has a very strong capability of propagation, which has caused some negative effects, such as occupying ecological niches of some seashells and blocking harbors by fast sediment deposition. As a result, ecological control of S. alterniflora in some areas has drawn wide attention from biologists and ecologists in China and abroad. For this paper, we studied the technology of topography and hydrology modification to substitute S. alterniflora with P. asutralis and reported our results in a project applying this technology. Furthermore, we studied various ways to make use of biomass of S. alterniflora and found that such ways were a good alternative to ecological control of S. alterniflora. [Copyright &y& Elsevier]

The fluxes of trichloromethane (CHCl3, CM) and tetrachloromethane (CCl4, TCM) were seasonally measured using static flux chambers over an annual cycle in a coastal salt marsh, East China. The salt marsh presented as a large sink for both the compounds in the growing season (from April to October), but it was a minor source for the gas species in the non-growing season. Generally, the cordgrass marsh acted as a sink of CM and TCM. The net consumption of CM and TCM observed in the study marsh may result from the high ambient atmospheric concentrations and enriched soil organic matter that result in anoxic sediments. Higher plants were suggested to be an important sink for CM and TCM in the growing season, but a net source in the non-growing season. However, the mechanism responsible for the plant removal process is not clear. [Copyright &y& Elsevier]

Yancheng Biosphere Reserve (YBR) is located along the coastal zone of the Yellow China Sea with 900 km long in Jiangsu Province. Human activities have greatly interfered the original wetlands in YBR for migratory birds using this region as the Flyway with rapidly economic development since 1980. Much of the experimental zones and buffer zones are transferred to agriculture, aquaculture, transportation or buildings, etc. which directly results in many birds losing their habitats and becoming globally threatened, such as the Spotted Greenshank (Tringa guttifer) and the Spoon-billed Sandpiper (Eurynorhynchus pygmeus). So since 1993 some constructed wetlands have been created in the core zone of YBR in order to protect those threatened and near-threatened shorebirds. How to evaluate the sustainability of these original and constructed wetlands is a concern to managers, scientists and local stakeholders. This paper is an initial study on emergy evaluation of original wetlands and recently constructed wetlands in YBR, China. Two new emergy indices, base emergy change (Bec) and net profit (Np), are presented in order to compare the ecological-economic benefits of these different kinds of wetlands. Results show that a waterfowl pond, constructed for ecological reasons at the edge of the core zone of YBR, has much more Bec than the original wetlands and fishponds, while its Np is negative and much lower than the other sites. Fishponds built for economic reasons in the buffer zone have negative Bec while their Np is the highest. However, the emergy yield ratio (Yr) of the original wetlands is the highest. The constructed waterfowl pond can draw more coastal birds than before. Likewise the constructed fishponds can win large economic benefits to maintain the feedback to the waterfowl pond. But no more fishponds should be constructed due to the highest emergy yield ratio of the original wetlands and high Bec in the waterfowl pond. Finding the best way to harmonize conservation and development in the YBR is of great importance to a sustainable future. [Copyright &y& Elsevier]

Vegetation establishment is the most important among physical, chemical and biological reconstructions for wetland restoration. However, sources of plant propagules such as seeds, shoots and rhizomes in native sediments or from adjacent sites are limited and often have other disadvantages. There have been very few reports focusing on the solving of the problem. This paper deals with our strategies and techniques in vegetation recovering on degraded coastal marshes, and highlights the solving of propagules deficiency. First, to select tool species, soil chemical components are analyzed to determine the key factors that restrict the growth of plants, and experimental plantings of candidate species are set up inside objective sites. Then, aiming to solve the problem of propagule resource deficiency, tissue culture is conducted in laboratory to clone enough seedlings of the tool species; and to increase the surviving rate, the seedlings are grown and trained in green house for a certain period. Thirdly, healthy seedlings are transplanted on objective sites in large scale with paper cups. Our recent projects in Yancheng and Tanggu in China''s east coast are demonstrated in this paper. [Copyright &y& Elsevier]

Abstract: The current energy crisis is a worldwide problem, and developing energy from biomass is considered an effective partial solution. Sheyang Saltern is located in a coastal area in East China. The administration of saltern cooperated with our Halophyte Research Lab to create a Five-year Plan of Biomass Energy on Saline Land. In this plan, 3330ha of salt-tolerant oil plants will be planted on the coastal saline land in Sheyang Saltern, including 2664ha of Ricinus communis and 666ha of Kosteletzkya virginica (L.) presl. These plants will produce biomass energy from land that is not fit for common crops, and thus this plan will not affect crop production. Moreover, the biomass of plants will be fully utilized in a hierarchical way, guided by an ecological engineering design. Thus, more outputs and more profits will be gained by applying this plan. This study uses the emergy analysis to predict and analyze the saltern ecosystem''s ecological potential and compare it with an existing system founded in 2007, a 33.3ha field of the two plants in the saltern. Four main emergy indices of the two ecosystems, EYR, EIR, ELR and ESI, are calculated and compared. To better show the system''s ecological potential, we establish a new emergy index-potential yield ratio (PYR). PYR is designed to measure artificial ecosystems’ potential output capacity. It reflects a system''s potential to transform stored emergy into output emergy using ecological engineering technology. The value of the predicted system''s PYR is as great as 225, indicating that the system has a bright future to develop salt-tolerant oil plants. The system''s future ecological potential and additional ways to utilize the two plants – the use of ricin and tuberous roots, etc. are also discussed in this paper. Our results will be helpful to the government''s policy making, and provides useful information for enterprises. [Copyright &y& Elsevier]

Background: In China, people living with HIV (PLWH) are aging. The study compared prevalence of probable depression between older PLWH and their HIV-negative counterparts, and tested the hypothesis that the between-group difference in depressive symptoms would be mediated by attitudes toward aging.Methods: With informed consent, a cross-sectional survey was conducted via anonymous face-to-face interviews to 337 and 363 HIV-positive and HIV-negative people aged ≥50, respectively, in Yongzhou City, Hunan, China from December 2017 to August 2018. Depression was measured by the Center for Epidemiologic Studies Depression (CES-D) scale. Attitudes toward aging were measured by the Attitudes to Aging Questionnaire (subdomains: psychosocial loss, physical change, psychological growth). Bootstrapping analyses were performed to test the mediation hypothesis.Results: The prevalence of probable depression (CES-D ≥ 16) was significantly higher in the HIV-positive group than the HIV-negative group (44.8% versus 20.4%). The HIV-positive participants presented more negative attitudes toward aging (in psychosocial loss and physical change) than their HIV-negative counterparts. Negative attitudes toward aging were associated with more depressive symptoms. Overall attitudes toward aging (effect size=41.3%) and the subdomains of psychosocial loss (effect size=38.5%) and physical change (effect size=16.3%) partially mediated the association between HIV status and depressive symptoms, respectively.Limitations: The cross-sectional design limited the ability of causal inference. Selection bias, information bias, and confounding bias might exist.Conclusions: Older PLWH might be more depressed than their HIV-negative counterparts in mainland China, partially because they possessed more negative attitudes toward aging. Interventions for depression may include components of improving attitudes toward aging. [ABSTRACT FROM AUTHOR]

An integrated emergy and economic evaluation of a 7-step ecological engineering system (7-step EES) located in Jiangsu Province, China was carried out. This 7-step EES was constructed to fully utilize existing S. alterniflora production through a low waste, clean production process and to help control the expansion of this invasive grass. First, the above ground S. alterniflora biomass removed for invasion control is used as the feedstock for the extraction of a bio-mineral liquid and its encapsulation, both of which provide a health supplement to treat gout and angiocardiopathy patients. Next, the residues left after extraction are used as a medium for mushroom cultivation, and then for raising earthworms. Finally, the remaining residues become the main component of a microbe enriched organic fertilizer, which is then returned to the soil. A suite of emergy indices were constructed on multiple temporal and spatial scales to examine the operation of the whole system and its subsystems. The results showed that the temporal sustainability of the 7-step EES was relatively high at different spatial scales, especially at the local scale as indicated by its EISD LS (1.55E+03). Full implementation of the 7-step EES for S. alterniflora currently residing on the coast of China can result in a potential economic output that is greater than 2% of the national GDP, with an economic output/input ratio over 29. In addition, the 7-step EES had an environmental loading ratio lower than that of the regional system. Sensitivity analysis showed that decreasing the cost of the purchased inputs needed to make the capsules is the key problem that needs to be solved to optimize the system, both for its sustainability and economic viability, on all spatial and temporal scales. • Indices were developed on multiple temporal and spatial scales for use in emergy evaluation. • The efficacy of a 7-step EES to utilize exotic S. alterniflora with low waste was evaluated. • Specific optimization points for the process were explored by sensitivity analysis. [ABSTRACT FROM AUTHOR]

Abstract: A field experiment was carried out in the coastal region of eastern China to determine an economic and environmentally friendly approach to saline soil bioremediation. The effects of inoculation with an arbuscular mycorrhizal fungus (AMF), Glomus mosseae, and a phosphate-solubilizing fungus Mortierella sp. on the physico-chemical and biological characteristics of coastal saline soil in the rhizospheres of castor bean (Ricinus communis L.) were assessed during the two-year growing season. Co-inoculation with G. mosseae and Mortierella sp. enhanced the survival percentage and growth of castor bean. AMF colonization in July and September, bacterial population in September, and actinomyces population in July were also improved by microbe inoculation. Soil electrical conductivity values and Na concentrations after microbe inoculation were significantly lower than those in non-inoculation treatments in July and September. P and organic matter content in the soil were significantly enhanced by microbe inoculation during the entire growing season. However, hydrolyzable N content increased only in June and July. No significant differences in soil pH were observed in the inoculation and non-inoculation treatments. Inoculation induced significantly stimulating effects on alkaline phosphatase and catalase activities in July as well as on urease activity in July and August. Invertase activity was stimulated in the entire growing period, except in July. The results indicate that castor bean inoculated with fungi may enlarge the C pool of the coastal saline soil. [Copyright &y& Elsevier]

Abstract: In order to conserve the remaining rare dolomite rocks and restore Mt. Mufu, a forest restoration program has been implemented over ten years. Emergy analysis was used to evaluate the current status of the restored ecosystem, in addition, the ecological potential of the fully developed system was predicted and analyzed. Four main emergy indices of the two systems, EYR, EIR, ELR, and ESI, were calculated and compared. In addition, a relatively new emergy index, PYR, was used to evaluate the restored forest system''s ecological potential. The results revealed that the current restored forest system was still in the initial stage of ecological restoration but it has already resulted in several positive effects, such as richness of plant biodiversity and improving air condition. The value of the predicted system''s PYR is as great as 201.53, demonstrating that the restored forest system has a great potential for ecological development in the future. [Copyright &y& Elsevier]

Abstract: A field experiment was conducted in 2007–2009 in coastal saline regions of Yancheng city in Jiangsu province of China (120°13′E, 33°38′N). The experiment was to investigate relationships among canopy spectral reflectance, canopy chlorophyll density (CCD), leaf area index (LAI), and yield of two Chinese castor varieties (Zi Bi var. and Yun Bi var.) across four N fertilizer rates of 0, 90, 180, and 360kgNha−1. These N rates were used to generate a wide range of difference in canopy structure and seed yield. Measurements of canopy reflectance were made throughout the growing season using a hand-held spectroradiometer. Samples for CCD and LAI were obtained on days that reflectance measurements were made. Fifteen hyperspectral reflectance indices were calculated. Canopy spectral characteristics were heavily influenced by saline soil background in the rapid growing period (RGP), thus hyperspectral data obtained in this period were not suited for reflecting castor growth condition or predicting final yield. CCD increased linearly with most reflectance indices in the full coverage period (FCP) and senescent period (SP) for the two castor varieties, whereas LAI did not. Most of reflectance indices were significantly correlated with yield of two varieties in different growing periods. The OSAVI model provided the best yield prediction for Zi Bi var. with predicted values very close to observed ones (R 2 =0.799), and the mSRVI705 model was well used for Yun Bi var. yield estimation (R 2 =0.759). These results indicate that the hyperspectral data measured at appropriate time could be well used for castor yield estimation. [ABSTRACT FROM AUTHOR]

Abstract: Kosteletzkya virginica, a perennial dicot halophytic species of the Malvaceae, is native to American salt marsh. It was introduced into China as a potential species to improve coastal wetlands and to develop ecologically sound saline agriculture. K. virginica adapts excellently to the tidal-flat habitats in China''s east coast, with multiple eco-benefits; in particular, its seed oil could be used to produce biodiesel. The purpose of this study was thus to develop a standardized protocol to induce a high frequency of callus and subsequent plantlet regeneration system for a K. virginica breeding program with the final objective of applying transgenic techniques to improve seed oil yield. The embryonic axes of K. virginica were used as explants for callus induction, shoot induction from the callus and then adventitious root induction from the shoots on nine culture media with different hormone combinations. The best results were achieved on the following media: (1) 93.94% callus induction on MS medium supplemented with 1.0mgL−1 indole-3-acetic acid (IAA), 0.3mgL−1 kinetin, 30gL−1 sucrose and 8gL−1 agar; (2) 65.83% shoot induction on 1/2MS medium supplemented with 0.1mgL−1 IAA, 0.5mgL−1 zeatin, 30gL−1 sucrose and 8gL−1 agar; (3) 96.67% rooting on MS medium containing 30gL−1 sucrose and 8gL−1 agar. The survival rate of plantlets by organogenic regeneration was 85% after being transplanted into potting soil in flowerpots and placed in the greenhouse. This experiment indicates that we established successful callus induction and plant regeneration protocols for K. virginica. [Copyright &y& Elsevier]

Evaluating the ecological and economic benefits of nature reserves in a fair way is a difficult problem confronting not only conservation scientists and managers but also governments and private land owners. Nature reserves and other social and economic land uses must be evaluated on an objective basis to provide an accurate measure of relative benefits for decision-making. The ecological and economic benefits of various land uses can be expressed in equivalent terms using emergy as a common denominator. Emergy synthesis is a biophysical, donor-based method of valuation that we used to assess the ecological-economic system of the Yancheng Biosphere Reserve (YBR) in North Jiangsu Province, China. In this paper, we introduce new emergy measures designed especially to capture the conservation value of natural lands, as well as a measure of the economic viability of nature reserves. The network structure of natural resources, economic production, and conservation activities in Yancheng reserve was examined and compared to the Maipo Nature Reserve (MNR) in Hong Kong, and a salt marsh ecological-engineering system also in Yancheng. This study showed that there is about a 10:1 return on the emergy invested by government in operating the Yancheng Biosphere Reserve, which is a major migratory stop-over and wintering site for the endangered red-crowned crane (Grus japonensis). Only 2.2% of the support for conservation in YBR comes from the private sector compared to 41.4% for MNR. One way to improve social self-sufficiency of the reserve is to develop ecotourism and private donors, which will increase economic vitality and mitigate the intense economic competition for reserve land. [Copyright &y& Elsevier]

Aims: To evaluate the risk of type 2 diabetes mellitus (T2DM) in a prospective study with hypertriglyceridemic waist-to-height ratio (HWHtR) and its dynamic status.Methods: We collected data for 12,248 participants ≥18 years in this study. Cox's proportional-hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for T2DM risk by baseline HWHtR. Multiple logistic regression analysis was used to estimate odds ratios (ORs) and 95% CIs for T2DM risk by transformation in HWHtR.Results: We identified 839 T2DM cases during a median follow-up of 5.92 years. Compared with normal TG level and normal WHtR, T2DM risk was increased with high TG level and high WHtR (aHR 2.04, 95% CI 1.49-2.79). Similar results were observed in subgroup analyses by sex and age. During follow-up, T2DM risk was increased with stable high TG level and high WHtR (aOR 4.45, 95% CI 2.76-7.17) compared with stable normal TG level and normal WHtR. The results above were robust in sensitivity analyses.Conclusions: HWHtR phenotype and its dynamic status were associated with risk of T2DM. Our study suggests that primary prevention and avoiding the appearance of the HWHtR phenotype in the rural Chinese population may reduce the T2DM risk. [ABSTRACT FROM AUTHOR]

Background: To assess the associations of single-nucleotide polymorphisms (SNPs) and methylation of transcription factor 7-like 2 (TCF7L2) gene with type 2 diabetes mellitus (T2DM) risk and further explore the interactions among SNPs, methylation, and environmental factors involved in T2DM risk.Methods: We conducted a nested case-control study with 290 pairs of T2DM cases and matched controls. We genotyped 3 SNPs of TCF7L2 in all included participants and tested 14 CpG loci of TCF7L2 in 76 pairs of cases and controls. Conditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for T2DM risk according to SNPs and methylation of TCF7L2. Multifactor dimensionality reduction (MDR) analysis was used to explore the potential TCF7L2 gene-environment interactions in T2DM risk.Results: We found no statistically significant association between the TCF7L2 polymorphisms and T2DM risk. We observed significant positive associations of methylation at CpG5 and CpG7_8 with T2DM risk. For each 1% increase in DNA methylation at CpG5 and CpG7_8, T2DM risk increased 12% (OR 1.12, 95% CI 1.01-1.25) and 32% (OR 1.32, 95% CI 1.07-1.63), respectively. Additionally, MDR analyses identified significant SNP-environment interactions among rs290487, alcohol drinking, and hypertension and methylation-environment interactions among CpG5, CpG7_8 and hypertension (P <0.05).Conclusions: TCF7L2 polymorphisms were not independently associated with T2DM risk. However, TCF7L2 methylation were positively associated with T2DM risk in rural Chinese adults. Interactions among TCF7L2 polymorphisms, TCF7L2 methylation and environmental factors also suggest a possible etiologic pattern for T2DM. [ABSTRACT FROM AUTHOR]

Background and Aims: Few researchers have compared the effectiveness of traditional and novel obesity indicators in predicting stroke incidence. We aimed to evaluate the associations between six obesity indices and stroke risk, and to further identify the optimal indicator., Methods and Results: A total of 14,539 individuals from the Rural Chinese Cohort Study were included in the analyses. We used the Cox proportional hazards regression models to evaluate the association between six obesity indices (including body mass index [BMI], waist circumference [WC], conicity index [C-index], lipid accumulation product [LAP], visceral adiposity index [VAI], and Chinese visceral adiposity index [CVAI]) and stroke risk. Receiver operating characteristic curves were employed to compare their predictive ability on stroke risk. During a median follow-up period of 11.13 years, a total of 1257 cases of stroke occurred. In the multiple-adjusted Cox regression model, WC, BMI, C-index, and CVAI were positively associated with ischemic stroke (P < 0.01) rather than hemorrhagic stroke risk. Dose-response analyses showed a linear correlation of WC, BMI, C-index, and LAP (P overall <0.05, and P nonlinear >0.05), but a non-linear correlation of CVAI (P overall <0.05, and P nonlinear <0.05) with the risk of ischemic stroke. CVAI demonstrates the highest areas under the curves (AUC: 0.661, 95% CI: 0.653-0.668), indicating a superior predictive ability for ischemic stroke occurrence compared to other five indices (P < 0.001)., Conclusion: WC, BMI, C-index, LAP, and CVAI were all positively related to the risk of ischemic stroke, among which CVAI exhibited stronger predictive ability for ischemic stroke., Competing Interests: Declaration of competing interest The author declare that they have no competing interests., (Copyright © 2024 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Our aim was to examine the independent and joint associations of estimated cardiorespiratory fitness (CRF) and its changes and obesity with risk of hypertension in a rural Chinese population. A prospective cohort including 9848 adults without hypertension at baseline was enrolled. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated by logistic regression models. Restricted cubic splines were used to model the dose-response relationship. During 6 years follow-up, 2,019 individuals developed hypertension. A negative association between estimated CRF and hypertension incidence was observed, with the risk being 0.87 (0.84-0.90) per MET increment. For estimated CRF change, the risks of hypertension were 1.50 (1.27-1.77) and 0.75 (0.59-0.97) for decreasers and increasers, respectively, compared to maintainers. Joint analyses showed individuals in the overweight/obesity-fourth quartile of estimated CRF had a 2.08 times higher risk of hypertension than those in the normal weight-first quartile (P interaction  < 0.05). Those overweight/obesity-decreasers had the highest risk (OR: 2.19, 95%CI: 1.71-2.81; P interaction  < 0.05) compared to the normal-maintainers. Similar results for abdominal obesity were also observed. Estimated CRF and its dynamic changes showed a negative association with hypertension incidence in the rural Chinese population., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Adherence to post-exposure prophylaxis and post-exposure vaccination (PEV) is an important measure to prevent rabies. The purpose of this study was to explore the adherence to the vaccination protocol and its influencing factors among rabies-exposed patients in Shenzhen, China. A cross-sectional survey was conducted in a tertiary hospital in Shenzhen, China, to obtain epidemiological characteristics of patients; knowledge, attitude, and practice scores of rabies prevention; and medical records. A total of 326 patients requiring full rabies PEV were included in this study, and only 62% (202) completed the full course of vaccination according to the norms of the vaccination guidelines. After multifactor logistic regression, the factors influencing adherence to vaccination were as follows: age 31 to 40 years, time spent to reach the nearest rabies prevention clinic was >60 min, the time of injury was at night to early morning, the place of injury was a school/laboratory, the animal causing injury was a cat, the health status of the animal causing injury could not be determined, and patients with higher practice scores (all p <0.05). Understanding the factors influencing rabies vaccination adherence among rabies-exposed patients in urban areas of China and promote changes in patients' practice toward rabies prevention is essential for rabies elimination by 2030.

Objective: This study aimed to investigate the sex-specific association between hyperuricemia and the risk of hypertension and whether obesity mediates this association., Methods: This study included 31,395 (47.0% women) adults without hypertension, cardiovascular disease, or cancer at baseline who completed at least one follow-up annual examination between 2009 and 2016. Cox regression models were performed to calculate hazard ratios and 95% confidence intervals. Mediation analysis was conducted to estimate the effect of body mass index on the association between hyperuricemia and hypertension., Results: During a median 2.9-year follow-up, hyperuricemia was significantly associated with a higher risk of hypertension (HR 1.15, 95%CI 1.07-1.24 for all participants; HR 1.12, 95%CI 1.03-1.22 for men; and HR 1.23, 95%CI 1.02-1.48 for women) after adjustment for potential confounders. Additional adjustment for body mass index attenuated this association (HR 1.09, 95%CI 1.08-1.10 for all participants; HR 1.07; 95%CI 0.98-1.16 for men; HR 1.18; 95%CI 0.96-1.44 for women). Mediation analysis showed that BMI partially mediated the relationship between hyperuricemia and incident hypertension (indirect effect HR 1.09, 95%CI 1.08-1.10; direct effect: HR 1.08, 95%CI 1.02-1.15). The percentage of the mediation effect was 53.2% (95%CI 37.9-84.5)., Conclusion: Hyperuricemia is associated with a risk of hypertension in both sexes, and BMI partially mediates hyperuricemia-related incident hypertension.

To estimate the associations between single-nucleotide polymorphisms (SNPs) and methylation of SLC30A8 gene and T2DM risk, and the interactions among SNPs, methylation, and environmental factors on T2DM risk. We genotyped 9 SNPs and tested methylation at 46 CpG loci of SLC30A8 in the baseline DNA of 290 T2DM cases and 290 matched controls nested in the Rural Chinese Cohort Study. A conditional logistic regression model was used to estimate the associations between SNPs and SLC30A8 methylation and T2DM risk. Multifactor Dimensionality Reduction analysis was used to estimate the effect of interactions among SNPs, methylation, and environment on T2DM risk. Probability of T2DM was decreased with rs11558471 (GG vs. AA, OR = 0.55, 95% CI 0.32, 0.96), with rs13266634 (TT vs. CC, OR = 0.55, 95% CI 0.32, 0.94), with rs3802177 (AA vs. GG, OR = 0.54, 95%CI 0.31, 0.94), and its probability was increased with rs2466293 of SLC30A8 (GA vs. AA, OR = 1.63, 95% CI 1.08-2.47). Its probability was also significantly associated with methylation of CG9 and CG45 (OR = 0.56 [95% CI 0.33-0.97] and 1.61 [95%CI 1.03--2.51]). T2DM probability was significantly associated with the interaction effect between rs2466293 and hypertension (p = 0.045). T2DM probability was also significantly associated with the combination effects of rs2466293 with BMI, hypertension, and hypertriglyceridemia, with the combination effects of hypertriglyceridemia with rs11558471, rs13266634, and methylation of CG45., (© 2022. The Author(s), under exclusive licence to The Japan Society of Human Genetics.)

Background: Neurocognitive impairments are prevalent among older people in China. It is more problematic among older people living with HIV., Objective: This study aims to compare neurocognitive performance between older people living with HIV and HIV-negative controls, and to explore whether the association between HIV status and neurocognitive performance was mediated by depressive symptoms and level of physical activity., Methods: A cross-sectional study was conducted in Yongzhou, China. All people living with HIV aged ≥50 years listed in the registry were invited. Frequency matching was used to sample HIV-negative controls from the general population according to the distribution of age, sex, and years of formal education of older people living with HIV. A total of 315 older people living with HIV and 350 HIV-negative controls completed the face-to-face interview and comprehensive neuropsychological assessment of seven domains (learning, memory, working memory, verbal fluency, processing speed, executive function, and motor skills)., Results: As compared to HIV-negative controls, older people living with HIV performed worse in global score and all seven domains (P<.05). HIV infection was associated with higher depressive symptoms (P<.001) and lower level of physical activity (P<.001). Depressive symptoms and physical activity were negatively correlated (P<.001). Depressive symptoms and level of physical activity mediated the association between HIV status and global z-score and four domain z-scores of neurocognitive performance (learning, memory, verbal fluency, and processing speed)., Conclusions: Change in mental health and physical activity after HIV infection may partially explain why older people living with HIV are more susceptible to neurocognitive impairment. Promoting mental health and physical activity are potential entry points to slow down the progress of neurocognitive impairment among older people living with HIV., (©Pei Qin, Jianmei He, Xue Yang, Siyu Chen, Xi Chen, Hui Jiang, Ada Wai Tung Fung, Zixin Wang, Joseph Tak Fai Lau. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 19.08.2022.)

Aims: The evidence for association between cardiovascular health (CVH) metrics and type 2 diabetes mellitus (T2DM) in Chinese population is limited. We explored the association between the number of ideal CVH metrics and risk of incident T2DM in a rural Chinese population., Materials and Methods: A total of 12,150 rural Chinese participants (median age 51 years) were enrolled. A Cox proportional-hazards model was used to assess the association between the number of ideal CVH metrics and risk of incident T2DM by using hazard ratios (HRs) and 95% confidence intervals (CIs). We another conducted multiplicative and additive interaction effect between the number of ideal CVH metrics and sex or age on incident T2DM, and subgroup analyses of the association were also conducted by sex and age., Results: During a median of 6.01 years of follow-up, 840 incident cases of T2DM occurred. The number of ideal CVH metrics was negatively associated with risk of incident T2DM (per unit increase: HR = 0.76, 95% CI 0.70-0.82). We also observed both multiplicative and additive interaction effect between lower number of ideal CVH metrics and sex on incident T2DM, and multiplicative interaction effect between lower number of ideal CVH metrics and age on incident T2DM was observed. The association remained statistically significant for both men and women, or participants with age < 65 years., Conclusions: Increasing number of ideal CVH metrics was associated with reduced risk of incident T2DM, which presented age- and sex-related differential associations., (© 2022. Springer-Verlag Italia S.r.l., part of Springer Nature.)

Objectives: Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), easily accessible systemic inflammation response parameters, were reported to associate with poor lung cancer prognosis. However, research on the effects of these markers on the risk of positive nodules (PNs) and lung cancer is limited., Methods: Participants in this retrospective study were those who had their first computed tomography (CT) screening at Jiangsu Province Hospital's Health Promotion Center between January 1, 2017 and December 31, 2020. We identified PNs (≥6 mm in diameter) from free text of CT reports and lung cancer from medical records. Multivariate logistic analysis was used to assess the association between NLR, PLR, or SII and PNs or lung cancer., Results: The detected rate of PNs was 9.60% among the 96,476 participants. Age, smoking and body mass index were possible influencing factors for PNs. We observed linear dose-effect relationship between NLR, PLR, or SII and PNs (p non-linear  > 0.05). Compared with low quintile, participants with top quintiles of NLR, PLR or SII had an increased risk of PNs, with the adjusted ORs of 1.19 (1.11-1.28), 1.11 (1.04-1.19) or 1.11 (1.03-1.18), respectively. Meanwhile, NLR showed the U-shaped relationship with lung cancer, with adjusted ORs of 1.40 (1.08-1.81) comparing highest NLR quintile to the third quintile. The high PLR and SII showed significantly associated with lung cancer with adjusted ORs of 1.29 (0.99-1.68) and 1.35 (1.04-1.74) comparing to the lowest quintile., Conclusions: The high levels of systemic inflammation markers were associated with the risk of positive pulmonary nodules and lung cancer, which suggested systemic immune response may be an important pre-clinical feature for the early identification of diseases., (© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Background and Aims: The purpose of this study is to explore the relationship between Chinese visceral adipose index (CVAI) and the risk of coronary heart disease (CHD) in Chinese through a large cohort study., Methods and Results: This study included 42,165 adults who were without CHD at baseline and who completed at least one annual follow-up between 2009 and 2016. We used the Cox proportional hazards model to estimate Hazard Ratios (HRs) and 95% Confidence Intervals (CIs) for the association between CVAI and risk of CHD. During the median follow-up of 3.36 years (154,808 person years), 520 participants developed CHD, including 374 males and 146 females. Compared with the first quartile of CVAI, the risk of CHD was significantly increased in the fourth quartile of CVAI in multivariate model (HR [95% CI]: 9.92 [5.45, 18.04], P < 0.001). Sensitivity analysis by excluding incident CHD developed in the first two years of follow-up reinforced our results. Gender stratification analyses showed that the relationship between CVAI and CHD risk was higher in males than that in females. The restricted cubic spline showed a non-linear dose-response relationship between CVAI and CHD risk. In addition, CVAI was associated with CHD risk in the subgroups of participants without T2DM, without hypertension, and without fatty liver., Conclusion: CVAI was significantly associated with the risk of CHD. Individuals should keep CVAI at normal level to prevent CHD., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Background We aimed to evaluate the association between the Chinese visceral adiposity index (CVAI) and its dynamic change and risk of carotid plaque based on a large Chinese cohort. Methods and Results This cohort included 23 522 participants aged 20 to 80 years without elevated carotid intima-media thickness and carotid plaque at baseline and who received at least 2 health checkups. CVAI was calculated at baseline and at every checkup. The dynamic change in CVAI was calculated by subtracting CVAI at baseline from that at the last follow-up. Cox proportional hazard regression model was used to estimate hazard ratios (HRs) and 95% CIs. The restricted cubic spline was applied to model the dose-response association between CVAI and carotid plaque risk. During the 82 621 person-years of follow-up, 5987 cases of carotid plaque developed (7.25/100 person-years). We observed a significant positive correlation between CVAI and carotid plaque risk (HR, 1.53; 95% CI, 1.48-1.59 [ P <0.001]) in a nonlinear dose-response pattern ( P nonlinearity <0.001). The sensitivity analyses further confirmed the robustness of the results. The association was significant in all subgroup analyses stratified by sex, hypertension, and fatty liver disease except for the diabetes subgroup. The association between CVAI and carotid plaque risk was much higher in men than in women. No significant association was identified between change in CVAI and carotid plaque risk. Conclusions CVAI was positively associated with carotid plaque risk in a nonlinear dose-response pattern in this study. Individuals should keep their CVAI within a normal level to prevent the development of carotid plaque.

Mangrove actinomycetia are considered one of the promising sources for discovering novel biologically active compounds. Traditional bioactivity- and/or taxonomy-based methods are inefficient and usually result in the re-discovery of known metabolites. Thus, improving selection efficiency among strain candidates is of interest especially in the early stage of the antibiotic discovery program. In this study, an integrated strategy of combining phylogenetic data and bioactivity tests with a metabolomics-based dereplication approach was applied to fast track the selection process. A total of 521 actinomycetial strains affiliated to 40 genera in 23 families were isolated from 13 different mangrove soil samples by the culture-dependent method. A total of 179 strains affiliated to 40 different genera with a unique colony morphology were selected to evaluate antibacterial activity against 12 indicator bacteria. Of the 179 tested isolates, 47 showed activities against at least one of the tested pathogens. Analysis of 23 out of 47 active isolates using UPLC-HRMS-PCA revealed six outliers. Further analysis using the OPLS-DA model identified five compounds from two outliers contributing to the bioactivity against drug-sensitive A. baumannii . Molecular networking was used to determine the relationship of significant metabolites in six outliers and to find their potentially new congeners. Finally, two Streptomyces strains (M22, H37) producing potentially new compounds were rapidly prioritized on the basis of their distinct chemistry profiles, dereplication results, and antibacterial activities, as well as taxonomical information. Two new trioxacarcins with keto-reduced trioxacarcinose B, gutingimycin B ( 16 ) and trioxacarcin G ( 20 ), together with known gutingimycin ( 12 ), were isolated from the scale-up fermentation broth of Streptomyces sp. M22. Our study demonstrated that metabolomics tools could greatly assist classic antibiotic discovery methods in strain prioritization to improve efficiency in discovering novel antibiotics from those highly productive and rich diversity ecosystems.

Background: The evidence for the association between metabolic score for insulin resistance (METS-IR) and type 2 diabetes mellitus (T2DM) is limited. We aimed to explore the association of METS-IR and its 6-year change with risk of incident T2DM in a rural Chinese population., Methods: We analyzed data for 12 107 participants (mean age 50.48 years). A Cox proportional-hazard model was used to estimate the association of METS-IR with incident T2DM by using hazard ratios (HRs) and 95% confidence intervals (CIs); a logistic regression model was used to assess the association of 6-year METS-IR change with incident T2DM by using odds ratios (ORs) and 95% CIs. We used subgroup analyses of the association of METS-IR and its 6-year change with incident T2DM by sex, age, and baseline fasting plasma glucose (FPG) level as well as restricted cubic splines to describe the dose-response association., Results: The association of METS-IR and 6-year METS-IR change with incident T2DM was significant (per SD unit increase: HR = 1.80, 95% CI: 1.60-2.02 for METS-IR, OR = 1.42, 95% CI: 1.28-1.57 and OR = 1.59, 95% CI: 1.44-1.76 for relative and absolute METS-IR change). The significant association remained on subgroup analyses by sex, age, and baseline FPG level. Dose-response analysis demonstrated that the probability of incident T2DM was significantly increased with increasing METS-IR and 6-year METS-IR change., Conclusions: Increased METS-IR and 6-year METS-IR change were positively associated with risk of incident T2DM in a rural Chinese population. METS-IR may be a vital indicator for identifying T2DM., (© 2021 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)

The present study aimed to investigate the association of the Chinese visceral adiposity index (CVAI) and its 6-year change with hypertension risk and compare the ability of CVAI and other obesity indices to predict hypertension based on the Rural Chinese Cohort Study. Study participants were randomly recruited by a cluster sampling procedure, and 10 304 participants ≥18 years were included. Modified Poisson regression was used to derive adjusted relative risks (RR) and 95 % CI. We identified 2072 hypertension cases during a median of 6·03 years of follow-up. The RR for the highest v. lowest CVAI quartile were 1·29 (95 % CI 1·05, 1·59) for men and 1·53 (95 % CI 1·22, 1·91) for women. Per-sd increase in CVAI was associated with hypertension for both men (RR 1·09, 95 % CI 1·02, 1·16) and women (RR 1·14, 95 % CI 1·06, 1·22). Also, the area under the receiver operating characteristic curve value for hypertension was higher for CVAI than the four other obesity indices for both sexes (all P < 0·05). Finally, per-sd increase in CVAI change was associated with hypertension for both men (RR 1·26, 95 % CI 1·16, 1·36) and women (RR 1·23, 95 % CI 1·15, 1·30). Similar results were observed in sensitivity analyses. CVAI and its 6-year change are positively associated with hypertension risk. CVAI has better performance in predicting hypertension than other visceral obesity indices for both sexes. The current findings suggest CVAI as a reliable and applicable predictor of hypertension in rural Chinese adults.

Objective: The association between non-alcoholic fatty liver disease (NAFLD) and thyroid hormones in euthyroid subjects is unclear. We investigated the relationship between thyroid function and the severity of hepatic steatosis and liver fibrosis in a large cohort of euthyroid Chinese adults., Methods: A total of 3496 participants were enrolled. Liver ultrasonography was used to define the presence of NAFLD (n=2172) or the absence of NAFLD (n=1324). Anthropometric and biochemical measurements were made and thyroid function parameters including free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH) were measured. The severity of hepatic steatosis and liver stiffness was assessed by transient elastography., Results: Levels of FT3 were significantly higher in the severe NAFLD group and moderate NAFLD group than in the mild NAFLD group (5.18 ± 0.58 vs 5.11 ± 0.57 vs 4.98 ± 0.60 pmol/L, P <0.001). Participants with F4 and F3 liver fibrosis had higher FT3 levels than those with F2 fibrosis (6.33 ± 0.39 vs 5.29 ± 0.48 vs 5.20 ± 0.50 pmol/L, P <0.001). However, FT4 and TSH levels did not correlate with hepatic steatosis or liver fibrosis severity. In addition, the proportions of participants with NAFLD (46.0% vs 63.1% vs 73.3%, P <0.001) and liver fibrosis (11.5% vs 18.6% vs 20.8%, P <0.001) increased as FT3 levels increased. Logistic regression analysis showed that FT3 levels were positively associated with the severity of hepatic steatosis and liver fibrosis presence, even after adjustment for metabolic risk factors including BMI. In non-obese participants, the FT3 level was an independently risk factor for the severity of hepatic steatosis., Conclusions: There are positive associations of FT3 levels with the severity of hepatic steatosis and the presence of liver fibrosis in NAFLD with euthyroidism., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Guo, Qin, Li, Wu, Lu, Zhu, Diao, Xu and Zhang.)

To investigate the association of blood pressure (BP) categories with total and premature cardiovascular disease (CVD) mortality in rural Chinese. The study included 14,539 adults ≥18 years in rural China. Baseline study visits were conducted in 2007-2008, and follow-up visits in 2013-2014. Data were collected by face-to-face questionnaire interview, and anthropometric and laboratory measurements. A sub-distribution hazards model was used to calculate adjusted sub-distribution hazard ratios (aSHRs) and 95% confidence intervals (CIs). During the 6-year follow-up, 257 total and 209 premature CVD deaths occurred. As compared with normal BP (systolic BP/diastolic BP (SBP/DBP) < 120/80 mmHg), for men and people aged ≥60 years, hypertension (SBP/DBP ≥ 140/90 mmHg) associated with total CVD mortality (aSHR 3.57, 95% CI 2.06-6.17; aSHR 2.15, 1.29-3.56) and premature CVD mortality (aSHR 4.41, 2.37-8.21; aSHR 2.31, 1.27-4.19). Also, as compared with normal BP, for men and people aged ≥60 years with high normal BP (SBP/DBP 120-139/80-89 mmHg), risk of total CVD mortality increased (aSHR 1.85, 1.05-3.28; aSHR 1.78, 1.05-3.04), as was premature CVD mortality (aSHR 1.89, 0.99-3.64; aSHR 1.91, 1.03-3.54). Among men and people aged ≥60 years in rural China, risk of total and premature CVD mortality was increased for those with high normal BP and hypertension. Prevention and treatment strategies for additional CVD risk reduction targeting men and elderly people with hypertension or even high normal BP are needed to reduce CVD mortality risk., (© 2020. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Serum alkaline phosphatase (ALP) has been recognized as a biomarker of cardiovascular disease (CVD) risk, recently. This study aimed to explore the association of ALP with arterial stiffness and 10-year CVD risk., Methods: A total of 12 539 participants without CVD who underwent health examinations including serum ALP level were retrospectively analysed. Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV), and 10-year CVD risk was evaluated by Framingham risk score., Results: All participants were stratified into four groups according to the quartile of serum ALP. Participants with high ALP quartiles had higher cardiovascular parameters and baPWV, as well as an increase 10-year CVD risk. There was a dose-response relationship between serum ALP level and baPWV (OR = 1.134, 95% CI 1.103-1.165, P < .001). Logistic regression analysis showed that serum ALP was positively associated with elevated baPWV and 10-year CVD risk after adjustment for traditional CVD risk factors in both women and men. In receiver operating characteristic (ROC) curve analysis, the optimal cut-off point of serum ALP for elevated baPWV was 84U/L and the area under the ROC curve (AUROC) was 0.740 (95% CI 0.726-0.754, P < .001), with 71.2% and 63.4% sensitivity and specificity, respectively, in women. The AUROC of serum ALP in women was larger than that in men [0.575 (95% CI 0.559-0.590), P < .001]., Conclusions: Serum ALP is independently associated with arterial stiffness and 10-year CVD risk. Our results imply that serum ALP may be a promising marker to identify an increased risk for subclinical atherosclerosis in women needing further evaluation., (© 2021 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)