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Background: Fine particulate matter (PM 2.5 ) is a recognized risk factor for respiratory and cardiovascular diseases, but the association between PM 2.5 and rheumatoid arthritis (RA) is still controversial. Additionally, evidence on the relationship of green space with RA is scarce. This study aimed to investigate the separate and combined associations of PM 2.5 and green space with risk of RA., Methods: Our study involved 30,684 participants from the Yinzhou cohort in Ningbo, China. PM 2.5 concentrations were determined using a land-use regression model. Residential green space was assessed using the Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) from satellite images. We employed the Cox proportional hazard model to evaluate the relationships of PM 2.5 and green space with RA., Results: During the 176,894 person-years of follow-up period, 354 cases of RA were identified. Hazard ratio (HR) and the corresponding 95% confidence interval (95% CI) for every interquartile range (IQR) increase in PM 2.5 were 1.23 (95% CI: 1.02, 1.49). Compared with lower exposure to residential green space, individuals living in areas with more green space had a decreased risk of RA (HR was 0.80 (95% CI: 0.70, 0.92), 0.80 (95% CI: 0.70, 0.92), and 0.79 (95% CI: 0.70, 0.89) for 250m, 500m, and 1000m NDVI buffers, respectively). Similar results were observed for the association between EVI and RA. Furthermore, a significant multiplicative interaction was observed between PM 2.5 and green space (NDVI 250m and EVI 250m). No mediating effect of PM 2.5 on the relationship between green space and RA was observed., Conclusion: Our findings indicated that living in areas with higher green space was linked to a reduced risk of RA, whereas living in areas with higher PM 2.5 was associated with an increased risk of RA. The beneficial effect of high green space may be offset by exposure to PM 2.5 ., Competing Interests: Declaration of Competing Interest ☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ☐ The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:, (Copyright © 2024. Published by Elsevier Inc.)

Purpose: Severe open forearm fractures commonly involve segmental bone defects. Although several methods have been proposed to treat segmental bone defects with such fractures, research comparing the radiological and clinical outcomes of free vascularized fibular grafts (FVFG) and the Masquelet technique (MT) is rare., Methods: Data on 43 patients with open forearm fractures and segmental bone defects treated surgically in our hospital from January 2005 to January 2021 were retrospectively analyzed, and these patients were divided into an FVFG group (18 cases) and an MT group (25 cases). Clinical and radiological evaluations were performed regularly, and the minimum follow-up was 18 months., Results: All 43 patients were followed up for 18 to 190 months, with a mean of 46.93 months. The mean follow-up time was significantly longer in the FVFG group than in the MT group (p = 0.000). Bone healing time was 3-16 months, with a mean of 4.67 months. The QuickDASH score at the last follow-up was 0-38.6, with a mean of 17.71, and there was no statistically significant difference between the two groups. Operative time, hospital stay, and intraoperative bleeding for bone defect reconstruction were higher in the FVFG group compared to the MT group (p = 0.000), whereas the number of procedures was lower in the FVFG group than in the MT group (p = 0.035)., Conclusions: FVFG and the MT showed satisfactory clinical results for segmental bone defects of the forearm. Compared with FVFG, the MT exhibited a lower operative time, hospital stay, and intraoperative bleeding., Level of Evidence: Level IV. Trial registration This study was registered in the Chinese Clinical Trial Registry (registration no. ChiCTR2300067675; registered 17 January 2023), https://www.chictr.org.cn/showproj.html?proj=189458 ., (© 2024. The Author(s).)

Background: Air pollution and outdoor light at night (LAN) have been reported to be related to type 2 diabetes (T2D). However, their interaction with risk of T2D remains uncertain. Therefore, our study aimed to explore the relationship between outdoor LAN, air pollution and incident T2D., Methods: Our study included a cohort of 24,147 subjects recruited from 2015 to 2018 in Ningbo, China. Land use regression models were used to evaluate particulate matter with a diameter ≤2.5 μm (PM 2.5 ), ≤10 μm (PM 10 ) and nitrogen dioxide (NO 2 ). Satellite images data with a spatial resolution of 500m was used to estimate outdoor LAN levels. T2D new cases were identified by medical records based on health information system. Cox proportional hazards models were used to estimate Hazard ratios (HRs) and 95% confidence intervals (CIs). Moreover, we investigated the multiplicative and additive interactions between air pollution and outdoor LAN., Results: During 108,908 person-years of follow-up period, 1016 T2D incident cases were identified. The HRs (95% CIs) were 1.22 (1.15, 1.30) for outdoor LAN, 1.20 (1.00, 1.45) for PM 2.5 , 1.23 (1.11, 1.35) for PM 10 and 1.19 (1.04, 1.37) for NO 2 in every interquartile range increase, respectively. Furthermore, significant interactions were observed between outdoor LAN and NO 2 ., Conclusions: Our findings indicated that air pollution and outdoor LAN were positively associated with T2D. Moreover, we observed an interaction between outdoor LAN and NO 2 suggesting that stronger associations for outdoor LAN and T2D in areas with higher levels of NO 2 , and for NO 2 and T2D in areas with higher levels of outdoor LAN., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Low permeability barrier has emerged as a promising, cost-effective technology for anti-seepage and pollution mitigation in geotechnical engineering. However, its efficacy in organic pollution sites, particularly those contaminated with chlorinated hydrocarbons (CHCs) pales in comparison to its performance in areas contaminated by heavy metals. In order to rectify this deficiency, a novel bentonite backfill, modified with dihexadecyl dimethyl ammonium chloride (DDAC) and designated as DDAC-LPB, is proposed for use in low permeability barriers to contain CHCs in groundwater at contaminated sites. A series of rigid-wall permeability tests, mechanical properties tests, and diffusion tests were conducted to investigate the impact of CHCs solution on hydraulic conductivity, unconfined compression strength and adsorption properties of the LPB, respectively. The results reveal that LPB containing 10 % DDAC modified bentonite exhibits excellent impermeability and mechanical workability, with a 2-5 fold increase in adsorption capacity, primarily driven by the hydrophobic interaction between CHCs and DDAC. Moreover, this study has innovatively applied computational fluid dynamics simulation to the field of solute transport modeling to evaluate the performance of DDAC-LPB in containing CHCs within lateral flowing groundwater. This novel approach was benchmarked against the widely embraced convection-diffusion equation modeling method, demonstrating a significant improvement in predictive accuracy. In a typical field scenario, the breakthrough time for CHCs using the DDAC-LPB technique ranged from 25.3 to 25.5 years, with a barrier thickness of 1 m. This duration satisfactorily aligns with the expected service life of real-world projects. Overall, the DDAC-LPB has demonstrated superior performance and practical applicability in enhancing the containment of CHCs in contaminated groundwater., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

To investigate the genetic basis of processing quality- and yield-related traits in bread wheat ( Triticum aestivum L., AABBDD), a systematic analysis of wheat processing quality- and yield-related traits based on genome-wide association studies (GWASs) of 285 regional test lines of wheat from Hebei province, China, was conducted. A total of 87 quantitative trait loci (QTL), including twenty-one for water absorption (WA), four for wet gluten content, eight for grain protein content, seventeen for dough stability time (DST), thirteen for extension area (EA), twelve for maximum resistance (MR), five for thousand-grain weight (TGW), one for grain length, and six for grain width were identified. These QTL harbored 188 significant single-nucleotide polymorphisms (SNPs). Twenty-five SNPs were simultaneously associated with multiple traits. Notably, the SNP AX-111015470 on chromosome 1A was associated with DST, EA, and MR. SNPs AX-111917292 and AX-109124553 on chromosome 5D were associated with wheat WA and TGW. Most processing quality-related QTL and seven grain yield-related QTL identified in this study were newly discovered. Among the surveyed accessions, 18 rare superior alleles were identified. This study identified significant QTL associated with quality-related and yield-related traits in wheat, and some of them showed pleiotropic effects. This study will facilitate molecular designs that seek to achieve synergistic improvements of wheat quality and yield.

A candidate reference measurement procedure (RMP) for serum theophylline via isotope dilution liquid chromatography-tandem mass spectrometry (LC-MS/MS) was developed. With a single-step precipitation pretreatment and a 6-min gradient elution, the method achieved baseline separation of theophylline and its analogs on a C18-packed column. A bracketing calibration method was used to ensure repeatable signal intensity and high measurement precision. The intra-assay and inter-assay imprecisions were 1.06%, 0.84%, 0.72% and 0.47%, 0.41%, 0.25% at concentrations of 4.22 µg/mL (23.40 µmol/L), 8.45 µg/mL (46.90 µmol/L), and 15.21 µg/mL (84.43 µmol/L), respectively. Recoveries ranged from 99.35 to 102.34%. The limit of detection (LoD) was 2 ng/mL, and the lowest limit of quantification (LLoQ) was 5 ng/mL. The linearity range extended from 0.47 to 60 µg/mL (2.61-333.04 µmol/L). No ion suppression and carry-over (< 0.68%) were observed. The relative bias for this candidate RMP that participated in 2023 External Quality Control for Reference Laboratories (RELA) conducted by the International Federation of Clinical Chemistry (IFCC) was within a range of 0.17 to 0.93%. Furthermore, two clinical immunoassay systems were compared with this candidate RMP, demonstrating good correlations. The results of the Trueness Verification Plan indicate significant differences among routine systems, highlighting the need for standardization efforts. The developed candidate RMP for serum theophylline serves as a precise reference baseline for standardizing clinical systems and assigning values to reference materials., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.)

A novel and environmentally friendly magnetic iron zeolite (MIZ) core-shell were successfully fabricated using municipal solid waste incineration bottom ash-derived zeolite (MWZ) coated with Fe 3 O 4 and innovatively investigated as a heterogeneous persulfate (PS) catalyst. The morphology and structure composition of as-prepared catalysts were characterised, and it was proved that the core-shell structure of MIZ was successfully synthesised by coating Fe 3 O 4 uniformly on the MWZ surface. The tetracycline hydrochloride (TCH) degradation experiment indicate that the optimum equimolar amount of iron precursors was 3 mmol (MIZ-3). Compared with other systems, MIZ-3 possessed a superior catalytic performance, and the degradation efficiency of TCH (50 mg·L -1 ) in the MIZ-3/PS system reached 87.3%. The effects of reaction parameters on the catalytic activity of MIZ-3, including pH, initial concentration of TCH, temperature, the dosage of catalyst, and Na 2 S 2 O 8 , were assessed. The catalyst had high stability according to three recycling experiments and the leaching test of iron ions. Furthermore, the working mechanism of the MIZ-3/PS system to TCH was discussed. The electron spin resonance (ESR) results demonstrated that the reactive radicals generated in the MIZ-3/PS system were sulphate radical ( S O 4 - ∙ ) and hydroxyl radical (•OH). This work provided a novel strategy for TCH degradation under PS with a broad perspective on the fabrication of non-toxic and low-cost catalysts in practical wastewater treatment.

Growing evidences showed that heavy metals exposure may be associated with metabolic diseases. Nevertheless, the mechanism underlying arsenic (As) exposure and metabolic syndrome (MetS) risk has not been fully elucidated. So we aimed to prospectively investigate the role of serum uric acid (SUA) on the association between blood As exposure and incident MetS. A sample of 1045 older participants in a community in China was analyzed. We determined As at baseline and SUA concentration at follow-up in the Yiwu Elderly Cohort. MetS events were defined according to the criteria of the International Diabetes Federation (IDF). Generalized linear model with log-binominal regression model was applied to estimate the association of As with incident MetS. To investigate the role of SUA in the association between As and MetS, a mediation analysis was conducted. In the fully adjusted log-binominal model, per interquartile range increment of As, the risk of MetS increased 1.25-fold. Compared with the lowest quartile of As, the adjusted relative risk (RR) of MetS in the highest quartile was 1.42 (95% confidence interval, CI: 1.03, 2.00). Additionally, blood As was positively associated with SUA, while SUA had significant association with MetS risk. Further mediation analysis demonstrated that the association of As and MetS risk was mediated by SUA, with the proportion of 15.7%. Our study found higher As was remarkably associated with the elevated risk of MetS in the Chinese older adults population. Mediation analysis indicated that SUA might be a mediator in the association between As exposure and MetS., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Aims: Comorbid anxiodepressive-like symptoms (CADS) in chronic pain are closely related to the overactivation of the lateral habenula (LHb). Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels have been implicated to play a key role in regulating neuronal excitability. However, the role of HCN channels in the LHb during CADS has not yet been characterized. This study aimed to investigate the effect of HCN channels in the LHb on CADS during chronic pain., Methods: After chronic neuropathic pain induction by spared nerve injury (SNI), mice underwent a sucrose preference test, forced swimming test, tail suspension test, open-field test, and elevated plus maze test to evaluate their anxiodepressive-like behaviors. Electrophysiological recordings, immunohistochemistry, Western blotting, pharmacological experiments, and virus knockdown strategies were used to investigate the underlying mechanisms., Results: Evident anxiodepressive-like behaviors were observed 6w after the SNI surgery, accompanied by increased neuronal excitability, enhanced HCN channel function, and increased expression of HCN2 isoforms in the LHb. Either pharmacological inhibition or virus knockdown of HCN2 channels significantly reduced LHb neuronal excitability and ameliorated both pain and depressive-like behaviors., Conclusion: Our results indicated that the LHb neurons were hyperactive under CADS in chronic pain, and this hyperactivation possibly resulted from the enhanced function of HCN channels and up-regulation of HCN2 isoforms., (© 2024 The Author(s). CNS Neuroscience & Therapeutics published by John Wiley & Sons Ltd.)

Aims: To explore the associations between visit-to-visit lipid variability and risk of ischemic heart disease (IHD) in a population-based cohort in China., Methods: We evaluated lipid variability in 30,217 individuals from the Yinzhou Health Information System who had ≥3 recorded lipid measurements during 2010-2014. We used various indicators including standard deviation (SD), coefficient of variation (CV), variability independent of the mean (VIM), and average real variability (ARV) to quantify the variability in triglycerides, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs)., Results: Overall, a total of 1305 participants with IHD were identified during the follow-up of 194,421 person-years. Subjects in Q4 had a 21% elevated risk of IHD (HR = 1.21, 95% CI: 1.03-1.41) for LDL-C variability (CV) compared with the reference (Q1). The HRs for Q4 vs Q1 were 1.21 (95% CI: 1.04-1.42) for HDL-C variability, and 1.28 (95% CI: 1.10-1.50) for TC variability. However, no association was observed between triglycerides variability and risk of IHD., Conclusions: Higher variability in LDL-C, HDL-C, and TC levels was associated with an elevated risk of IHD, suggesting that lipid variability could be considered as an independent risk factor of IHD., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Whether the dynamic weight change is an independent risk factor for mortality remains controversial. This study aimed to examine the association between weight change and risk of all-cause and cause-specific mortality based on the Linxian Nutrition Intervention Trial (NIT) cohort., Methods: Body weight of 21,028 healthy residents of Linxian, Henan province, aged 40-69 years was measured two times from 1986 to 1991. Outcome events were prospectively collected up to 2016. Weight maintenance group (weight change <2 kg) or stable normal weight group was treated as the reference. Cox proportional hazard model was performed to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) to estimate the risk of mortality., Results: A total of 21,028 subjects were included in the final analysis. Compared with the weight maintenance group, subjects with weight loss ≥2 kg had an increased risk of death from all-cause (HR All-cause  = 1.14, 95% CI: 1.09-1.19, P  <0.001), cancer (HR Cancer  = 1.12, 95% CI: 1.03-1.21, P  = 0.009), and heart disease (HR Heart diseases  = 1.21, 95% CI: 1.11-1.31, P  <0.001), whereas subjects with weight gain ≥5 kg had 11% (HR Cancer  = 0.89, 95% CI: 0.79-0.99, P  = 0.033) lower risk of cancer mortality and 23% higher risk of stroke mortality (HR Stroke  = 1.23,95% CI: 1.12-1.34, P  <0.001). For the change of weight status, both going from overweight to normal weight and becoming underweight within 5 years could increase the risk of total death (HR Overweight to normal = 1.18, 95% CI: 1.09-1.27; HR Becoming underweight = 1.35, 95% CI: 1.25-1.46) and cancer death (HR Overweight to normal = 1.20, 95% CI: 1.04-1.39; HR Becoming underweight = 1.44, 95% CI: 1.24-1.67), while stable overweight could increase the risk of total death (HR Stable overweight = 1.11, 95% CI: 1.05-1.17) and death from stroke (HR Stable overweight = 1.44, 95% CI: 1.33-1.56). Interaction effects were observed between age and weight change on cancer mortality, as well as between baseline BMI and weight change on all-cause, heart disease, and stroke mortality (all Pinteraction  <0.01)., Conclusions: Weight loss was associated with an increased risk of all-cause, cancer, and heart disease mortality, whereas excessive weight gain and stable overweight were associated with a higher risk of stroke mortality. Efforts of weight management should be taken to improve health status., Trial Registration: https://classic.clinicaltrials.gov/ , NCT00342654., (Copyright © 2024 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

Previous studies on temperature and infectious diseases primarily focused on individual disease types, yielding inconsistent conclusions. This study collected monthly data on notifiable infectious disease cases and meteorological variables across 7 provinces in China from 2011 to 2019. A distributed lag nonlinear model was used to evaluate the association between ambient temperature and infectious diseases within each province, and random meta-analysis was applied to evaluate the pooled effect. Extreme hot temperature (the 97.5th percentile) was positively associated with the risk of respiratory infectious diseases with the relative risk (RR) of 1.45 (95%CI: 1.01-2.08). Conversely, extreme cold temperature (the 2.5th percentile) was negatively associated with intestinal infectious diseases and zoonotic diseases and vector-borne diseases, reporting RRs of 0.43 (95%CI: 0.30-0.60) and 0.46 (95%CI: 0.38-0.57), respectively. This study described the nonlinear association between ambient temperature and infectious diseases with different transmission routes, informing comprehensive prevention and control strategies for temperature-related infectious diseases.

Water fluoride pollution has caused non-negligible harm to the environment and humans, and thus it is crucial to find a suitable treatment technology. In this study, La-Fe@PTA adsorbent was synthesized for the defluoridation of mine water. The results showed that the optimum conditions for defluoridation by La-Fe@PTA were pH close to 7.0, the initial F - concentration of 10 mg/L, the dosage of 0.5 g/L and the adsorption time of 240 min. Compared with SO 4 2‒ , Cl ‒ , NO 3 ‒ , Ca 2+ and Mg 2+ , CO 3 2‒ and HCO 3 ‒ presented severer inhibition on fluoride uptake by La-Fe@PTA. The adsorption process fits well with the pseudo-second-order kinetic model and Freundlich model, and the maximum adsorption capacity of Langmuir model was 95 mg/g. Fixed-bed adsorption results indicated that fluoride in practical fluorinated mine water could be effectively removed from 3.6 mg/L to less than 1.5 mg/L within 130 bed volume (BV) by using 1.5 g La-Fe@PTA. Furthermore, the adsorbent still had good adsorption capacity after regeneration, which confirms the great application potential of La-Fe@PTA as a fluoride ion adsorbent. The mechanism analysis showed that La-Fe@PTA adsorption of fluorine ions is a physicochemical reaction driven by electrostatic attraction and ion exchange., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article., (Copyright © 2023. Published by Elsevier B.V.)

Advanced oxidation processes (AOPs) based on ozone are gaining continuously growing popularity in wastewater treatment. This study explored the treatment of coking wastewater using a combination of ozonation (O 3 ), ultraviolet (UV), and hydrogen peroxide (H 2 O 2 ) process expressed by % chemical oxygen demand (COD) removal, % total organic carbon (TOC), % UV 254 , % fluorescence intensity removal and its electrical energy consumption. The obtained results demonstrated that, the combination of O 3 , UV, and H 2 O 2 which is denoted by O 3 /UV/H 2 O 2 in this study achieved great success in COD removal (92.08%), TOC removal (78.25%), and reduction of fluorescence intensity (99.82%). Compared with the O 3 and O 3 /UV processes, O 3 /UV/H 2 O 2 improved the COD removal by approximately 54-69% and 38-51%, respectively. In addition, the energy consumption was reduced by 53-67%. The TOC removal rate in the effluent ranged 71% and 83%, while the UV 254 removal rate was up to 90%. The fluorescence spectroscopy showed that the O 3 /UV/H 2 O 2 combination process reduced the fluorescence intensity by almost 97% within 10 min. Furthermore, the total polycyclic aromatic hydrocarbons (PAHs) concentration in the effluent was less than 10μg/L (removal efficiency > 80%) and the most toxic benzo(a)pyrene (BaP) was less than 0.03 μg/L (0.018μg/L). In addition, the energy consumption of the O 3 /UV/H 2 O 2 process was 53-67% lower than those of O 3 and O 3 /UV processes. Furthermore, the energy consumption was 80.26 kWh m -3 after 60 min of reaction time when the COD (69.3 mg/L) met the standard discharge. Finally, the O 3 /UV/H 2 O 2 process could be an effective method for improving the mineralisation of refractory organic matter.

Background: We sought to explore the associations of outdoor light at night (LAN) and air pollution with the risk of cerebrovascular disease (CeVD)., Methods: We included a total of 28 302 participants enrolled in Ningbo, China from 2015 to 2018. Outdoor LAN and air pollution were assessed by Satellite-derived images and land-use regression models. CeVD cases were confirmed by medical records and death certificates and further subdivided into ischemic and hemorrhagic stroke. Cox proportional hazard models were used to estimate hazard ratios and 95% CIs., Results: A total of 1278 CeVD cases (including 777 ischemic and 133 hemorrhagic stroke cases) were identified during 127 877 person-years of follow-up. In the single-exposure models, the hazard ratios for CeVD were 1.17 (95% CI, 1.06-1.29) for outdoor LAN, 1.25 (1.12-1.39) for particulate matter with an aerodynamic diameter ≤2.5 µm, 1.14 (1.06-1.22) for particulate matter with aerodynamic diameter ≤10 μm, and 1.21 (1.06-1.38) for NO 2 in every interquartile range increase. The results were similar for ischemic stroke, whereas no association was observed for hemorrhagic stroke. In the multiple-exposure models, the associations of outdoor LAN and PM with CeVD persisted but not for ischemic stroke. Furthermore, no interaction was observed between outdoor LAN and air pollution., Conclusions: Levels of exposure to outdoor LAN and air pollution were positively associated with the risk of CeVD. Furthermore, the detrimental effects of outdoor LAN and air pollution might be mutually independent., Competing Interests: Disclosures None.

Background: Environmental factors play an important role in developing mental disorders. This study aimed to investigate the associations of metal and nonmetal elements in drinking water with the risk of depression and anxiety and to assess whether diets modulate these associations., Methods: We conducted a prospective cohort study including 24,285 participants free from depression and anxiety from the Yinzhou Cohort study in the 2016-2021 period. The exposures were measured by multiplying metal and nonmetal element concentrations in local pipeline terminal tap water samples and total daily drinking water intakes. Cox regression models adjusted for multi-level covariates were used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (95%CIs)., Results: During an average follow-up period of 4.72 and 4.68 years, 773 and 1334 cases of depression and anxiety were identified, respectively. A 1 standard deviation (SD) increase in manganese exposure reduced the incidence of depression by 8% (HR 0.92, 95%CI 0.88 to 0.97). In contrast, with a 1 SD increase in copper and cadmium exposure, the incidence of depression increased by 6% (HR 1.06, 95%CI 1.01 to 1.11) and 8% (HR 1.08, 95%CI 1.00 to 1.17), respectively. The incidence of anxiety increased by 39% (HR 1.39, 95%CI 1.20 to 1.62), 33% (HR 1.33, 95%CI 1.03 to 1.71), and 14% (HR 1.14, 95%CI 1.03 to 1.25) respectively for a 1 SD increase in manganese, iron, and selenium exposure. Diets have a moderating effect on the associations of metal and nonmetal elements with the risk of anxiety. Stronger associations were observed in older, low-income groups and low-education groups., Conclusions: We found significant associations between exposure to metal and nonmetal elements and depression and anxiety. Diets regulated the associations to some extent., (© 2024. The Author(s).)

This study investigated the use of H 2 -driven CO 2 biomethanation for integrated CO 2 capture and conversion (iCCC). Anaerobic chambers containing Na 2 CO 3 -amended microbial growth medium provided with H 2 were inoculated with anaerobic granular sludge. Microorganisms were enriched that could regenerate carbonate by using the bicarbonate formed from CO 2 absorption to generate methane. Multiple absorption-regeneration cycles were performed and effective restoration of CO 2 absorption capacity and stable carbonate recycling via CO 2 biomethanation were observed for CO 2 absorbents adjusted to three different pH values (9.0, 9.5, and 10.0). The pH = 10.0 group had the highest CO 2 absorption capacity; 65.3 mmol/L in the 5th cycle. A slight alkaline inhibition of acetoclastic methanogenesis occurred near the end of regeneration, but had limited impact on the cyclic performance of the iCCC process. Microbial communities were dominated by H 2 -utilizing and alkali-tolerant species that could participate in CO 2 biomethanation and survive under alternating neutral and alkaline conditions., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: Previous studies have reported sex differences in non-alcoholic fatty liver disease (NAFLD) among adults; however, little is known about its occurrence in children and adolescents. This study aims to examine the prevalence of NAFLD among them and investigate the relationship between sex hormones and NAFLD., Method: This study included 2999 obese Chinese children aged 2-18 years. We examined the prevalence of NAFLD by sex, age, and Tanner stage. The regression model and principal component analysis were used to analyze the relationship between sex hormones and NAFLD., Results: The prevalence of NAFLD increased with age in both sexes, and the gender difference appeared before puberty. The prevalence in boys tended to stabilize at the age of 11 years, whereas girls reached their peak temporarily. NAFLD prevalence was positively associated with estradiol in boys (p = 0.011), but the opposite trend was observed in girls (p = 0.031). Testosterone levels decreased with the increase of NAFLD prevalence in boys (p < 0.001). Luteinizing hormone and prolactin were inversely associated with NAFLD prevalence in boys and girls, respectively. Results from the principal component analysis showed that sex hormone levels and fat distribution were important risk factors for the prevalence of NAFLD in obese children (p < 0.001)., Conclusion: The significant difference in NAFLD prevalence between genders in obese children begins in early childhood. This distinction emerges long before puberty onset and tends to stabilize during late adolescence. Sex hormones are associated with NAFLD prevalence and are influenced by the Tanner stages and fat distribution., (© 2023. The Author(s).)

The wireless transmission of video data mainly entails addressing the massive video stream data and ensuring the quality of image frame transmission. To reduce the amount of data and ensure an optimal data transmission rate and quality, we propose a free-space optical video transmission system that applies compressed sensing (CS) algorithms to wireless optical communication systems. Based on the Artix-7 series field programmable gate array (FPGA) chip, we completed the hardware design of the optical wireless video transceiver board; the CS image is transmitted online to the FPGA through Gigabit Ethernet, and the video data is encoded by gigabit transceiver with low power (GTP) and converted into an optical signal, which is relayed to the atmospheric turbulence simulation channel through an attenuator and a collimating mirror. After the optical signal is decoded by photoelectric conversion at the receiving end, the Camera-Link frame grabber is d; thus, the image is collected, and it is reconstructed offline. Herein, the link transmission conditions of different algorithm sampling rates, optical power at the receiving end, and atmospheric coherence length are measured. The experimental results indicate that the encrypt-then-compress (ETC) type algorithm exhibits a more optimal image compression transmission reconstruction performance, and that the 2D compressed sensing (2DCS) algorithm exhibits superior performance. Under the condition that the optical power satisfies the link connectivity, the PSNR value of the reconstructed image is 3-7 dB higher than that of the comparison algorithm. In a strong atmosphere turbulence environment, the peak signal-to-noise ratio (PSNR) of the corresponding reconstructed image under different transmission rates at the receiving end can still exceed 30 dB, ensuring the complete reconstruction of the image.

The industrial effluent from glyphosate production has high salinity and refractory organic contaminants. The removal of organics and the recycling of inorganic salts from this kind of water are challenging issues. In this study, electro-Fenton (EF) and membrane distillation (MD) were coupled in a single reactor utilizing a membrane-based electrode (Mem-GDE) with the ability to bidirectionally transfer vapor and oxygen and electrochemically synthesize H 2 O 2 . The operating thermal conditions for MD significantly promoted Fenton reactions and, thus, the removal of glyphosate. During operation, Fe species deposited on the Mem-GDE and enhanced its catalytic activity and adsorptive capacity, which markedly increased the apparent reaction rate constant of glyphosate by 6 times. This novel EF-MD process simultaneously removed organics and concentrated the inorganics, which is very meaningful for decreasing the costs for subsequent crystallization and achieving high-quality crystal salts. This study provides an efficient method for the treatment of organic-inorganic hybrid wastewater.

The large-scale commercial application of Li metal batteries is hindered by uncontrolled Li dendrite growth. Most of the present interfacial engineering strategies in lithium metal batteries can only prolong the nucleation time of lithium dendrites but cannot prevent the growth of lithium dendrites in three-dimensional space. In this work, a nickel-based catecholate (Ni-CAT) conductive interlayer that can guide the orderly migration of lithium ions and inhibit the disordered deposition of lithium dendrites is successfully constructed between the solid electrolyte and lithium metal through a reasonable design. The experimental analysis proves that the Ni-CAT nanorod arrays with unique vertical structures are closely connected to the solid electrolyte, which can reduce the charge-transfer resistance at the interface and guide lithium ions to be preferentially deposited on the surface of the Ni-CAT intermediate layer through the conduction gradient. Hence, this structure effectively avoids the phenomenon of apical growth during lithium deposition. In addition, the rich pores and inherent nanochannels of Ni-CAT itself act as an "ion sieve", successfully inducing the uniform deposition of lithium metal, which greatly reduces the occurrence of dead lithium due to the loss of electrical contact of lithium during cycling. This strategy holds promise for solving the lithium dendrite problem.

Persulfate (PS) is a widely used oxidant for the chemical oxidation of organic pollutants. The accurate measurement of PS concentration is crucial for the practical application process. The iodometry is the most recommended method for PS determination, and its principle is based on the redox reaction between S 2 O 8 2- and iodide ions. However, hydrogen peroxide (H 2 O 2 ), an important intermediate product in the process of PS use, often leads to abnormally high determination concentrations of PS. Given this, a novel method was developed for the determination of PS based on the principle of the oxidation of chloride ion (Cl - ). The concentration of PS is calculated according to the consumption of Cl - concentration, which is not disturbed by H 2 O 2 . The optimized test conditions were explored as: C(H + ) = 2 mol/L, T = 80℃, C(Cl - ):C(PS) = 4:1 and t = 30 min. Under the optimized conditions, the limit of detection and the limit of quantification of PS concentration determined by this method were 0.26 and 0.85 g/L, respectively. And the linear range of the PS determination was 1-100 g/L with an error of 0.53%-12.06%. The spike recovery rate for determining PS concentration in the actual wastewater ranged from 94.07%-109.52%. Interfering factors such as H 2 O 2 , Fe 3+ , MnO 2 and natural organic matter had almost no effect on the results. This method could not only accurately determine the concentration of PS in industrial wastewater, but also determine the purity of PS industrial products., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

To investigate the association of long-term exposure to ambient air pollution with the risk of allergic rhinitis (AR), we performed a longitudinal analysis of 379,488 participants (47.4% women) free of AR at baseline in the UK Biobank. The annual average concentrations of PM 2.5 , PM coarse , PM 10 , NO 2 , and NO x were estimated by land use regression models. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). A weighted polygenic risk score was constructed. During a median follow-up period of 12.5 years, 3095 AR cases were identified. We observed significant associations between the risk of AR and PM 2.5 (HR: 1.51, 95% CI: 1.27-1.79, per 5 μg/m 3 ), PM coarse (HR: 1.28, 95% CI: 1.06-1.55, per 5 μg/m 3 ), PM 10 (HR: 1.45, 95% CI: 1.20-1.74, per 10 μg/m 3 ), NO 2 (HR: 1.14, 95% CI: 1.09-1.19, per 10 μg/m 3 ), and NO x (HR: 1.10, 95% CI: 1.05-1.15, per 20 μg/m 3 ). Moreover, participants with high air pollution combined with high genetic risk showed the highest risk of AR, although no multiplicative or additive interaction was observed. In conclusion, long-term exposure to air pollutants was associated with an elevated risk of AR, particularly in high-genetic-risk populations, emphasizing the urgent need to improve air quality.

In the light of circular economy aspects, processing of large-scale municipal wastewater treatment plants (WWTPs) needs reconsideration to limit the overuse of energy, implement of non-green technologies and emit abundant greenhouse gas. Along with the huge increase in the worldwide population and agro-industrial activities, global environmental organizations have issued several recent roles to boost scientific and industrial communities towards sustainable development. Over recent years, China has imposed national and regional standards to control and manage the discharged liquid and solid waste, as well as to achieve carbon peaking and carbon neutrality. The aim of this report is to analyze the current state of Chinese WWTPs routing and related issues such as climate change and air pollution. The used strategies in Chinese WWTPs and upgrading trends were critically discussed. Several points were addressed including the performance, environmental impact, and energy demand of bio-enhanced technologies, including hydrolytic acidification pretreatment, efficient (toxic) strain treatment, and anaerobic ammonia oxidation denitrification technology, as well as advanced treatment technologies composed of physical and chemical treatment technologies, biological treatment technology and combined treatment technology. Discussion and critical analysis based on the current data and national policies were provided and employed to develop the future development trend of municipal WWTPs in China from the construction of sustainable and "Zero carbon" WWTPs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Importance: Emerging studies have suggested that environmental factors are associated with fracture. However, little is known about the association of neighborhood walkability and residential greenness with fracture., Objective: To investigate the association of long-term exposure to walkability and greenness with incident fracture and explore the potential interaction effect., Design, Setting, and Participants: This cohort study recruited participants aged 40 years or older in Ningbo, China from June 2015 to January 2018. Participants were observed for outcomes through February 2023, with data analysis conducted in March 2023., Exposures: Neighborhood walkability was measured by a modified walkability calculation method according to a walk score tool. Residential greenness was assessed by satellite-derived normalized difference vegetation index (NDVI) within a 1000-m buffer., Main Outcomes and Measures: Incident fracture was ascertained according to International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes via the Yinzhou Health Information System. Cox proportional hazards models were fit, with age as time scale to estimate the associations of walkability and greenness with fracture. Potential effect modification was explored by covariates, as well as the interactive effect of walkability and greenness., Results: A total of 23 940 participants were included in this study with 13 735 being female (57.4%). The mean (SD) age at baseline was 63.4 (9.4) years. During a follow-up period of 134 638 person-years, 3322 incident fractures were documented. In the full adjusted model, every IQR increment in neighborhood walkability and residential greenness was associated with a hazard ratio (HR) of 0.88 (95% CI, 0.83-0.92) and 0.84 (95% CI, 0.80-0.89), respectively, for fracture. Furthermore, the association of greenness and fracture was greater with an increase in walkability. The HR (Q4 vs Q1) for greenness was 0.62 (95% CI, 0.46-0.82) in neighborhoods with the highest quartile of walkability., Conclusions and Relevance: This population cohort study suggested that long-term exposure to neighborhood walkability and residential greenness were both associated with lower risk of incident fracture. The benefits of greenness increased in more walkable areas.

We developed and evaluated two-level, namely 2017011 and 2017012, serum-based reference materials (RMs) for 17 beta-estradiol (17 β-E2) by the reference method of isotope dilution liquid chromatography tandem mass spectrometry (ID-LC-MS/MS) from the remaining serum samples after routine clinical tests, to help improve clinical routine testing and provide the traceability of results. This paper describes the development process of these RMs. The National Metrology Institute of Japan (NMIJ) certified reference material (CRM) 6004-a was used as the primary RM for the measurement of 17 β-E2. These serum-based RMs showed satisfactory homogeneity and stability. They also assessed the commutability between the reference method and the three routine clinical immunoassay systems. Besides, a collaborative study was carried out in five reference laboratories, all of which had been accredited by the China National Accreditation Service for Conformity Assessment (CNAS) in accordance with ISO/WD 15725-1. Statistical analysis of raw results and uncertainty assessment obtained certified values: 2017011 was 445.2 ± 39.0 pmol/L, and 2017012 was 761.9 ± 35.5 pmol/L., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.)

Background: Sleep disorders are a common syndrome and could affect the life quality of the older adults., Aims: This study aimed to investigate the association between nutritional status and sleep quality in the Chinese community-dwelling older adults., Methods: A total of 2,878 participants ≥ 65 years old from the Yiwu Elderly Cohort were included in the study. Nutritional status was assessed using the Mini Nutritional Assessment Short Form (MNA-SF). Participants were categorized as subjects with malnutrition, at risk of malnutrition or well-nourished based on their MNA-SF score. Pittsburgh Sleep Quality Index (PSQI) was used to identify sleep disorders. PSQI score ≥ 6 was categorized as poor sleep quality., Results: Among the 2,878 participants (mean age 72.71 ± 5.79 years, 50.3% men), 31.5% (n = 906) were classified as having sleep disorders, and 25.5% were identified as malnutrition or at risk of malnutrition. We found a significantly relationship between nutritional status and sleep quality in older adults, and the results showed well-nourished decreased the risk of sleep disorders (OR = 0.32, 95% CI = 0.13, 0.75). And well-nourished status was significantly associated with less daytime dysfunction, adequate sleep duration, and good subjective sleep quality (all P < 0.05)., Conclusion: There was a close association of nutritional status and sleep quality in older adults. We should pay more attention to the nutritional status of older people with sleep problems, as well as the sleep quality of older adults with malnutrition., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Introduction: Gustilo IIIB open forearm fractures are severe injuries often associated with extensive bone and soft tissue injuries. The treatment of Gustilo IIIB open forearm fractures remains a challenging problem, with a high morbidity rate such as infection, nonunion, even amputation. External fixation is preferred for open lower limb fractures. However, there are significant differences between open bone injuries of the upper and lower extremity in terms of treatment plans. Use of internal fixation methods for open fractures is a controversial issue, as it requires early coverage of skin and soft tissue defects after radical debridement and irrigation. The optimal approach for open forearm fractures remains to be determined. The present study evaluated whether early internal fixation combined with free flap placement is effective for the treatment of Gustilo IIIB open forearm fracture., Hypothesis: Early internal fixation combined with the free flap technique in the treatment of Gustilo IIIB open forearm fracture provides good consolidation results., Material and Methods: From January 2015 to January 2020, 20 patients with Gustilo IIIB open forearm fracture treated with early internal fixation combined with free skin flap placement were retrospectively analyzed. There were 9 males and 11 females, with an average age of 40 years. In all cases, the injuries were classified as Gustilo type IIIB. The area of the wounds ranged from 9×3cm to 27×10cm. Fist-stage plate fixation was adopted in 16 cases. Four patients presenting with major contamination received first-stage fixation with Kirschner wires and external fixation, and the second-stage surgery of surgical treatment included flap placement and internal fixation within 10 days. The rates of limb salvage and complications were recorded. The Anderson scoring system was utilized to assess limb function., Results: Limb salvage was successful in all 20 cases. The average length of hospital was 19 days (range, 7-28 days). Four patients developed superficial infections. After debridement, the wounds were covered with skin grafts. No deep infections or osteomyelitis occurred. Three patients developed nonunion, and bone grafts achieved bone healing later. The donor skin flaps healed well, with partial pigmentation. No complete necrosis of the flaps occurred. Only the distal part of flaps became necrotic in two cases, which were then successfully treated by debridement and skin grafting. The average follow-up duration was 14.7 months (range, 8-24 months). According to the Anderson scoring system, 7 cases were graded as excellent, 6 cases as good, 5 cases as fair, and 2 cases as poor., Conclusion: For Gustilo IIIB type injuries, early and thorough debridement along with early internal fixation and skin flap coverage of the wound can achieve satisfactory clinical results, shorten the treatment cycle, and maximize limb function recovery., Level of Evidence: IV, retrospective study without control group., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

We investigated the association of long-term exposure to atmospheric PM 2.5 with non-accidental and cause-specific mortality in Yinzhou, China. From July 2015 to January 2018, a total of 29,564 individuals aged ≥ 40 years in Yinzhou were recruited for a prospective cohort study. We used the Cox proportional-hazards model to analyze the relationship of the 2-year average concentration of PM 2.5 prior to the baseline with non-accidental and cause-specific mortality. The median PM 2.5 concentration was 36.51 μg/m 3 (range: 25.57-45.40 μg/m 3 ). In model 4, the hazard ratios per 10 μg/m 3 increment in PM 2.5 were 1.25 (95%CI: 1.04-1.50) for non-accidental mortality and 1.38 (95%CI:1.02-1.86) for cardiovascular disease mortality. We observed no associations between PM 2.5 and deaths from respiratory disease or cancer. In the subgroup analysis, interactions were observed between PM 2.5 and age, as well as preventive measures on hazy days. The observed association between long-term exposure to atmospheric PM 2.5 at a relatively moderate concentration and the risk of non-accidental and cardiovascular disease mortality among middle-aged and elderly Chinese adults could provide evidence for government decision-makers to revise environmental policies towards a more stringent standard.

Aims/hypothesis: The age-specific associations between type 2 diabetes and cancer risk are not fully understood. The aim of this study was to assess how age at diagnosis modifies the associations between type 2 diabetes and cancer risk., Methods: We used data from the Yinzhou Health Information System, and included 42,279 individuals who were newly diagnosed with type 2 diabetes between 2010 and 2014, as well as 166,010 age- and sex-matched control individuals without diabetes who were selected randomly from the electronic health records of the entire population. Patients were divided into four age groups according to age at diagnosis: <50, 50-59, 60-69 and ≥70 years. Stratified Cox proportional hazards regression models, with age as the time scale, were used to estimate the HRs and 95% CIs for the associations of type 2 diabetes with the risks of overall and site-specific cancers. Population-attributable fractions were also calculated for outcomes associated with type 2 diabetes., Results: During median follow-up periods of 9.20 and 9.32 years, we identified 15,729 incident cancer cases and 5383 cancer deaths, respectively. Patients diagnosed with type 2 diabetes before 50 years of age had the highest relative risks of cancer incidence and mortality, with HRs (95% CI) of 1.35 (1.20, 1.52) for overall cancer incidence, 1.39 (1.11, 1.73) for gastrointestinal cancer incidence, 2.02 (1.50, 2.71) for overall cancer mortality, and 2.82 (1.91, 4.18) for gastrointestinal cancer mortality. Risk estimates decreased gradually with each decade increase in diagnostic age. The population-attributable fractions for overall cancer and gastrointestinal cancer mortality also decreased with increasing age., Conclusions/interpretation: The associations of type 2 diabetes with cancer incidence and mortality varied by age at diagnosis, with a higher relative risk among patients who were diagnosed at a younger age., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

With China's recent commitment to reducing carbon emissions and achieving carbon neutrality, anaerobic digestion and anaerobic ammonium oxidation (anammox) have emerged as promising technologies for treating nitrogenous organic wastewater. Anaerobic digestion can convert organic matter into volatile fatty acids (VFAs), methane, and other chemicals, while anammox can efficiently remove nitrogen with minimal energy consumption. This study evaluates the principles and characteristics of enhanced chemical flocculation and bioflocculation, as well as membrane separation, for capturing organic matter. Additionally, the paper evaluates the production of acids and methane from anaerobic digestion, exploring the influence of various factors and the need for control strategies. The features, challenges, and concerns of partial nitrification-anammox (PN/A) and partial denitrification-anammox (PD/A) are also outlined. Finally, an integrated system that combined organic capture, anaerobic digestion, and anammox is proposed as a sustainable and effective solution for treating nitrogenous organic wastewater and recovering energy and resources., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Evidence regarding associations of general and abdominal obesity with the risk of conventional adenomas (ADs) and serrated polyps (SPs) from Asian population is scarce. Our study aimed to investigate the independent and joint associations of general obesity assessed by body mass index (BMI) and abdominal obesity assessed by waist circumference (WC) or waist-to-hip ratio (WHR) with the risk of ADs and SPs among 25 222 participants recruited by a population-based screening program. Compared to participants with normal BMI, those with a BMI ≥28 kg/m 2 had increased risk of ADs (odds ratio [OR] 1.52, 95% confidence interval [CI]: 1.36-1.70) and SPs (OR 1.69, 95% CI: 1.38-2.07). For participants with a WC ≥102 cm (≥88 cm for females), the risk of ADs (OR 1.37, 95% CI: 1.25-1.51) and SPs (OR 1.81, 95% CI: 1.52-2.16) was higher than that of the reference group. For participants with a WHR ≥0.95 (≥0.90 for females), the risk of ADs (OR 1.26, 95% CI: 1.16-1.36) and SPs (OR 1.46, 95% CI: 1.26-1.69) was higher than that of the reference group. Moreover, participants with both BMI ≥28 kg/m 2 and WC ≥102 cm (≥88 cm for females) had 61% and 119% higher risk of ADs (OR 1.61, 95% CI: 1.39-1.85) and SPs (OR 2.19, 95% CI: 1.70-2.82) compared to those with both normal BMI and WC. These findings indicate that both general and abdominal obesity are associated with SPs and ADs, presenting stronger association with SPs than ADs. Moreover, the association is more evident when both obesities exist., (© 2023 UICC.)

Background: Neurodegenerative disease has a great adverse impact on population's death and disability worldwide. However, the association of air pollution and residential greenness with neurodegenerative disease and their potential mechanisms still remain uncertain., Methods: We used data from a population-based prospective cohort in Ningbo, China. Exposure to PM 2.5 , PM 10 and NO 2 were assessed by land-use regression (LUR) models and residential greenness was estimated by Normalized Difference Vegetation Index (NDVI). Our primary outcomes were all neurodegenerative diseases, Parkinson's disease (PD) and Alzheimer's disease (AD). Cox proportional hazards regression models were used to examine the association of air pollution and residential greenness with risk of incident neurodegenerative disease. Furthermore, we also explored the potential mediation relationship and effect modification between greenness and air pollutants., Results: During the follow-up period, we identified a total of 617 incident neurodegenerative diseases, 301 PD and 182 AD. In single-exposure models, PM 2.5 was positively associated with all outcomes (e.g. AD hazard ratio (HR): 1.41, 95 % confidence interval (CI): 1.09-1.84, per interquartile range (IQR) increment), whereas residential greenness showed protective effects (e.g. neurodegenerative disease, HR: 0.82, 95%CI: 0.75-0.90, per IQR increment for NDVI in 1000 m buffer). NO 2 was positively associated with risk of neurodegenerative disease and PM 10 was associated with neurodegenerative disease and AD. In two-exposure models, after adjustment for PM 2.5 , the association for greenness generally attenuated towards null. Moreover, we identified the significant modification effect of greenness on PM2.5 on additive and multiplicative scales., Conclusion: In this prospective study, we found that exposure to higher residential greenness and lower concentrations of particulate matter were associated with lower risk of neurodegenerative disease, PD and AD. Residential greenness could modify the association of PM 2.5 with neurodegenerative disease., Competing Interests: Declaration of competing interest The authors declare that there are no known competing financial interests., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Cancer is one of the most common causes of death. Excess body weight (EBW), a risk factor for cancer, is highly prevalent in China. We aimed to estimate the number and proportion of cancer deaths attributed to EBW and their changes during 2006-2015 in China., Methods: Population attributable fractions in 2006, 2010, and 2015 were calculated with 1) prevalence of overweight/obesity, exacted from the China Health and Nutrition Survey conducted in 8-9 provinces of China in 1997, 2000, and 2004; 2) relative risks for EBW and site-specific cancers, obtained from previous studies; 3) data on cancer deaths in 2006, 2010, and 2015, originated from the Chinese Cancer Registry Annual Report., Results: In 2015, EBW contributed to 45,918 (3.1% of all) cancer deaths in China, with 24,978 (2.6%) in men and 20,940 (3.8%) in women. By region, the fraction of cancer deaths attributable to EBW ranged from 1.6% (West) to 4.1% (Northeast). Cancers of liver, stomach, and colorectum were the main EBW-attributable cancers. The fractions of cancer deaths attributable to EBW were 2.4% (95%CI: 0.8-4.2%) in 2006, 2.9% (95%CI: 1.0-5.2%) in 2010, and 3.1% (95%CI: 1.0-5.4%) in 2015, respectively, and increased for all gender, region, and cancer site during 2006-2015., Conclusions: The proportion of cancer deaths attributed to EBW was higher in women and Northeastern China, with an upward trend in the recent decade. A combination of comprehensive and individualized measures is necessary to reduce the prevalence of EBW and related cancer burden in China., Competing Interests: Declaration of Competing Interest We declare that we have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Environmental factors, such as drinking water and diets, play an important role in the development of inflammatory bowel disease (IBD). This study aimed to investigate the associations of metal elements and disinfectants in drinking water with the risk of inflammatory bowel disease (IBD) and to assess whether diet influences these associations. We conducted a prospective cohort study including 22,824 participants free from IBD from the Yinzhou cohort study in the 2016-2022 period with an average follow-up of 5.24 years. The metal and disinfectant concentrations were measured in local pipeline terminal tap water samples. Cox regression models adjusted for multi-level covariates were used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (95% CIs). During an average follow-up period of 5.24 years, 46 cases of IBD were identified. For every 1 standard deviation (SD) increase in the concentration of manganese, mercury, selenium, sulfur tetraoxide (SO 4 ) , chlorine, and nitrate nitrogen (NO 3 &#95;N) were associated with a higher risk of IBD with the HRs of 1.45 (95% CI: 1.14 to 1.84), 1.51 (95% CI: 1.24-1.82), 1.29 (95% CI: 1.03-1.61), 1.52 (95% CI: 1.26-1.83), 1.26 (95% CI: 1.18-1.34), and 1.66 (95% CI: 1.32-2.09), whereas zinc and fluorine were inversely associated with IBD with the HRs of 0.42 (95% CI: 0.24 to 0.73) and 0.68 (95% CI: 0.54-0.84), respectively. Stronger associations were observed in females, higher income groups, low education groups, former drinkers, and participants who never drink tea. Diets have a moderating effect on the associations of metal and nonmetal elements with the risk of IBD. We found significant associations between exposure to metals and disinfectants and IBD. Diets regulated the associations to some extent., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Physical function (PF), such as muscle strength, performing daily activities, has gradually declined with the increase of age, causing the occurrence of disability and diseases burden. Air pollution exposure and physical activity (PA) were both linked to PF. We aimed to explore the individual and joint effects of particulate matter <2.5 μm (PM 2.5 ) and PA on PF., Methods: A total of 4537 participants and 12,011 observations aged ≥45 years old from the China Health and Retirement Longitudinal Study (CHARLS) cohort from 2011 to 2015 were included into the study. PF was assessed by a combined score of four tests, including grip strength, walking speed, sense of balance, and chair standing tests. Air pollution exposure data was from The ChinaHighAirPollutants (CHAP) dataset. The annual PM 2.5 exposure for each individual was estimated based on county-level resident addresses. We estimated the volume of moderate-to-vigorous physical activity (MVPA) by quoting metabolic equivalent (MET). Multivariate linear model was conducted for baseline analysis, and linear mixed model with random participant intercepts was constructed for cohort longitudinal analysis., Results: PM 2.5 was negatively associated with PF, while PA was positively associated with PF in baseline analysis. In cohort longitudinal analysis, a 10 μg/m 3 increase in PM 2.5 was associated to a 0.025 point (95 % CI: -0.047, -0.003) decrease in PF score, and a 10-MET-h/week increase in PA was related to a 0.004 point (95 % CI: 0.001, 0.008) increase in PF score. The association between PM 2.5 and PF decreased by increased PA intensity, and PA reversed the detrimental effects between PM 2.5 and PF., Conclusion: PA attenuated the association of air pollution with PF at both high and low levels of air pollution, implying that PA may be an effective behavior to reduce the adverse effects of poor air quality on PF., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Blood glucose is an important monosaccharide functioning as the main source of energy for the human body. The accurate measurement of blood glucose is crucial for the screening, diagnosis, and monitoring of diabetes and diabetes-associated diseases. To assure the reliability and traceability of blood glucose measurements, we developed a reference material (RM) for use in human serum at two different concentrations, which were certified by the National Institute of Metrology (NIM) as GBW(E)091040 and GBW(E)091043., Methods: Raw serum samples were collected from residual samples after clinical testing, filtered, and repackaged under mild stirring. The homogeneity and stability of the samples were examined according to ISO Guide 35: 2017. Commutability was evaluated in compliance with CLSI EP30-A. Value assignment was carried out in six certified reference laboratories using the JCTLM-listed reference method for serum glucose. Moreover, the RMs was further applied in a trueness verification program., Results: The developed RMs was homogeneous and commutable enough for clinical use. They were also stable for 24 h at 2-8 ℃ or 20-25 ℃ and for at least 4 years at - 70 ℃. The certified values were 5.20 ± 0.18 mmol/L and 8.18 ± 0.19 mmol/L (k = 2) for GBW(E)091040 and GBW(E)091043, respectively. The pass rates were evaluated by bias, coefficient of variation (CV), and total error (TE) for 66 clinical laboratories in the trueness verification program were 57.6%, 98.5%, and 89.4% of GBW(E)091040, and 51.5%, 98.5%, and 90.9% of GBW(E)091043, respectively., Conclusion: The developed RM could be used for the standardization of reference and clinical systems with satisfactory performance and traceable values, providing strong support for the accurate measurement of blood glucose., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Aim: To investigate the associations of baseline body mass index (BMI) and longitudinal BMI trajectories with all-cause mortality among patients with type 2 diabetes mellitus (T2DM)., Methods,: We used data from the diabetes surveillance system of Yinzhou Health Information System with T2DM patients registered from 2010 to 2015. Participants aged ≥ 40 years were included and were followed up until September 30, 2021. The latent class growth mixture model was used to identify different changing patterns in BMI for 5 years from registration. Cox proportional hazards models were used to examine the associations of baseline BMI and 5-year BMI trajectories with all-cause mortality., Results: We observed a nonlinear association between baseline BMI and all-cause mortality (P for nonlinearity < 0.001), with an increased risk of death for low but not high BMI. However, compared with participants with medium-stable BMI for 5 years from baseline, individuals with increasing BMI had higher mortality, with adjusted hazard ratios (95% confidence intervals) 1.21 (1.02;1.43) for early-increasing and 1.47 (1.19;1.80) for late-sharp increasing groups., Conclusion: These findings suggest that while obesity itself may not be associated with an increased risk for mortality, weight gain, and in particular rapid weight gain, is a risk factor for mortality among patients with T2DM., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Background: Walkability has been considered to be associated with metabolic and cardiovascular diseases, but the relationship between walkability and chronic obstructive pulmonary disease (COPD) remains unclear. Moreover, fine particulate matter (PM 2.5 ), possibly positively correlated to walkability, may lead to an increased risk of COPD. The separate and joint effects of PM 2.5 and walkability on risk of COPD were explored in our study., Methods: We used prospective data of 29,572 participants from the Yinzhou cohort in Ningbo, China. COPD cases were diagnosed based on the Yinzhou Health Information System (YHIS). Walkability was measured using walk score in relation to the built environment based on geographic information systems (GIS). Air pollution levels were assessed by fitting land use regression (LUR) models. Cox proportional hazards models were used to evaluate the relationships of PM 2.5 and walkability with COPD. Furthermore, we also examined additive and multiplicative interactions between walkability and PM 2.5 ., Results: Overall, a total of 29,572 participants were included in the final analysis and 722 COPD incident cases were identified during 134,846 person-years of follow-up. Compared with subjects with lower walkability, individuals with higher walkability had a decreased risk of COPD (HR = 0.88, 95 % CI: 0.82-0.95) for every IQR increase. By contrast, exposure to PM 2.5 (every IQR increase) was associated with an elevated risk of COPD (HR = 1.21, 95 % CI: 1.06-1.37). No interaction between PM 2.5 and walkability was observed., Conclusions: Living in a highly walkable neighborhood could decrease risk of COPD, whereas high levels of PM 2.5 were positively associated with COPD. In addition, the beneficial effects of walkability were not attenuated by exposure to PM 2.5 ., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

The primary goal of modern wheat breeding is to develop new high-yielding and widely adaptable varieties. We analyzed four yield-related agronomic traits in 502 wheat accessions under normal conditions (NC) and drought treatment (DT) conditions over three years. The genome-wide association analysis identified 51 yield-related and nine drought-resistance-related QTL, including 13 for the thousand-grain weight (TGW), 30 for grain length (GL), three for grain width (GW), five for spike length (SL) and nine for stress tolerance index (STI) QTL in wheat. These QTL, containing 72 single nucleotide polymorphisms (SNPs), explained 2.23 - 7.35% of the phenotypic variation across multiple environments. Eight stable SNPs on chromosomes 2A, 2D, 3B, 4A, 5B, 5D, and 7D were associated with phenotypic stability under NC and DT conditions. Two of these stable SNPs had association with TGW and STI. Several novel QTL for TGW, GL and SL were identified on different chromosomes. Three linked SNPs were transformed into kompetitive allele-specific PCR (KASP) markers. These results will facilitate the discovery of promising SNPs for yield-related traits and/or drought stress tolerance and will accelerate the development of new wheat varieties with desirable alleles., 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 © 2023 Zhao, Sun, Gao, Hu, Mu, Cheng, Wang, Zhao, Li, Wang, Li and Zhang.)

Background: Epidemiological studies have reported an association between traffic-related pollution with risk of metabolic syndrome (MetS). However, evidence from prospective studies on the association of walkability and nitrogen dioxide (NO 2 ) with MetS is still scarce. We, therefore, aimed to evaluate the association of long-term exposure to NO 2 and walkability with hazards of incident MetS., Methods: A total of 17,965 participants without MetS diagnosed within one year at baseline were included in our study from a population-based prospective cohort in Yinzhou District, Ningbo, Zhejiang Province, China. Participants were followed up by the regional Health Information System (HIS) until December 15, 2021. MetS was defined based on the criteria of Chinese Diabetes Society (CDS2004). We used walkscore tools, calculating with amenity categories and decay functions, and spatial-temporal land-use regression (LUR) models to estimate walkability and NO 2 concentrations. We used Cox proportional hazards regression models to examine the association of walkability and NO 2 with hazards of MetS incidence reporting with hazard ratios (HRs) and 95% confidence intervals (CIs)., Results: Overall, we followed up 77,303 person-years and identified 4040 incident cases of MetS in the entire cohort. Higher walkability was inversely associated with incident MetS (HR = 0.94, 95 % CI: 0.91-0.99), whereas NO 2 was positively associated with MetS incidence (HR = 1.07, 95 %CI: 1.00-1.15) per interquartile range increment in two-exposure models. Furthermore, we found a significant multiplicative interaction between walkability and NO 2 . Stronger associations were observed for NO 2 and incident MetS among men, smokers, drinkers and participants who aged < 60 years and had higher levels of income., Conclusion: In summary, we found living in areas with lower walkability and higher concentrations of NO 2 were associated with increased incidence of MetS. The beneficial effect of higher walkability may be attenuated by exposure to NO 2 ., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Emissions from mobile sources and stationary sources contribute to atmospheric pollution in China, and its components, which include ultrafine particles (UFPs), volatile organic compounds (VOCs), and other reactive gases, such as NH 3 and NO x , are the most harmful to human health. China has released various regulations and standards to address pollution from mobile and stationary sources. Thus, it is urgent to develop online monitoring technology for atmospheric pollution source emissions. This study provides an overview of the main progress in mobile and stationary source monitoring technology in China and describes the comprehensive application of some typical instruments in vital areas in recent years. These instruments have been applied to monitor emissions from motor vehicles, ships, airports, the chemical industry, and electric power generation. Not only has the level of atmospheric environment monitoring technology and equipment been improving, but relevant regulations and standards have also been constantly updated. Meanwhile, the developed instruments can provide scientific assistance for the successful implementation of regulations. According to the potential problem areas in atmospheric pollution in China, some research hotspots and future trends of atmospheric online monitoring technology are summarized. Furthermore, more advanced atmospheric online monitoring technology will contribute to a comprehensive understanding of atmospheric pollution and improve environmental monitoring capacity., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier B.V.)

Background & Aims: Metal exposure is suspected to be associated with the risk of chronic kidney disease (CKD). Copper (Cu) is an essential yet toxic trace element in humans. Epidemiological evidence on the association of Cu exposure with CKD remains inconsistent. This study aims to investigate the association of blood Cu and its co-exposure to other metals with CKD., Methods: A cross-sectional study was conducted among 3285 older participants in Zhejiang, China. The whole blood levels of Cu as well as other 10 metals were measured using the inductively coupled plasma mass spectrometry (ICP-MS). CKD events were defined as the presence of albuminuria or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m 2 . Multivariable logistic regression and linear regression models were applied to assess the association of Cu with kidney function. The Bayesian kernel machine regression (BKMR) was used to examine the association of metal interactions with CKD., Results: In logistic models, we found a dose-dependent positive association between blood Cu and the prevalence of CKD. Compared to the lowest quartile of blood Cu, the odds ratio (OR) of CKD in the highest quartile was 1.65 (95% confidence interval, CI: 1.25, 2.17), and the β of eGFR was -1.74 (95% CI: -3.15, -0.34) after adjusting for multiple covariates. The positive linear dose-response association was found between blood Cu and the OR of CKD, and negative linear association was found between Cu and the β of eGFR. The positive association between blood Cu and CKD risk was stronger at lower level of manganese (Mn) in the BKMR model., Conclusion: The whole blood level of Cu was remarkably associated with the risk of CKD and showed positive dose-response relationships in the older Chinese population. The toxicity of Cu on kidney function could be antagonized by the exposure of Mn. These findings shed new light on the potential role of Cu in kidney health., Competing Interests: Conflicts of interest All authors declare that they have no known actual or potential competing financial interests., (Copyright © 2022 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background: This study was conducted to characterize the long-term effect of mobile-based education on Chinese female freshmen and disclose the possible predictors of their willingness to get vaccinated based on the information-motivation-behavioral skills (IMB) model., Methods: We randomly assigned 509 participants to a 7-day mobile-based educational intervention or control group and collected information about general information, health, and sexual behavior, HPV vaccination intention and action, HPV-related knowledge, cognition, and behavioral skill by an online self-administrated questionnaire at baseline, post-intervention, and at the 1-month and 3-month follow-ups., Results: The intervention arm showed an improvement in IMB scores after education. Despite the persistent improvement in knowledge, the improvement in their motivation and behavioral skills decreased at the 1-month and 3-month follow-ups. Participants' vaccination willingness was elevated after the baseline survey in both the intervention and control groups, while the overall appointment/vaccination rate was only 3.73% 3 months later. The intention to get vaccinated was associated with knowing HPV (adjusted OR: 2.37, 95% CI: 1.44 - 3.89), perceiving more barriers (adjusted OR: 2.16, 95% CI: 1.44 - 3.25), higher subjective norms (adjusted OR: 2.05, 95% CI: 1.26 - 3.32), and having more behavioral skills (adjusted OR: 2.95, 95% CI: 1.79 - 4.87)., Conclusion: Seven-day mobile-based education was effective to increase IMB model scores among female freshmen. However, the improvement in motivation and behavioral skills was not persistent. Information, perceived barriers, subjective norms, and behavioral skills were discovered to be influencing factors of vaccination intention. Future research with longer, more convenient, and more tailored education to the main influencing factors is warranted.

Exposure to residential greenness might affect population health through increasing physical activity and social engagement, improving mental health, and reducing harmful environmental exposure. However, evidence on the association of greenness with risk of diabetes is still controversial. In this study, we recruited a total of 22,535 participants aged ≥18 years from Yinzhou District, Ningbo, Zhejiang Province, China to investigate the associations between residential greenness and risk of diabetes incidence. Residential greenness was estimated using Normalized Difference Vegetation Index (NDVI), Enhanced Vegetation Index (EVI), and Vegetation Continuous Field (VCF). We also calculated cumulative average NDVI, EVI and VCF values, and changes in NDVI, EVI and VCF during the follow-up period. We used Cox proportional hazards models controlling for demographic characteristics, lifestyles, individual socioeconomic status, history of diseases and particulate matter with an aerodynamic diameter ≤2.5 μm (PM 2.5 ) to examine hazard ratios (HRs) and 95% confidence intervals (95% CIs) and assessed physical activity, body mass index (BMI) or PM 2.5 as potential mediators. During 84,992.64 person-years of follow-up, a total of 1,154 incident cases of diabetes occurred. In multivariable models, living in the highest quartile of cumulative average NDVI, EVI and VCF within 250-m buffer was associated with 57% (HR = 0.43, 95% CI: 0.36, 0.52), 62% (HR = 0.38, 95% CI: 0.32, 0.45), and 55% (HR = 0.45, 95% CI: 0.38, 0.54) reduction in diabetes risk compared with the lowest quartile, respectively. Results remained similar for NDVI, EVI, and VCF within 500-m and 1000-m buffers. Stratified analyses showed stronger association for residential greenness and diabetes among older people. The association between greenness and diabetes did not appear to be mediated by physical activity, PM 2.5 or BMI. Our findings suggested that higher residential greenness was significantly associated with lower risk of diabetes., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

A poor diet cannot fully explain the prevalence of obesity. Other environmental factors (e.g., heavy metals) have been reported to be associated with obesity. However, limited evidence is available for the combined effect of these factors on obesity. Therefore, we conducted a cross-sectional study and used the data from the National Health and Examination Survey (2007−2018) to explore the associations between diet quality and heavy metals and obesity. Diet quality was evaluated by the Healthy Eating Index-2015 (HEI-2015) score. Heavy metals included serum cadmium (Cd), lead (Pb), and mercury (Hg). We included 15,959 adults, with 5799 of obesity (body mass index ≥ 30 kg/m2). After adjustment for covariates, every interquartile range increase in HEI-2015 scores, Pb, Cd and Hg was associated with a 35% (odds ratios [OR] = 0.65, 95% confidence interval [CI]: 0.60, 0.70), 11% (OR = 0.89, 95% CI: 0.82, 0.98), 9% (OR = 0.91, 95% CI: 0.87, 0.96), 5% (OR = 0.85, 95% CI: 0.82, 0.89) reduction in risk of peripheral obesity, respectively. In addition, the association between the HEI-2015 scores and peripheral obesity was attenuated by higher levels of heavy metals (All p interaction < 0.05). Results remained similar for abdominal obesity. Our study reveals the distinct effects of a high-quality diet and heavy metals on obesity prevalence, and the beneficial effect of a high-quality diet could be weakened by higher levels of heavy metals.

Greener residential surroundings are associated with beneficial health outcomes, whereas higher air pollution exposure is linked with elevated risks of chronic diseases. To date, limited studies have explored the interaction between residential greenness and air pollution on the risk of ischemic heart disease (IHD). We performed a prospective cohort study that included 29,141 adult participants recruited from Yinzhou District, Ningbo, China. Normalized Difference Vegetation Index (NDVI) around each participant's residence was calculated to measure residential greenness exposure. Land-use regression models were conducted to estimate long-term individual exposure to air pollutants, including nitrogen dioxide (NO 2 ) and particulate matter with aerodynamic diameters ≤ 2.5 μm (PM 2.5 ) and ≤10 μm (PM 10 ). Cox proportional hazard models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the associations of residential greenness and air pollutants with the risk of incident IHD. During 101,172.5 person-years of follow-up, 1392 incident IHD cases were reported in the study population. Residential greenness, expressed as an interquartile range (IQR) increase in NDVI within 250 m, was inversely associated with incident IHD (HR = 0.89, 95%CI: 0.81,0.98). However, long-term exposures to air pollution were associated with higher IHD incidence (HR = 1.21, 95%CI:1.10,1.33 per IQR increase for PM 2.5 ; HR = 1.12, 95%CI:1.03,1.22 per IQR increase for PM 10 ; HR = 1.09, 95%CI:1.02,1.16 per IQR increase for NO 2 ). Mediation analyses suggested that the beneficial effect of residential greenness on incident IHD could be partly mediated by reducing the exposure to PM 2.5 . These findings suggested that higher greenness was associated with decreased risk of IHD, while air pollutants were positively associated with incident IHD. Meanwhile, residential greenness may decrease the risk of IHD by reducing exposure to PM 2.5 ., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: The novel long noncoding RNA MEF2C-AS1 has been identified to play suppressor roles during tumorigenesis. DNA methylation has a regulatory effect on gene expression in cancer initiation and progression. However, the methylation status of MEF2C-AS1 and its role in colorectal cancer (CRC) development remain unclear., Methods: The expression and methylation levels of MEF2C-AS1 were systematically analyzed among 31 cancers with available qualified data in GEPIA and UCSC Xena databases. Then, the MEF2C-AS1 methylation status was firstly examined among 12 CRCs by Illumina Infinium MethylationEPIC BeadChip in in-house step 1 and further quantified among 48 CRCs by the MassARRAY method in in-house step 2. Subsequently, its methylation and expression levels were quantified among 81 non-advanced adenomas (NAAs), 81 advanced adenomas (AAs), and 286 CRCs using the MassARRAY method, and among 34 NAAs, 45 AAs, and 75 CRCs by qRT-PCR, in in-house step 3, respectively. The effect of MEF2C-AS1 methylation on CRC survival was analyzed by the Kaplan-Meier method. Additionally, in vitro cell proliferation, migration and invasion assays, and bioinformatics analysis were performed to explore the role of MEF2C-AS1 in colorectal carcinogenesis., Results: Lower expression and higher methylation of MEF2C-AS1 were found in CRC by online databases. In the comparisons of lesion tissues with adjacent normal tissues, MEF2C-AS1 hypermethylation of each individual site and mean level was found among CRC patients in in-house step 1 and step 2, more meaningfully, among NAA patients, AA patients, and CRC patients at all stages during colorectal carcinogenesis in in-house step 3 (all p < 0.05). Further comparisons demonstrated significant differences between CRC and NAA (p = 0.025), AA and NAA (p = 0.020). Moreover, MEF2C-AS1 hypermethylation was associated with poorer disease-specific survival of CRC patients (p = 0.044). In addition, hypermethylation and lower expression of MEF2C-AS1 were verified in RKO cells, and the MEF2C-AS1 overexpression significantly suppressed RKO cell proliferation, migration, and invasion., Conclusions: The findings reveal that MEF2C-AS1 hypermethylation might be an early driven event during colorectal carcinogenesis. It might serve as a promising prognostic biomarker for CRC survival. Our study also indicates the potential tumor-suppressing role of MEF2C-AS1 in CRC., (© 2022. The Author(s).)