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BackgroundThis study aimed to explore the impact of social activity frequency on mid- and long-term overall survival in older Chinese people.MethodsThe association between social activity frequency and overall survival was analysed in 28 563 subjects from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) cohorts.ResultsA total of 21 161 (74.1%) subjects died during the follow-up of 132 558.6 person-years. Overall, more frequent social activity was associated with longer overall survival. From baseline to 5 years of follow-up, adjusted time ratios (TRs) for overall survival were 1.42 (95% CI 1.21 to 1.66, pConclusionFrequent participation in social activity was significantly associated with prolonged overall survival in older people. However, only participating in social activity almost every day could significantly prolong long-term survival.

Aims Inspiratory muscle training (IMT) can increase the strength or endurance of the diaphragm and accessory muscles of inspiration, yet there is no evidence that endorses the role of IMT in patients of transcatheter aortic valve replacement (TAVR). This study for the first time tested the effects of IMT plus usual cardiac rehabilitation (CR) function in patients after TAVR. Methods and results A double-blinded, randomized controlled, single-centre clinical trial was undertaken. Participants who had a confirmed diagnosis of valve heart disease and were clinically stable after TAVR were recruited and received a CR programme during the hospital stay. A total of 96 patients were recruited and randomly assigned to the IMT + CR group (n = 48) or the CR group (n = 48) in a 1:1 ratio. The group difference in the primary outcome, the 6-min walk distance at the discharge of the hospital, significantly favoured the IMT + CR group (mean difference −33.52, 95% CI: −64.42 to −2.62, P = 0.034). The significant difference was maintained at the 1-month and 3-month follow-ups (mean difference: 41.51, 95% CI: 1.82–81.21, P = 0.041). In addition, the mean hospital stays of subjects in the IMT + CR group was 11 days, which was significantly shorter than the 12.5 days in the CR group (P = 0.016). Sensitivity analysis using per-protocol analysis supported these findings. No adverse treatment-related events were reported. Conclusion Compared with usual CR, IMT plus CR can effectively improve exercise endurance, pulmonary ventilation function, and inspiratory muscle strength in patients after TAVR and shorten the length of hospital stay.

The main purpose of this study was to reveal the nutritional value and antioxidant activity of 34 edible flowers that grew in Yunnan Province, China, through a comprehensive assessment of their nutritional composition and antioxidant indices. The results showed that sample A3 of Asteraceae flowers had the highest total flavonoid content, with a value of 8.53%, and the maximum contents of vitamin C and reducing sugars were from Rosaceae sample R1 and Gentianaceae sample G3, with values of 143.80 mg/100 g and 7.82%, respectively. Samples R2 and R3 of Rosaceae were the top two flowers in terms of comprehensive nutritional quality. In addition, the antioxidant capacity of Rosaceae samples was evidently better than that of three others, in which Sample R1 had the maximum values in hydroxyl radical (·OH) scavenging and superoxide anion radical (·O2−) scavenging rates, and samples R2 and R3 showed a high total antioxidant capacity and 2,2-diphenyl-1-pyridylhydrazine (DPPH) scavenging rate, respectively. Taken together, there were significant differences in the nutrient contents and antioxidant properties of these 34 flowers, and the comprehensive quality of Rosaceae samples was generally better than the other three families. This study provides references for 34 edible flowers to be used as dietary supplements and important sources of natural antioxidants.

It is unknown whether the sex difference whereby female transcatheter aortic valve replacement (TAVR) candidates had a lower risk profile, a higher incidence of in-hospital complications, but more favorable short- and long-term survival observed in tricuspid cohorts undergoing TAVR would persist in patients with bicuspid aortic valves (BAVs).The aim of this study was to reexamine the impact of sex on outcomes following TAVR in patients with BAVs.In this single-center study, patients with BAVs undergoing TAVR for severe aortic stenosis from 2012 to 2021 were retrospectively included. Baseline characteristics, aortic root anatomy, and in-hospital and 1-year valve hemodynamic status and survival were compared between sexes.A total of 510 patients with BAVs were included. At baseline, women presented with fewer comorbidities. Men had a greater proportion of Sievers type 1 BAV, higher calcium volumes (549.2 ± 408.4 mmIn patients with BAVs undergoing TAVR, women presented with fewer comorbidities, while men had a greater proportion of type 1 BAV, more calcification, and larger aortic roots. In-hospital outcomes favored men, with fewer complications except for the need for second valve implantation, but 1-year survival was comparable between sexes.

Higher levels of serum alkaline phosphatase (ALP) as a novel risk factor was recently found associated with mortality in different population, whereas, the relationship remains unknown in hypertrophic cardiomyopathy (HCM) population. In this study, we hypothesized that increased ALP could predict all-cause mortality in the adult HCM population. In this cohort study, retrospective data from 538 HCM patients consecutively recruited in West China Hospital were collected. Patients were divided into two groups by baseline ALP with 80 IU/L as the cutoff. All-cause mortality was set as the endpoint. Subgroup analysis was conducted in patients with normal liver function. In total, 461 adult HCM patients were included. After a median follow-up of 4.7 years, 91 patients died. Alkaline phosphatase was an independent predictor of all-cause mortality since patients in the higher ALP group had an increased risk (adjusted HR 2.0, 95% CI: 1.3–3.3, P < 0.01) compared with those in the lower ALP group. In subgroup analysis, the relationship was consistent with the overall (adjusted HR: 3.0, 95% CI: 1.7–5.3, P < 0.01 for the higher ALP group). In the Chinese cohort study of HCM patients, serum ALP is independently associated with all-cause mortality. Patients with a measured value above 80 IU/L had an increased risk of all-cause mortality and this cutoff might help with risk stratification in HCM population.

α-Lipoic acid has excellent antioxidant activity, but its poor lipid solubility greatly limits its practical application. This study was undertaken (i) to develop a novel and efficient enzymatic synthesis of lipophilic lipoic acid esters using Candida sp. 99-125 lipase as a catalyst; and (ii) to systematically evaluate their antioxidant potential against bulk oil, oil-in-water emulsion (O/W) and cooked ground meat.Lipophilic lipoic acid esters were successfully and efficiently synthesized using phytosterols as acyl receptor in the presence of Candida sp. 99-125 lipase. The product was identified as phytosterol lipoate by mass spectrometry, Fourier transform infrared spectroscopy and nuclear magnetic resonance. The maximum conversion of phytosterol lipoate surpassed 90% within 12 h and its final yield exceeded 81%. Interestingly, the oil solubility of lipoic acid was increased at least 25-fold and other physicochemical properties were significantly improved. Most importantly, phytosterol lipoate exhibited higher antioxidant activity than lipoic acid in bulk oil, O/W emulsions and cooked ground meat.The antioxidant capacity of lipoic acid can be significantly enhanced by esterification with phytosterols. Therefore, phytosterol lipoate could be further developed as a new antioxidant for use in oil- and fat-based foods. © 2022 Society of Chemical Industry.

Tree peony seed oil (TPSO) is an important plant source of n-3 polyunsaturated fatty acid (α-linolenic acid, ALA > 40%) that is receiving increasing attention for its excellent antioxidant and other activities. However, it has poor stability and bioavailability. In this study, a bilayer emulsion of TPSO was successfully prepared using a layer-by-layer self-assembly technique. Among the proteins and polysaccharides examined, whey protein isolate (WPI) and sodium alginate (SA) were found to be the most suitable wall materials. The prepared bilayer emulsion contained 5% TPSO, 0.45% whey protein isolate (WPI) and 0.5% sodium alginate (SA) under selected conditions and its zeta potential, droplet size, and polydispersity index were −31 mV, 1291 nm, and 27%, respectively. The loading capacity and encapsulation efficiency for TPSO were up to 84% and 90.2%, respectively. It was noteworthy that the bilayer emulsion showed significantly enhanced oxidative stability (peroxide value, thiobarbituric acid reactive substances content) compared to the monolayer emulsion, which was accompanied by a more ordered spatial structure caused by the electrostatic interaction of the WPI with the SA. This bilayer emulsion also exhibited markedly improved environmental stability (pH, metal ion), rheological properties, and physical stability during storage. Furthermore, the bilayer emulsion was more easily digested and absorbed, and had higher fatty acid release rate and ALA bioaccessibility than TPSO alone and the physical mixtures. These results suggest that bilayer emulsion containing WPI and SA is an effective TPSO encapsulation system and has significant potential for future functional food development.

Background To develop a fully automatic framework for the diagnosis of cause for left ventricular hypertrophy (LVH) via cardiac cine images. Methods A total of 302 LVH patients with cine MRI images were recruited as the primary cohort. Another 53 LVH patients prospectively collected or from multi-centers were used as the external test dataset. Different models based on the cardiac regions (Model 1), segmented ventricle (Model 2) and ventricle mask (Model 3) were constructed. The diagnostic performance was accessed by the confusion matrix with respect to overall accuracy. The capability of the predictive models for binary classification of cardiac amyloidosis (CA), hypertrophic cardiomyopathy (HCM) or hypertensive heart disease (HHD) were also evaluated. Additionally, the diagnostic performance of best Model was compared with that of 7 radiologists/cardiologists. Results Model 3 showed the best performance with an overall classification accuracy up to 77.4% in the external test datasets. On the subtasks for identifying CA, HCM or HHD only, Model 3 also achieved the best performance with AUCs yielding 0.895–0.980, 0.879–0.984 and 0.848–0.983 in the validation, internal test and external test datasets, respectively. The deep learning model showed non-inferior diagnostic capability to the cardiovascular imaging expert and outperformed other radiologists/cardiologists. Conclusion The combined model based on the mask of left ventricular segmented from multi-sequences cine MR images shows favorable and robust performance in diagnosing the cause of left ventricular hypertrophy, which could be served as a noninvasive tool and help clinical decision.

Background Whether healthy lifestyles mediate the association of socioeconomic status (SES) with mortality in older people is largely unknown. Methods A total of 22,093 older participants (age ≥ 65 years) from 5 waves (2002–2014) of Chinese Longitudinal Healthy Longevity Survey cohort were included for analysis. Mediation analysis of lifestyles on the association of SES with all-cause mortality was conducted. Results During a mean follow-up period of 4.92 ± 4.03 years, 15,721 (71.76%) deaths occurred. Compared with high SES, medium SES increased the risk of mortality by 13.5% (HR [total effect]: 1.135, 95% CI 1.067–1.205, p p = 0.936). The total effect when participants of low SES were compared with participants of high SES was HR = 1.161 (95% CI 1.088–1.229, p p p for trend Conclusion Promotion of healthy lifestyles alone can only reduce a small proportion of socioeconomic inequity-related mortality risk in older Chinese people. Even so, healthy lifestyles are important in reducing the overall mortality risk within each SES level.

Frameshift variant c.577del in the EPO gene can result in the extension of the amino acid sequence of EPO by invalidating the termination codon. As the molecular weight of its encoded protein EPO (VAR-EPO) is similar to that of rEPO, the World Anti-Doping Agency has published Annex B to the TD2022EPO in order to protect athletes with variant c.577del from the suspicion of rEPO administrations. However, it is still necessary to develop a confirmation method for rEPO that can discriminate rEPO from VAR-EPO. Based on the glycosylated characteristic of EPO, we selected the detection of de-N-glycosylated EPO as a complementary confirmation method for rEPO in blood samples. All samples were analyzed for both intact EPO and de-N-glycosylated EPO with SDS-PAGE, including rEPO spiked samples and blank samples. The results showed that, after de-N-glycosylation, a single-band was detected in samples collected from non-variant carriers, no matter whether the sample was spiked with rEPO. In samples collected from variant carriers, a double-band was detected. The ratio of lower band to upper band increased significantly corresponding to the concentration of rEPO. We calculated a series of cut-off values by normality distribution function to identify the presence of rEPO. Neither false positive results in blank samples nor false negative results in spiked samples at the applicable Minimum Required Performance Levels were found. This indicates that this method could be adopted as a complementary confirmation method for rEPO in blood samples. A revised testing strategy was also proposed, which would discriminate rEPO directly without further investigation.

The crisis of arsenic (As) accumulation in rhizomes threatens the quality and safety of Panax notoginseng(Burk.) F.H. Chen, which is a well-known traditional Chinese herb with a long clinical history. The uptake of arsenate (AsV) could be suppressed by supplying phosphate (Pi), in which Pi transporters play important roles in the uptake of Pi and AsV. Herein, the P. notoginseng Pi transporter-encoding gene PnPht1;3 was identified and characterised under Pi deficiency and AsV exposure. In this study, the open reading frame (ORF) of PnPht1;3 was cloned according to RNA-seq and encoded 545 amino acids. The relative expression levels revealed that PnPht1;3 was significantly upregulated under phosphate deficiency and AsV exposure. Heterologous expression in Saccharomyces cerevisiae MB192 demonstrated that PnPht1;3 performed optimally in complementing the yeast Pi-transport defect and accumulated more As in the cells. Combined with the subcellular localisation prediction, it was concluded that PnPht1;3 encodes a functional plasma membrane-localised transporter protein that mediates putative high-affinity Pi/H+ symport activity and enhances the uptake of Pi and AsV. Therefore, a better understanding of the roles of the P. notoginseng Pi transporter could provide new insight for solving As accumulation in medicinal plants.

Background Albumin to fibrinogen ratio (AFR) has emerged as a useful indicator for adverse outcomes in several diseases. However, whether the AFR could be a new useful indicator to predict mortality in HCM patients remains to be evaluated. The study investigated the predictive value of the AFR for HCM-related death in adult HCM patients. Methods A total of 404 HCM patients were retrospectively enrolled. Patients were divided into two groups based on the median of baseline AFR. The association between AFR and HCM-related death was analyzed. Results During a median follow-up duration of 4.75 years, 45 patients (11.1%) occurred in HCM-related death. The incidence of HCM-related death was significantly higher in the low AFR group (Log-rank p

Background: This study investigates the predictive value of the systemic immune-inflammation index (SII), which was calculated as platelet × neutrophil/lymphocyte ratio, for all-cause mortality in patients with hypertrophic cardiomyopathy (HCM). Methods: A total of 360 HCM patients were enrolled. They were divided into three groups based on the tertiles of baseline SII. The association between SII and all-cause mortality was analyzed. Results: There were 53 HCM patients who died during a mean follow-up time of 4.8 years (min: 6 days and max: 10.8 years), and the mortality rate was 3.0 per 100 person years. The cumulative mortality rate was significantly different among the three tertiles of SII (P = 0.004), and the mortality rate in tertile 3 was much higher than that in the first two tertiles. In reference to tertile 1, the fully adjusted hazard ratios of all-cause mortality were 1.02 for the tertile 2 (95% confidence interval [CI]: 0.45–2.31, P = 0.966) and 2.31 for tertile 3 (95% CI: 1.10–4.87, P = 0.027). No significant interactions between SII and other variables were observed during subgroup analysis. The discriminative power was better for mid-term outcome than that for short-term or long-term outcomes. Sensitivity analyses including patients with normal platelet and white blood cell count have revealed similar results. Conclusion: SII was a significant risk factor for all-cause mortality in HCM patients. However, the discriminative power was poor to moderate. It could be used in combination with other risk factors in mortality risk stratification in HCM.

Owing to the rapid development of wireless communication technologies, microwave dielectric ceramics have been proposed to facilitate an increase in the performance of functional ceramic components. Herein, CaTiO3-LnAlO3(Ln=La, Nd) ceramics were synthesized via reaction sintering to produce low-cost, high-efficiency, materials. The reaction-sintering method, which imparts excellent comprehensive properties, was used to fabricate these ceramics. The subtle variations in the densification behavior, phase transformation, phase composition, microstructural evolution, and performance exhibited by the CaTiO3-LnAlO3(Ln=La, Nd) ceramics were systematically evaluated. The X-ray diffraction patterns obtained from each sample indicate that the Ca0.61La0.39Al0.39Ti0.61O3 (CTLA) and Ca0.7Nd0.3Ti0.7Al0.3O3 (CTNA) phases were generated under certain environmental conditions. The as-synthesized ceramics exhibited excellent performance parameters: er = 39.1, Q × f = 45 635 GHz, τf = −1.48 ppm/°C and er = 44.03, Q × f = 46 269 GHz, τf = +2.63 ppm/°C, respectively. In addition, the ceramics retained their strong performance parameters irrespective of external temperature fluctuations. The reaction sintering method provides an economical, convenient, and facile method for the fabrication of CaTiO3-LnAlO3(Ln=La, Nd) ceramics which, in turn, imparts broad prospects for the application and development of these materials.

Background Red blood cell distribution width (RDW) has emerged as a useful indicator for adverse outcomes in several cardiovascular diseases. The relation between RDW and the prognosis of hypertrophic cardiomyopathy (HCM) remains to be evaluated. We examined the relation between RDW and all-cause mortality and HCM-related death in a population of adult HCM patients. Methods We performed clinical evaluation in 414 consecutive adult HCM patients (median age, 57.5 years; male, 54.8%). Results During a median follow-up of 3.7 years, all-cause mortality and HCM-related death occurred in 75 (18.1%) and 50 (12.1%) patients, respectively. Based on the tertiles of baseline RDW, mortality increased with higher tertile. With the tertile 1 as reference, adjusted all-cause mortality hazard ratios (HRs) were 3.9 for the tertile 2 (95% confidence interval [CI]: 1.5–10.3) and 3.1 for the tertile 3 (95% CI: 1.1–8.2). Adjusted HCM-related death HRs were higher in the tertile 2 (HR: 5.5; 95% CI: 1.2–24.4) and tertile 3 (HR: 6.6; 95% CI: 1.5–29.0) compared with the tertile 1. Further smooth curve fitting exhibited a saturation effect after adjusting for confounders, and there were a two-stage change and an inflection point. Two-piecewise Cox model suggested mortality significantly increased with RDW level up to the inflection point (about 14.0% for both all-cause mortality and HCM-related death), and RDW was not associated with mortality after the point. Conclusion In adult HCM patients, we found increased RDW was a significant risk predictor for all-cause mortality and HCM-related death, and a saturation effect was observed.

This study presents a mathematical model and experimental verification of factors influencing thermal runaway propagation of NCM811/C lithium-ion battery module after fast charging operation. The key factors considered for the thermal runaway propagation include charging C-rate, battery spacing, triggering temperature, speed, and interval of the thermal runaway propagation. The analysis of the 3D model shows that increasing the spacing and triggering temperature of the battery will reduce the risk of thermal runaway propagation of the battery module and change the order of thermal runaway propagation. Further, the thermal runaway propagation speed increases gradually with the propagation process; however, it is inhibited by increasing triggering temperature and battery spacing and the decrease of charging C-rate. These observations play a critical role in the lithium-ion battery pack design.

To investigate the feasibility of automatic machine learning (autoML) based on native T1 mapping to predict late gadolinium enhancement (LGE) status in hypertrophic cardiomyopathy (HCM). Ninety-one HCM patients and 44 healthy controls who underwent cardiovascular MRI were enrolled. The native T1 maps of HCM patients were classified as LGE ( +) or LGE (-) based on location-matched LGE images. An autoML pipeline was implemented using the tree-based pipeline optimization tool (TPOT) for 3 binary classifications: LGE ( +) and LGE (-), LGE (-) and control, and HCM and control. TPOT modeling was repeated 10 times to obtain the optimal model for each classification. The diagnostic performance of the best models by slice and by case was evaluated using sensitivity, specificity, accuracy, and microaveraged area under the curve (AUC). Ten prediction models were generated by TPOT for each of the 3 binary classifications. The diagnostic accuracy obtained with the best pipeline in detecting LGE status in the testing cohort of HCM patients was 0.80 by slice and 0.79 by case. In addition, the TPOT model also showed discriminability between LGE (-) patients and control (accuracy: 0.77 by slice; 0.78 by case) and for all HCM patients and controls (accuracy: 0.88 for both). Native T1 map analysis based on autoML correlates with LGE ( +) or (-) status. The TPOT machine learning algorithm could be a promising method for predicting myocardial fibrosis, as reflected by the presence of LGE in HCM patients without the need for late contrast-enhanced MRI sequences. • The tree-based pipeline optimization tool (TPOT) is a machine learning algorithm that could help predict late gadolinium enhancement (LGE) status in patients with hypertrophic cardiomyopathy. • The TPOT could serve as an adjuvant method to detect LGE by using information from native T1 maps, thus avoiding the need for contrast agent. • The TPOT also detects native T1 map alterations in LGE-negative patients with hypertrophic cardiomyopathy.

Background: The detection of epidermal growth factor receptor (EGFR) mutations in patients with non-small cell lung cancer is critical for tyrosine kinase inhibitors therapy. EGFR detection requires tissue samples, which are difficult to obtain for some patients, losing the opportunity for further treatment. To realize EGFR mutation prediction without molecular detection, we aim to build a high accuracy deep learning model with only hematoxylin-eosin-stained slides. Methods: A total of 326 hematoxylin-eosin-stained non-small cell lung cancer slides were collected from Beijing Chest Hospital, China. After digitalized into whole slide images, 226 slides (88 with EGFR mutation) among them were fed to a convolutional neural network for model training. The remaining 100 images (50 with EGFR mutation) were used as the test set. Results: The sensitivity and specificity of the model were 76% and 74%, respectively, with an area under the curve of 0.82. When applying the double threshold approach, the deep learning model could screen out 40% of the patients with a sensitivity and specificity of 96% and 94%, respectively. By further involving adenocarcinoma subtype information, 37.3% of the adenocarcinoma patients could be screened out with 100% sensitivity and specificity. Conclusions: In this research, we show rapid and inexpensive pre-screening potentials of the deep learning-based EGFR mutation prediction model. It could not only act as a high-accuracy complement to current molecular detection techniques, but also provide opportunities for non-small cell lung cancer patients with limited sample to receive further treatment.

Single self-reported measures of daily sleep duration are associated with adverse health outcomes; however, the association between changes in daily sleep duration and all-cause mortality has not been thoroughly evaluated among a large group of older people.Using data from the Chinese Longitudinal Healthy Longevity Surveys, a total of 8588 older participants were included in the present study. Changes in daily sleep duration were assessed using annual changes, and Cox regression analysis examined the association of the annual changes with mortality.The median age of the study population was 82.00 (IQR: 72.00, 90.00) years, and 3974 (46.27%) participants were men. During a median follow-up period of 3.81 (IQR: 2.03, 6.74) years, 5100 (59.39%) deaths were recorded. After adjusting for initial daily sleep duration and other confounders, there was a non-linear relationship between annual changes in daily sleep duration and all-cause mortality. Annual changes were not associated with mortality before 0.0 h/year, and mortality risk increased after 0.0 h/year, specially after 1 h/year (adjusted HR: 1.32 per 1-hour/year increment, 95% CI: 1.18-1.47). Compared to the stable group (annual changes between -1 and 1 h), adjusted HRs for mortality were 0.98 (95% CI: 0.89-1.08) for the shorter group (annual decline more than 1 h) and 1.29 (95% CI: 1.19-1.41) for the longer group (annual increase greater than 1 h), respectively. Stratified and sensitivity analyses suggested robustness of the results.The present study suggested there was a non-linear relationship between annual changes in daily sleep duration and all-cause mortality among older people: longer changes were associated with higher mortality; while, shorter changes were not associated with mortality. Specially, mortality risk increased significantly with longer than 1 h of annual changes. The findings highlight the importance of closely monitoring the changes in daily sleep duration among older people.

In the present work, a high quality (Q) Ca1.15Sm0.85Al0.85Ti0.15O4 (CSAT) ceramic was prepared via reaction sintering (RS) method. The phase structure, surface morphology, packing fraction (PF), and valence bond of the ceramic were systematically investigated. By studying the X-ray diffraction (XRD) pattern of the ceramic, it was determined to exhibit a single-phase tetragonal structure with the dimensions of a = b = 3.6943(13)A and c = 12.0320(23)A and volume of V = 164.22(10) A3. The influence of the intrinsic quality loss factor on the Q × f value was investigated by calculating the PF. Simultaneously, the bond valence of the samarium (Sm) sites was evaluated to elucidate the relationship with the temperature coefficient of resonant frequency (τf). The CSAT ceramic was sintered at 1550 °C for 6 h and exhibited exceptional characteristics in terms of the relative dielectric constant (er) = 17.5, quality factor (Q × f) = 66700 GHz, and τf = −6.93 ppm/°C. These results highlighted the excellent suitability of the RS method for preparing CSAT ceramics with outstanding microwave dielectric properties.

Background Recently, a new metabolic health (MH) definition was developed from NHANES-III. In the origin study, the definition may stratify mortality risks in people who are overweight or normal weight. We aimed to investigate the association between the new MH definition and all-cause mortality in a nonobese Chinese population. Methods The data were collected in 1992 and then again in 2007 from the same group of 1157 participants. The association between the new MH definition and all-cause mortality were analyzed by Cox regression models with overlap weighting according to propensity score (PS) as primary analysis. Results At baseline in 1992, 920 (79.5%) participants were categorized as MH, and 237 (20.5%) participants were categorized as metabolically unhealthy (MUH) based on this new definition. During a median follow-up of 15 years, all-cause mortality occurred in 17 (1.85%) participants in MH group and 13 (5.49%) in MUH group, respectively. In the crude sample, Kaplan–Meier analysis demonstrated a significantly higher all-cause mortality in MUH group when compared to MH group (log-rank p = 0.002), and MUH was significantly associated with increased all-cause mortality when compared to MH with HR at 3.04 (95% CI: 1.47–6.25, p = 0.003). However, Kaplan–Meier analysis with overlap weighting showed that the cumulative incidence of all-cause mortality was not significantly different between MH and MUH groups (adjusted p = 0.589). Furthermore, in the primary multivariable Cox analysis with overlap weighting, adjusted HR for all-cause mortality was 1.42 (95% CI: 0.49—4.17, p = 0.519) in MUH group in reference to MH group. Other additional PS analyses also showed the incidence of all-cause mortality was not significantly different between the two groups. Conclusion The new MH definition may be not appropriate for mortality risk stratification in non-obese Chinese people. Further investigations are needed.

In the present paper, the effect of mechanical ball milling time on the fretting wear of GCr15 steel balls at different displacement amplitudes is investigated. TiC powder coating was fabricated on the surface of GCr15 steel balls using various process times, and the fretting wear tests were conducted on an AISI 52100 steel disk with the applied force of 80 N. Additionally, various displacement amplitudes (10 μm, 20 μm, and 60 μm) were selected. Specimen attributes and wear scars were characterized using an inverted metallographic microscope, a microhardness tester, an X-ray diffractometry analyzer, a white light interferometer, and a scanning electron microscope. The results showed that thick and continuous coatings could be obtained at the milling time of 18 h. The specimens processed for a longer milling time demonstrated better fretting wear resistance, which we attribute to higher microhardness of the surface layer. The coefficient of friction and wear volume of specimens at each different displacement amplitude significantly decreased with increasing milling time. As the displacement amplitude increased, the three fretting states were: partial slip coordinated by elastic deformation; partial slip state coordinated by plastic deformation; and gross slip condition. Our observations indicate that mechanical ball milling could be an efficient approach to improve the fretting wear resistance of GCr15 steel balls.

ObjectiveBecause of rapid economic growth and followed urban expansion in China, many people drinking natural water had to change their water sources to tap water. We aimed to test the unknown association that whether continued use of natural water for drinking is different from switching to tap water in all-cause mortality risks in elderly people.MethodsIn total, based on Chinese Longitudinal Healthy Longevity Survey, 26,688 elderly participants drinking natural water from childhood to young-old were included in the final analyses. Associations between whether changing drinking water sources or not and all-cause mortality risk were then estimated by Cox regression models with the use of multiple propensity score methods, and the primary analysis used propensity score matching, with other propensity score methods confirming the robustness of the results.ResultsBaseline characteristics were fairly well balanced by the three post-randomization methods. During a median follow-up period of 3.00 (IQR: 1.52, 5.73) years, 21,379 deaths were recorded. The primary analysis showed people using natural water unchangeably was associated with a lower risk of all-cause mortality than those switching to tap water in later life (HR: 0.94, 95% CI: 0.91–0.97, p < 0.001). Other propensity score methods, as well as Cox regression analysis without using propensity score methods, showed similar results.ConclusionsAmong elderly people depending on natural water for drinking from their childhood to young-old in China, continued use of natural water was associated with a lower all-cause mortality risk than conversion to tap water later. Further studies in different countries and populations are needed to verify our conclusions.

BACKGROUND: It is unknown whether there are differences in coronary access after transcatheter aortic valve replacement (TAVR) between bicuspid and tricuspid anatomy. AIMS: Our aim was to investigate coronary access after TAVR using a self-expanding transcatheter heart valve (THV) in bicuspid versus tricuspid aortic valves (BAV vs TAV), based on CT simulation. METHODS: A total of 86 type 0 BAV, 70 type 1 BAV, and 132 TAV patients were included. If the coronary ostium faced the sealed parts of the THV or the tilted-up native leaflet (NL), this was defined as THV- or NL-related challenging coronary access, respectively. If coaxial engagement was not allowed due to interference from the unwrapped frame, THV-related complex coronary access was defined. RESULTS: The incidence of THV-related challenging coronary access was 21.2% for the left coronary artery (LCA) and 17.7% for the right coronary artery (RCA), and type 0 BAV patients encountered fewer THV-related challenging LCA access than their TAV counterparts (OR 0.42, 95% CI: 0.20-0.89). NL-related challenging coronary access was observed in 3.1% for LCA and 1.4% for RCA, and THV-related complex coronary access was identified in 5.9% for LCA and 17.0% for RCA; however, no significant differences were found among groups. The proportion of optimal fluoroscopic viewing angles suitable for guiding LCA engagement was similar among groups (64.0% vs 70.0% vs 62.1%), but those suitable for guiding RCA engagement were significantly higher in the type 0 BAV group (31.4% vs 4.3% vs 9.1%). CONCLUSIONS: Coronary access may be challenging or complex in a significant proportion of both BAV and TAV patients after TAVR. Type 0 BAV anatomy may be more favourable for post-TAVR coronary access.

Background The metabolic syndrome (Mets) is a multiplex risk factor for atherosclerotic cardiovascular diseases. The aims of the study were to assess the association of the Mets with TyG index and TyG-related parameters in an urban Chinese population. Methods The data were collected in 1992 and then again in 2007 from the same group of 590 individuals (363 males and 227 females) without Mets in 1992. The fasting lipid profile and blood glucose were measured. TyG index and related parameters were calculated, and Mets defined according to the harmonized criteria. The area under the curve (AUC) of receiver operating characteristic curves was used to evaluate TyG index and related parameters for their diagnostic ability to identify people with Mets. Odd ratios (OR) for Mets prediction were calculated using stepwise logistic regression analyses. Results The incidence of Mets was 18.64% over the 15-year follow-up period.During 15 years’ follow-up, TyG-waist to height ratio (TyG-WHtR) shows the largest AUC for Mets detection (0.686) followed by TyG-waist circumference (TyG-WC) (0.660), TyG-waist-to-hip ratio (TyG-WHpR) (0.564), and TyG index (0.556) in all participants. Gender analysis revealed that TyG-WHtR and TyG-WC have the largest AUC in both genders. TyG-WHtR significantly predicted Mets in all participants, with an unadjusted odds ratio of 5.63 (95% CI 3.23–9.83 P Conclusions TyG-WHtR might be a strong and independent predictor for Mets in all participants in an urban Chinese population. TyG-related markers that combine obesity markers with TyG index are superior to other parameters in identifying Mets in both genders.

ObjectivesWith body mass index (BMI) failing to distinguish the mass of fat from lean, several novel predicted equations for predicted fat mass (FM), predicted lean mass (LM) and predicted per cent fat (PF) were recently developed and validated. Our aim was to explore whether the three novel parameters could better predict diabetes mellitus (DM) than the commonly used obesity indicators, including BMI, waist circumference, hip circumference and waist-hip ratio.DesignA 15-year prospective cohort was used.SettingIt was a prospective cohort, consisting of a general Chinese population from 1992 to 2007.ParticipantsThis cohort enrolled 711 people. People suffering from DM at baseline (n=24) were excluded, and 687 non-diabetics with complete data were included to the analysis.Primary outcomeNew-onset DM.ResultsAfter the follow-up, 74 (48 men and 26 women) incidences of DM were documented. For men, the adjusted HRs were 1, 5.19 (p=0.003) and 7.67 (pConclusionPredicted PF, predicted LM and predicted FM could independently predict the risk of DM for men, with predicted FM performing better in discrimination than other commonly used obesity indicators. For women, larger samples were further needed.

Neonicotinoid insecticides (NIs) have been widely detected in environmental media and human body with concentrations reaching hundreds of nanomolar to micromolar levels. However, the information about their human health toxicology and mechanism is deficient. Previous studies have implied that NIs might exert estrogenic disruption and promote breast cancer progression, but the molecular mechanism is unclear, especially the molecular initiating event. G protein-coupled estrogen receptor (GPER), as a candidate therapeutic target, plays vital roles in the development of breast cancer. This work aimed to reveal the potential mechanism through GPER pathway. Firstly, we screened the activities of seven most common NIs on GPER signal pathway by calcium mobilization assay. Clothianidin, acetamiprid (ACE), and dinotefuran activated GPER most potently and ACE displayed the highest agonistic activity with the lowest observed effective concentration (LOEC) of 1 μM. The molecular docking and dynamics simulation showed favored interaction trend between the NIs and GPER. The three NIs with GPER activity induced 4T1 breast cancer cells migration and ACE showed the highest potency with LOEC of 100 nM. ACE also induced 4T1 cells proliferation at high concentration of 50 μM and up-regulated GPER expression in a dose-dependent manner. We speculated that both the induction effects of ACE on 4T1 cells proliferation and migration might be owing to the activation and up-regulation of GPER. By using 4T1-Luc cells injected orthotopic tumor model, we found that ACE also promoted in-situ breast cancer growth and lung metastasis in normal mouse dependent on GPER. However, ACE only promoted in-situ breast cancer growth through GPER but not lung metastasis in ovariectomized mice, implying that the ACE-induced lung metastasis should be related to endogenous estrogen from ovary. Overall, we demonstrated that NIs promoted breast cancer progression via GPER pathway at human related exposure levels and their female health risks need urgent concerns.

0.85(0.74CaTiO3–0.26SmAlO3)–0.15Ca1.15Sm0.85Al0.85Ti0.15O4 (CSC) composite ceramics were prepared by a reaction-sintering method. The phase structure, sintering behavior and microwave dielectric properties of CSC ceramics were investigated. The preparation process of reaction-sintering route (RS) is simple. XRD patterns show that Ca0.74Ti0.74Sm0.26Al0.26O3 (similar to CaTiO3), SmAlO3 and Ca1.15Sm0.85Al0.85Ti0.15O4 phases are formed in the CSC ceramics. The grain size and dielectric constant of CSC ceramics increase with rising the sintering temperature. As the sintering temperature increases, the quality factor (Q × f) and τf value of the CSC ceramics increase to the maximum values first and then decrease. The bulk density fluctuates up and down around a value, but little change. The ceramics sintered at 1500 °C got the best microwave dielectric performances with er = 35.9, Q × f = 49,221 GHz, τf = − 0.53 ppm/°C.

A novel La2MgGeO6 ceramic was synthesized through a solid-state reaction process within a sintering temperature range of 1450–1550 °C. By a combination of X-ray diffraction and Rietveld refinement analyses, the ceramics were found to have a pure hexagonal phase structure belonging to space group R3/146. The scanning electron microscopy images revealed that the ceramic grains were closely connected. The effects of internal (lattice energy, valence bond, and fraction packing) and external factors (density) on the microwave properties of ceramics were also studied. The ceramic exhibited excellent microwave dielectric performances, with a relative permittivity (Ɛr) of 21.2, a quality factor (Q × f) of 52 360 GHz, and a temperature coefficient of resonant frequency (τf) of −44.2 ppm/°C, when sintered at 1500 °C for 4 h. The τf value of the La2MgGeO6 ceramic doped with CaTiO3 could be adjusted to zero. Particularly, 0.2La2MgGeO6-0.8CaTiO3 ceramics have good microwave dielectric properties with τf = +2.1 ppm/°C, Q × f = 15 610 GHz, and Ɛr = 40.3.

Primary percutaneous coronary intervention (PPCI), the preferred reperfusion strategy for all acute ST-segment elevation myocardial infarction (STEMI) patients, is not universally available in clinical practice. Pharmacoinvasive strategy has been proposed as a therapeutic option in patients with STEMI when timely PPCI is not feasible. However, pharmacoinvasive strategy has potential delay between clinical patency and complete myocardial perfusion. The optimal reperfusion strategy for STEMI patients with anticipated PPCI delay according to current practice is uncertain. OPTIMAL-REPERFUSION is an investigator-initiated, prospective, multicenter, randomized, open-label, superiority trial with blinded evaluation of outcomes. A total of 632 STEMI patients presenting within 6 hours after symptom onset and with an expected time of first medical contact to percutaneous coronary intervention (PCI) ≥120 minute will be randomized to a reduced-dose facilitated PCI strategy (reduced-dose fibrinolysis combined with simultaneous transfer for immediate invasive therapy with a time interval between fibrinolysis to PCI