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Background and Purpose The association of dyslipidemia with stroke has been inconsistent, which may be due to differing associations within etiological stroke subtypes. We sought to determine the association of lipoproteins and apolipoproteins within stroke subtypes. Methods Standardized incident case-control STROKE study in 32 countries. Cases were patients with acute hospitalized first stroke, and matched by age, sex and site to controls. Concentrations of total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (apoA1), and apoB were measured. Non-HDL-C was calculated. We estimated multivariable odds ratio (OR) and population attributable risk percentage (PAR%). Outcome measures were all stroke, ischemic stroke (and subtypes), and intracerebral hemorrhage (ICH). Results Our analysis included 11,898 matched case-control pairs; 77.3% with ischemic stroke and 22.7% with ICH. Increasing apoB (OR, 1.10; 95% confidence interval [CI], 1.06 to 1.14 per standard deviation [SD]) and LDL-C (OR, 1.06; 95% CI, 1.02 to 1.10 per SD) were associated with an increase in risk of ischemic stroke, but a reduced risk of ICH. Increased apoB was significantly associated with large vessel stroke (PAR 13.4%; 95% CI, 5.6 to 28.4) and stroke of undetermined cause. Higher HDL-C (OR, 0.75; 95% CI, 0.72 to 0.78 per SD) and apoA1 (OR, 0.63; 95% CI, 0.61 to 0.66 per SD) were associated with ischemic stroke (and subtypes). While increasing HDL-C was associated with an increased risk of ICH (OR, 1.20; 95% CI, 1.14 to 1.27 per SD), apoA1 was associated with a reduced risk (OR, 0.80; 95% CI, 0.75 to 0.85 per SD). ApoB/A1 (OR, 1.38; 95% CI, 1.32 to 1.44 per SD) had a stronger magnitude of association than the ratio of LDL-C/HDL-C (OR, 1.26; 95% CI, 1.21 to 1.31 per SD) with ischemic stroke (P

Arterial tissue delamination, manifested as the fracture failure between arterial layers, is an important process of the atherosclerotic plaque rupture, leading to potential life-threatening clinical consequences. Numerous models have been used to characterize the arterial tissue delamination fracture failure. However, only a few have investigated the effect of cohesive zone model (CZM) shapes on predicting the delamination behavior of the arterial wall. In this study, four types of CZMs (triangular, trapezoidal, linear–exponential, and exponential–linear) were investigated to compare their prediction of the arterial wall fracture failure. The Holzapfel–Gasser–Ogden (HGO) model was adopted for modeling the mechanical behavior of the aortic bulk material. The CZMs optimized during the comparison of the aortic media delamination simulations were also used to perform the comparative study of the mouse plaque delamination and human fibrous cap delamination. The results show that: (1) the numerical predicted the relationships of force–displacement in the delamination behaviors based on the triangular, trapezoidal, linear–exponential, and exponential–linear CZMs match well with the experimental measurements. (2) The traction–separation relationship results simulated by the four types of CZMs could react well as the corresponding CZM shapes. (3) The predicted load–load point displacement curves using the triangular and exponential–linear CZMs are in good agreement with the experimental data, relative to the other two shapes of CZMs. All these provide a new method combined with the factor of shape in the cohesive models to simulate the crack propagation behaviors and can capture the arterial tissue failure response well.

This paper investigates the heat effects of continuous high-power lasers on steel cylinders. A theoretical model combining the mechanical characteristics and heat transfer of the steel cylinder that irradiated by a high-power laser is established. Simulations in temperature fields predict the varying heat effects on steel cylinders corresponding to different laser power levels, and more importantly, the thresholds of laser penetrations. The predictions are further validated by experimental tests, which use 1.5–2.8 kW laser irradiating on 7–15 mm thick steel cylinders. It has been found that the ablation mechanism of steel cylinder is primarily dependent on either the mass transfer of vaporized ablation or liquefied material under the action of vaporized back pressing. The present 0–300 s temperature field analyses show that steel melts at 1720 K and vaporizing ablation happens at 3250 K. It has also been observed that in the contact region between the laser and steel cylinder, the melting and vaporization accompanied by the interaction of the ablation process are followed by the sharp splash phenomenon.

For the paper, experimental studies were performed on the damage of the Ge- and Si-based flat window by lasers out-of-band. The experimental results showed that lasers out-of-band can cause film damage and substrate damage to Ge and Si windows. The high-energy laser damage window mechanism mainly manifested as thermal effects. The composite laser damage thresholds for the substrate were an Si window of 21.6 J/cm2 and a Ge window of 3 J/cm2. Compared with continuous laser and long pulse laser experimental results, it was found that the use of long pulse-continuous composite constitution could effectively reduce the damage threshold. Compared to the long-pulse laser, the composite laser could achieve similar damage effects with a smaller energy density.

Background: Hypertension is considered the most important risk factor for cardiovascular diseases, but its control is poor worldwide. We aimed to assess the availability and affordability of blood pressure-lowering medicines, and the association with use of these medicines and blood pressure control in countries at varying levels of economic development. Methods: We analysed the availability, costs, and affordability of blood pressure-lowering medicines with data recorded from 626 communities in 20 countries participating in the Prospective Urban Rural Epidemiological (PURE) study. Medicines were considered available if they were present in the local pharmacy when surveyed, and affordable if their combined cost was less than 20% of the households' capacity to pay. We related information about availability and affordability to use of these medicines and blood pressure control with multilevel mixed-effects logistic regression models, and compared results for high-income, upper-middle-income, lower-middle-income, and low-income countries. Data for India are presented separately because it has a large generic pharmaceutical industry and a higher availability of medicines than other countries at the same economic level. Findings: The availability of two or more classes of blood pressure-lowering drugs was lower in low-income and middle-income countries (except for India) than in high-income countries. The proportion of communities with four drug classes available was 94% in high-income countries (108 of 115 communities), 76% in India (68 of 90), 71% in upper-middle-income countries (90 of 126), 47% in lower-middle-income countries (107 of 227), and 13% in low-income countries (nine of 68). The proportion of households unable to afford two blood pressure-lowering medicines was 31% in low-income countries (1069 of 3479 households), 9% in middle-income countries (5602 of 65 471), and less than 1% in high-income countries (44 of 10 880). Participants with known hypertension in communities that had all four drug classes available were more likely to use at least one blood pressure-lowering medicine (adjusted odds ratio [OR] 2·23, 95% CI 1·59–3·12); p

Cultivation of green manure (GM) crops in intensive cropping systems is important for enhancing crop productivity through soil quality improvement. We investigated yield sustainability, nutrient stocks, nutrient balances and enzyme activities affected by different long- term (1982−2016) green manure rotations in acidic paddy soil in a double-rice cropping system. We selected four treatments from a long-term experiment, including (1) rice-rice-winter fallow as a control treatment (R-R-F), (2) rice-rice-milkvetch (R-R-M), (3) rice-rice-rapeseed (R-R-R), and (4) rice-rice-ryegrass (R-R-G). The results showed that different GM rotations increased grain yield and the sustainable yield index compared with those of the R-R-F treatment. Compared with those of R-R-F, the average grain yield of early rice in R-R-M, R-R-R, and R-R-G increased by 45%, 29%, and 27%, respectively and that of late rice increased by 46%, 28%, and 26%, respectively. Over the years, grain yield increased in all treatments except R-R-F. Green manure also improved the soil chemical properties (SOM and total and available N and P), except soil pH, compared to those of the control treatment. During the 1983−1990 cultivation period, the soil pH of the R-R-M treatment was lower than that of the R-R-F treatment. The addition of green manure did not mitigate the soil acidification caused by the use of inorganic fertilizers. The soil organic matter (SOM), total nitrogen (TN) and total phosphorus (TP) contents and stocks of C, N and P increased over the years. Furthermore, GM significantly increased phosphatase and urease activities and decreased the apparent N and P balances compared with those in the winter fallow treatment. Variance partitioning analysis revealed that soil properties, cropping systems, and climatic factors significantly influenced annual grain yield. Aggregated boosted tree (ABT) analysis quantified the relative influences of the different soil properties on annual grain yield and showed that the relative influences of TN content, SOM, pH, and TP content on annual crop yield were 27.8%, 25.7%, 22.9%, and 20.7%, respectively. In conclusion, GM rotation is beneficial for sustaining high crop yields by improving soil biochemical properties and reducing N and P balances in acidic soil under double- rice cropping systems.

Abstract Based on a low-temperature route, monodispersed CoFe2O4 microspheres (MSs) were fabricated through aggregation of primary nanoparticles. The microstructural and magnetic characteristics of the as-prepared MSs were characterized by X-ray diffraction/photoelectron spectroscopy, scanning/transmitting electron microscopy, and vibrating sample magnetometer. The results indicate that the diameters of CoFe2O4 MSs with narrow size distribution can be tuned from over 200 to ~330 nm. Magnetic measurements reveal these MSs exhibit superparamagnetic behavior at room temperature with high saturation magnetization. Furthermore, the mechanism of formation of the monodispersed CoFe2O4 MSs was discussed on the basis of time-dependent experiments, in which hydrophilic PVP plays a crucial role.

BackgroundOne of the most robust genetic associations for cardiovascular disease (CVD) is the Chromosome 9p21 region. However, the interaction of this locus with environmental factors has not been extensively explored. We investigated the association of 9p21 with myocardial infarction (MI) in individuals of different ethnicities, and tested for an interaction with environmental factors.Methods and findingsWe genotyped four 9p21 SNPs in 8,114 individuals from the global INTERHEART study. All four variants were associated with MI, with odds ratios (ORs) of 1.18 to 1.20 (1.85×10(-8)≤p≤5.21×10(-7)). A significant interaction (p = 4.0×10(-4)) was observed between rs2383206 and a factor-analysis-derived "prudent" diet pattern score, for which a major component was raw vegetables. An effect of 9p21 on MI was observed in the group with a low prudent diet score (OR = 1.32, p = 6.82×10(-7)), but the effect was diminished in a step-wise fashion in the medium (OR = 1.17, p = 4.9×10(-3)) and high prudent diet scoring groups (OR = 1.02, p = 0.68) (p = 0.014 for difference). We also analyzed data from 19,129 individuals (including 1,014 incident cases of CVD) from the prospective FINRISK study, which used a closely related dietary variable. In this analysis, the 9p21 risk allele demonstrated a larger effect on CVD risk in the groups with diets low or average for fresh vegetables, fruits, and berries (hazard ratio [HR] = 1.22, p = 3.0×10(-4), and HR = 1.35, p = 4.1×10(-3), respectively) compared to the group with high consumption of these foods (HR = 0.96, p = 0.73) (p = 0.0011 for difference). The combination of the least prudent diet and two copies of the risk allele was associated with a 2-fold increase in risk for MI (OR = 1.98, p = 2.11×10(-9)) in the INTERHEART study and a 1.66-fold increase in risk for CVD in the FINRISK study (HR = 1.66, p = 0.0026).ConclusionsThe risk of MI and CVD conferred by Chromosome 9p21 SNPs appears to be modified by a prudent diet high in raw vegetables and fruits. Please see later in the article for the Editors' Summary.

Results of the recently published ONTARGET study (The Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial) showed that telmisartan (80 mg/day) was non-inferior to ramipril (10 mg/day) in reducing cardiovascular events. Clinicians in Asia doubt tolerability of these doses for their patients. We therefore analyzed data from this study and a parallel study TRANSCEND (Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease). Our objectives were to compare Asians and non-Asians with respect to the following: 1) Effectiveness of telmisartan vs. ramipril in reducing cardiovascular events;2) Proportions who reached the full dose of telmisartan, ramipril or placebo; and3) Proportions of overall discontinuations, and discontinuations due to adverse effects.The ONTARGET study randomized 25,620 patients at risk of cardiovascular events to ramipril, telmisartan, or their combination. The primary composite endpoint was death caused by cardiovascular disease, acute MI, stroke, and hospitalization because of congestive heart failure. TRANSCEND randomized 5926 high-risk patients with a history of intolerance to ACE-inhibitors to telmisartan or placebo. The primary outcome was the same. In this substudy, we compared Asians and non-Asians as to how well they tolerated telmisartan (given in both studies) and ramipril (given in ONTARGET).1) Telmisartan was non-inferior to ramipril in lowering the primary endpoint among Asians (RR = 0.92; 95% CI: 0.74, 1.13); 2) more Asians achieved the full dose of either drug; 3) less withdrew (overall); and 4) less withdrew for adverse effects. Furthermore, telmisartan was better tolerated than ramipril. This advantage was greater among Asians.Although Asians had lower BMI than non-Asians, Asians tolerated both drugs better. Regulatory agencies require reporting of safety and effectiveness data by ethnicity, but few comply with this requirement. This study shows that safety data in ethnic subgroups can help assess applicability of results to specific populations.ClinicalTrials.gov NCT00153101.

Background: It’s unknown wheather there is much benefit on central aortic pressure than brachial pressure while long-term administration of hydrochlorothiazide in patients with essential hypertension. Methods: The retrograde analysis was conducted at three of the participating centers in the Felodipine Event Reduction (FEVER) study. 76 of 129 patients in placebo group, who kept hydrochlorothiazide monotherapy over 36 months period, and took pulse wave recording at randomization, 12 month, 24 month and 36 month, were included into the final analysis. Radial artery pressure waveforms were measured with applanation tonometry, and convolved into the ascending aortic pressure waveforms, using the FDA-approved SphygmoCor system. The analysed parameters in aortic pressure waveform included first peak pressure, secondary peak pressure, diastolic pressure, pulse pressure, augmentation and augmentation index. Results: In comparison with baseline, there were substantial falls (P0.05) in augmentation index and heart rate. Conclusion: Long-term administration of hydrochlorothiazide resulted in the similar reduction of both brachial pressure and central aortic pressure without the change of augmentation index, which could exclude definite benefit on central aortic pressure than brachial pressure.

Abstract Background Plasma level of total homocysteine (tHcy) is negatively correlated with kidney function in general population. However, the causal mechanism of this correlation is poorly understood. The purpose of this study is to investigate the association of methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism, which is a major genetic determinant of the plasma tHcy level, with estimated glomerular filtration rate (eGFR) in Chinese. Methods A total of 18 814 hypertensive patients (6 914 males, 11 900 females) were included in the study. Results Association between the eGFR and MTHFR C677T genotype was examined by sex-specific regression analyses. In males, TT genotype was associated with 1.37 ml/min/1.73 m2 decrease in eGFR (p = 0.004) and with an increased risk (OR = 1.32, p = 0.008) for the lowest quintile of eGFR after adjusting for age, BMI, and blood pressures. However, such association was not observed in females (p > 0.05). This association suggests MTHFR C677T polymorphism may play a role in the regulation of eGFR in males. Conclusions MTHFR 677 T is a risk allele for decreased kidney function in Chinese males, implicating this gene in the pathogenesis of chronic kidney disease (CKD).

Abstract Background Inflammatory mechanisms are important in stroke risk, and genetic variations in components of the inflammatory response have been implicated as risk factors for stroke. We tested the inflammatory gene polymorphisms and their association with ischemic stroke in a Chinese Han population. Methods A total of 1,124 ischemic stroke cases and 1,163 controls were genotyped with inflammatory panel strips containing 51 selected inflammatory gene polymorphisms from 35 candidate genes. We tested the genotype-stroke association with logistic regression model. Results We found two single nucleotide polymorphisms (SNPs) in CCL11 were associated with ischemic stroke. After adjusting for multiple testing using false discovery rate (FDR) with a 0.20 cut-off point, CCL11 rs4795895 remained statistically significant. We further stratified the study population by their hypertension status. In the hypertensive group, CCR2 rs1799864, CCR5 rs1799987 and CCL11 rs4795895 were nominally associated with increased risk of stroke. In the non-hypertensive group, CCL11 rs3744508, LTC4S rs730012, FCER1B rs569108, TGFB1 rs1800469, LTA rs909253 and CCL11 rs4795895 were associated with ischemic stroke. After correction for multiple testing, CCR2 rs1799864 and CCR5 rs1799987 remained significant in the hypertensive group, and CCL11 rs3744508, LTC4S rs730012, FCER1B rs569108, TGFB1 rs1800469, LTA rs909253 remained significant in the non-hypertensive group. Conclusions Our results indicate that inflammatory genetic variants are associated with increased risk of ischemic stroke in a Chinese Han population, particularly in non-hypertensive individuals.

Abstract Background Previous genome-wide association studies for type 2 diabetes susceptibility genes have confirmed that a common variant, rs9939609, in the fat mass and obesity associated (FTO) gene region is associated with body mass index (BMI) in European children and adults. A significant association of the same risk allele has been described in Asian adult populations, but the results are conflicting. In addition, no replication studies have been conducted in children and adolescents of Asian ancestry. Methods A population-based survey was carried out among 3503 children and adolescents (6-18 years of age) in Beijing, China, including 1229 obese and 2274 non-obese subjects. We investigated the association of rs9939609 with BMI and the risk of obesity. In addition, we tested the association of rs9939609 with weight, height, waist circumference, waist-to-height ratio, fat mass percentage, birth weight, blood pressure and related metabolic traits. Results We found significant associations of rs9939609 variant with weight, BMI, BMI standard deviation score (BMI-SDS), waist circumference, waist-to-height ratio, and fat mass percentage in children and adolescents (p for trend = 3.29 × 10-5, 1.39 × 10-6, 3.76 × 10-6, 2.26 × 10-5, 1.94 × 10-5, and 9.75 × 10-5, respectively). No significant associations were detected with height, birth weight, systolic and diastolic blood pressure and related metabolic traits such as total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol and fasting plasma glucose (all p > 0.05). Each additional copy of the rs9939609 A allele was associated with a BMI increase of 0.79 [95% Confidence interval (CI) 0.47 to 1.10] kg/m2, equivalent to 0.25 (95%CI 0.14 to 0.35) BMI-SDS units. This rs9939609 variant is significantly associated with the risk of obesity under an additive model [Odds ratio (OR) = 1.29, 95% CI 1.11 to 1.50] after adjusting for age and gender. Moreover, an interaction between the FTO rs9939609 genotype and physical activity (p < 0.001) was detected on BMI levels, the effect of rs9939609-A allele on BMI being (0.95 ± 0.10), (0.77 ± 0.08) and (0.67 ± 0.05) kg/m2, for subjects who performed low, moderate and severe intensity physical activity. Conclusion The FTO rs9939609 variant is strongly associated with BMI and the risk of obesity in a population of children and adolescents in Beijing, China.

Purpose: We aimed to investigate risk factors for COVID-19 pneumonia in patients with hematological malignancies (HM) after Omicron infection. Methods: Data from a registered multi-center, prospective, observational study (ChiCTR2300071830) during the latest Omicron BA.5.2 wave in Chongqing, China was used for analysis. Results: A total of 475 HM patients enrolled in this study. COVID-19 pneumonia was observed in 15.8% (75/475) of patients, with a median age of 58 years (interquartile range [IQR], 48-69 years) and males accounting for 61.3%. Risk factors associated with COVID-19 pneumonia included: 1) Active disease status of HM at infection, with an odds ratio (OR) of 3.42 (95% confidence interval [CI]: 1.59-7.37, P=0.002) compared to complete remission (CR); 2) Incomplete COVID-19 vaccination, 1-2 doses of the vaccine (OR=2.55, 95% CI: 1.28-5.10, P=0.008) or no vaccination (OR=4.81, 95% CI: 2.45-9.43, P<0.001), as opposed to 3 doses (booster); 3) chemotherapy prior to infection, <6 months (OR=2.58, 95% CI: 1.12-5.96, P=0.027) or ≥ 6 months (OR=2.93, 95% CI: 1.31-6.53, P=0.009) compared to no chemotherapy history; 4) NK-cell reduction (< 150/μL) (OR=2.19, 95% CI: 1.27-3.79, P=0.005) versus a normal range of NK cells. During the 6-week follow-up period, 12 patients (2.5%) died, accounting for 16% of COVID-19 pneumonia patients. Conclusions: Our study investigated risk factors for COVID-19 pneumonia in HM patients after Omicron BA.5.2 infection. Highlights that HM patients with these risk factors may be susceptible to lung involvement after Omicron BA.5.2 infection and need to be taken seriously in clinical practice. Clinical Trial Registration: https://www.chictr.org.cn/bin/project/edit?pid=195998 , identifier ChiCTR2300071830. [ABSTRACT FROM AUTHOR]

Natural convection is a heat transfer mechanism driven by temperature or density differences, leading to fluid motion without external influence. It occurs in various natural and engineering phenomena, influencing heat transfer, climate, and fluid mixing in industrial processes. This work aims to use the Updated Lagrangian Particle Hydrodynamics (ULPH) theory to address natural convection problems. The Navier-Stokes equation is discretized using second-order nonlocal differential operators, allowing a direct solution of the Laplace operator for temperature in the energy equation. Various numerical simulations, including cases such as natural convection in square cavities and two concentric cylinders, were conducted to validate the reliability of the model. The results demonstrate that the proposed model exhibits excellent accuracy and performance, providing a promising and effective numerical approach for natural convection problems. [ABSTRACT FROM AUTHOR]

A fluid-structure interaction approach is proposed in this paper based on Non-Ordinary State-Based Peridynamics (NOSB-PD) and Updated Lagrangian Particle Hydrodynamics (ULPH) to simulate the fluid-structure interaction problem with large geometric deformation and material failure and solve the fluid-structure interaction problem of Newtonian fluid. In the coupled framework, the NOSB-PD theory describes the deformation and fracture of the solid material structure. ULPH is applied to describe the flow of Newtonian fluids due to its advantages in computational accuracy. The framework utilizes the advantages of NOSB-PD theory for solving discontinuous problems and ULPH theory for solving fluid problems, with good computational stability and robustness. A fluid-structure coupling algorithm using pressure as the transmission medium is established to deal with the fluid-structure interface. The dynamic model of solid structure and the PD-ULPH fluid-structure interaction model involving large deformation are verified by numerical simulations. The results agree with the analytical solution, the available experimental data, and other numerical results. Thus, the accuracy and effectiveness of the proposed method in solving the fluid-structure interaction problem are demonstrated. The fluid-structure interaction model based on ULPH and NOSB-PD established in this paper provides a new idea for the numerical solution of fluid-structure interaction and a promising approach for engineering design and experimental prediction. [ABSTRACT FROM AUTHOR]