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The development of neurodegenerative diseases is closely related to the disruption of central nervous system homeostasis. Microglia, as innate immune cells, play important roles in the maintenance of central nervous system homeostasis, injury response, and neurodegenerative diseases. Lactate has been considered a metabolic waste product, but recent studies are revealing ever more of the physiological functions of lactate. Lactylation is an important pathway in lactate function and is involved in glycolysis-related functions, macrophage polarization, neuromodulation, and angiogenesis and has also been implicated in the development of various diseases. This review provides an overview of the lactate metabolic and homeostatic regulatory processes involved in microglia lactylation, histone versus non-histone lactylation, and therapeutic approaches targeting lactate. Finally, we summarize the current research on microglia lactylation in central nervous system diseases. A deeper understanding of the metabolic regulatory mechanisms of microglia lactylation will provide more options for the treatment of central nervous system diseases.

ABSTRACT Background Acute ischemic stroke (AIS) is a common cerebrovascular disease with high mortality. AIS patients in the intensive care unit (ICU) often have severe conditions that require close monitoring and timely treatment. Receptor‐interacting protein kinase 1 (RIPK1) and RIPK3 play important roles in cell apoptosis and inflammation. However, the relevance of serum RIPK1/3 to AIS patients in the ICU has not been clarified. Objective To explore the correlation of serum RIPK1 and RIPK3 with the prognosis of AIS patients in the ICU. Methods One hundred and twenty AIS patients were selected as the research subjects for the retrospective analysis. The subjects were grouped based on the volume of cerebral infarction and the score of the National Institute of Health Stroke Scale (NIHSS) and mRS. The correlation was explored using Pearson analysis. The predictive value was valued using the ROC curve. Results The content of serum RIPK1 and RIPK3 was gradually elevated with increased cerebral infarction volume and the severity of the disease (p

We report here, a case of branch retinal artery occlusion (BRAO) in the left eye of a 76-year-old man that involved three arteries which was considered to be related to a COVID-19 infection due to high levels of blood cytokines and coagulation factors. Although the patient had hypertension and atherosclerosis, his hypertension had been well controlled for the past five years by regular antihypertensive medication. Twenty-five days after starting treatment with anti-inflammatory, anticoagulant and conservative therapy, the patient’s biomarkers of inflammation and coagulation returned to normal and his vision improved. However, some visual field defects remained and were probably a consequence of low oxygen saturation.

ObjectiveTo identify the relationship between thyroid autoimmunity and antinuclear antibody (ANA) prevalence in Chinese pregnant women.MethodsThe study involved 1923 first-trimester women who were measured for thyroid stimulating hormone (TSH) level, thyroid autoantibodies (thyroperoxidase antibody [TPOAb] and thyroglobulin antibody [TgAb]) and ANA titer. Social demographic data were collected through standardized questionnaires.ResultsIn this study, 23.3% of pregnant women tested positive for TPOAb and 9.9% tested positive for TgAb. Women with a positive ANA were more likely to be TPOAb-positive or TgAb-positive than women with a negative ANA (adjusted odds ratio [AOR] 1.96, 95% confidence interval [CI] 1.47–2.62 for TPOAb [+]; AOR 3.12, 95% CI 2.18–4.48 for TgAb[+]). In addition, ANA titers were closely associated with thyroid autoimmunity. Women with an ANA titer of >1:320 had a significant higher risk of being TPOAb positive or TgAb positive (AOR 4.49, 95% CI 1.48–13.66 for TPOAb [+]; AOR 5.51, 95% CI 1.65–18.49 for TgAb [+]). The higher the ANA titer, the greater the risk of developing thyroid autoimmunity, especially for those with a high ANA titer.ConclusionsANA positivity is strongly correlated with thyroid autoimmunity. Further study is warranted to clarify the causal relationship between thyroid autoimmunity and ANA in pregnant women.This research is essential to evaluate and predict the risk of co-existing autoimmune disorders,leading to improved care for pregnancy and neonatal health.

The phosphors with persistent luminescence in the NIR (near-infrared) region and the NIR-to-NIR Stokes luminescence properties have received considerable attention owing to their inclusive application prospects in the in vivo imaging field. In this paper, Nd3+ doped SrSnO3 phosphors with remarkable NIR emission performance were prepared using a high temperature solid state reaction method; the phase structure, morphology, and luminescence properties were discussed systematically. The SrSnO3 host exhibits broadband NIR emission (800–1300 nm) with absorptions in the near ultraviolet region. Nd3+ ions emerge excellent NIR-to-NIR Stokes luminescence under 808 nm laser excitation, with maximum emission at around ~1068 nm. The concentration-dependent luminescence properties, temperature dependent emission, and the luminescence decay curves of Nd3+ in the SrSnO3 host were also studied. The Nd3+ doped SrSnO3 phosphors exhibit exceptional thermal stability; the integrated emission intensity can retain approximately 66% at 423 K compared to room temperature. Most importantly, NIR persistent luminescence also can be observed for the SrSnO3:Nd3+ samples, which is in the first and second biological windows. A possible mechanism was proposed for the persistent NIR luminescence of Nd3+ based on the thermo-luminescence spectra. Consequently, the exciting results indicate that multifunctional NIR luminescence has been successfully realized in the SrSnO3:Nd3+ phosphors.

The emission of toxic gases from industrial production has intensified issues related to atmospheric pollution and human health. Consequently, the effective real-time monitoring and removal of these harmful gases have emerged as significant challenges. In this work, the density functional theory (DFT) method was utilized to examine the adsorption behaviors and electronic properties of the Ni-decorated InSe (Ni-InSe) monolayer when interacting with twelve gases (CO, NO, NO2, NH3, SO2, H2S, H2O, CO2, CH4, H2, O2, and N2). A comparative assessment of adsorption strength and sensing properties was performed through analyses of the electronic structure, work function, and recovery time. The results show that Ni doping enhances the electrical conductivity of the InSe monolayer and improves the adsorption capabilities for six toxic gases (CO, NO, NO2, NH3, SO2, and H2S). Furthermore, the adsorption of these gases on the Ni-InSe surface is characterized as chemisorption, as indicated by the analysis of the adsorption energy, density of states, and charge density difference. Additionally, the adsorption of CO, NO, NO2, and SO2 results in significant alterations to the bandgap of Ni-InSe, with changes of 18.65%, 11.37%, 10.62%, and −31.77%, respectively, underscoring its exceptional sensitivity. Moreover, the Ni-InSe monolayer exhibits a moderate recovery time of 3.24 s at 298 K for the SO2. Consequently, the Ni-InSe is regarded as a promising gas sensor for detecting SO2 at room temperature. This research establishes a foundation for the development of an Ni-InSe-based gas sensor for detecting and mitigating harmful gas emissions.

Background: The feasibility of using laparoscopic proximal gastrectomy (LPG) for the treatment of proximal early gastric cancer (EGC) has not been addressed. This study aimed to comparatively evaluate the effects on LPG with piggyback jejunal interposition double-tract reconstruction (PJIDTR) versus laparoscopic total gastrectomy (LTG) with Roux-en-Y reconstruction (overlap method) using propensity score matching for proximal EGC. Materials and Methods: We examined the clinical outcomes of LPG with PJIDTR for proximal EGC. We retrospectively collected data from patients with proximal EGC who were treated at Shanxi Cancer Hospital between January 2012 and December 2015. The complication rate, nutritional indicators, reflux oesophagitis incidence and overall survival were compared between LTG and LPG with PJIDTR. Results: Of the 424 patients, 200 were excluded, and 50 of the remaining patients received LPG with PJIDTR. Fifty matched LTG patients were screened. The incidence of early complications was 14% in the LPG group and 16% in the LTG group (P > 0.05). At 1 year after surgery, nutrition indices in the LPG group were significantly better than those in the LTG group (P < 0.05). One year after surgery, the Visick score II rate was 2% and 4%, and the endoscopic oesophagitis rate was 4% and 6% in the LPG and LTG groups, respectively. No tumour recurrence was observed in either group. The 5-year overall survival rates of the two groups were 98% and 90% (P = 0.08). Conclusions: LPG with PJIDTR may be suitable for proximal EGC.

Giant cell arteritis (GCA) is a granulomatous inflammation involving medium and large vessels that can lead to serious clinical manifestations associated with tissue ischemia. Temporal artery biopsy (TAB) is currently the gold standard method for the diagnosis of GCA, with a specificity of 100% and a sensitivity of 77%. However, the false-negative rate for TAB ranges from 9% to 61%. False negatives may be related to the timing of biopsy, the length of specimen, and the existence of “skip lesions.” We reviewed the relevant evidence for methods to improve the sensitivity and reduce the false-negative rate for TAB. To reduce the false-negative rate for TAB, it is recommended to perform TAB within 1 week of starting corticosteroid therapy. Although there is currently no consensus, we suggest that the temporal artery is cut to a length of 20‒30 mm and to prepare serial pathological sections. It is necessary to attach great importance to patients suspected of having GCA, and complete TAB should be performed as soon as possible while starting corticosteroid therapy promptly. We also discuss the clinical value of non-invasive vascular imaging technologies, such as DUS, CTA, MRA, and 18F-FDG-PET/CT, as auxiliary methods for GCA diagnosis that could partially replace TAB.

Multi-band emission luminescence materials are of great significance owing to their extensive application in diverse fields. In this research, we successfully prepared a series of Pr3+-doped Ca3Al2O6 multi-band emission phosphors via a high-temperature solid-state method. The phase structure, morphology, luminescence spectra and decay curves were investigated in detail. The Ca3Al2O6:Pr3+ phosphors can absorb blue lights and emit lights in the 450–750 nm region, and typical emission bands are located at 488 nm (blue), 525–550 nm (green), 611–614 nm (red), 648 nm (red) and 733 nm (deep red). The influence of the Pr3+ doping concentration was discussed, and the optimal Pr3+ doping concentration was determined. The impacts of charge compensator ions (Li+, Na+, and K+) on the luminescence of Pr3+ were also investigated, and it was found that all the charge compensator ions contributed positively to the emission intensity. More importantly, the emission intensity of the as-prepared phosphors at 423 K can still maintain 65–70% of that at room temperature, and the potential application for pc-LED was investigated. The interesting results indicate that the prepared phosphors may serve multifunctional and advanced applications.

Objective. To analyze the longitudinal changes in peripapillary capillary density in patients with acute VKH with or without optic disc swelling by optical coherence tomography angiography (OCTA). Methods. Retrospective case series. 44 patients (88 eyes) were enrolled and were divided into two groups according to presence/absence of optic disc swelling before treatment. Peripapillary capillary images were obtained by OCTA before and after 6 months of corticosteroid treatment and used to determine the radial peripapillary capillary (RPC), retinal plexus, and choriocapillaris vessel perfusion densities. Results. Optic disc swelling was present in 12 patients (24 eyes) and absent in 32 patients (64 eyes). The sex distribution, age, intraocular pressure, and best-corrected visual acuity before and after treatment were not significantly different between the two groups (all P>0.05). Compared to those in nonoptic disc swelling group, the percentages of decreased vessel perfusion densities after treatment in the supranasal (RPC, 100.00% vs. 75.00%), infranasal (RPC, 100.00% vs. 56.25%), infratemporal (RPC, 66.67% vs. 37.50%), and infranasal quadrants (retinal plexus, 83.33% vs. 56.25%) were significantly more in optic disc swelling group. The choriocapillaris vessel perfusion density increased after treatment in both groups. Conclusions. Decreases in vessel perfusion densities of the RPC and retinal plexus after treatment in VKH patients with optic disc swelling were more common than in those without optic disc swelling. The choriocapillaris vessel perfusion density increased after treatment, regardless of the presence/absence of optic disc swelling.

Glioblastoma (GBM) is the most malignant glioma in brain tumors with low survival and high recurrence rate. Irigenin, as an isoflavone compound extracted from Shegan, has shown many pharmacological functions such as antioxidant, anti-inflammatory and anti-tumor. However, the effects of irigenin on GBM cells and the related molecular mechanisms remain unexplored. In this study, we found that irigenin inhibited the proliferation of GBM cells in a dose-dependent manner by several assays in vitro. Subsequently, we found that irigenin arrested cell cycle at G2/M phase and induced apoptosis of GBM cells in vitro. In addition, irigenin inhibited the migration of GBM cells. Mechanically, we found that irigenin treatment decreased the expression of YAP (yes-associated protein), suppressed β-catenin signaling. Furthermore, overexpression of YAP partially restored the anti-tumor effects of irigenin on GBM cells in vitro. Finally, we found that irigenin inhibited the growth of tumor in GBM xenograft mice model through inactivation of YAP. Taken together, these results suggest that irigenin exerts its anticancer effects on GBM via inhibiting YAP/β-catenin signaling, which may provide a new strategy for the treatment of GBM.

AimTo determine the ideal surgical approach for Siewert type II EGJ carcinomas.MethodsWe conducted the randomized controlled trial (RCT) at Shanxi Cancer Hospital from January 2014 to August 2016. A total of 105 patients with T1-4N1-3M0 Siewert type II EGJ carcinomas were initially recruited. The final follow-up was up to June 30, 2019. Patients were randomized to undergo either a proximal gastrectomy plus jejunal interposition (PG+JI), proximal gastrectomy plus esophagogastrostomy (PG+EG), or total gastrectomy plus Roux-en-Y esophagojejunostomy (TG+RY). The primary endpoint was postoperative complications. Secondary endpoints were 5-year survival and recovery indexes.ResultsAmong 105 patients, 100 patients (95.2%; mean age, 56.2 years) with tumors

Abstract Background The incidence of adenocarcinoma of esophagogastric junction (AEG) has recently risen worldwide, including in Eastern Asia. The aim of the study was to explore the short-term and long-term clinical efficacy of piggyback jejunal interposition reconstruction single-tract reconstruction (PJIRSTR), piggyback jejunal interposition reconstruction double-tract reconstruction (PJIRDTR), and total gastrectomy esophageal jejunal Roux-en-Y anastomosis (TGRY) for the treatment of Siewert II and III AEG patients. Methods A total of 300 Siewert II and III AEG patients admitted to Shanxi Tumor Hospital from June 2015 to December 2017 were prospectively selected. Patients were randomly divided into PJIRSTR group (n = 98), PJIRDTR group (n = 103), and TGRY group (n = 99) using the random number table method. Results There were no statistically significant differences in total operation time, intraoperative blood loss, time of first anal exhaust, and postoperative hospital stay among the three groups (F = 2.526, 0.457, 0.234, 0.453; P > 0.05). The reconstruction time of PJIRSTR group and PJIRDTR group was longer than that of TGRY group (P < 0.01). There were no significant differences in cases of anastomotic leakage, anastomotic bleeding, abdominal infection, incision infection, ileus, and dumping syndrome in three groups (P > 0.05). The incidence of reflux esophagitis at 3, 6, 12, and 18 months after surgery in the PJIRSTR group and the PJIRDTR group were significantly lower than TGRY group in the same period (P < 0.05). Compared with PJIRDTR group and TGRY group, PJIRSTR group had a small fluctuation range of postoperative nutrition indexes and had basically recovered to the preoperative level at 18 months. Four patients of Visick grade IV presented in TGRY group 18 months postoperatively, which was significantly higher compared with the other two groups. Conclusion Compared with PJIRDTR and TGRY, PJIRSTR can significantly reduce the incidence of postoperative reflux esophagitis and improve the long-term nutritional status of patients. Trial registration Chinese Clinical Trial Registry, ChiCTR-IIR-16007733. Registered 07 November 2015 – Retrospectively registered, http://www.chictr.org.cn/searchproj.aspx.

Identification of circulating tumor cells (CTCs) from a majority of various cell pools has been an appealing topic for diagnostic purposes. This study numerically demonstrates the isolation of CTCs from blood cells by the combination of dielectrophoresis and magnetophoresis in a microfluidic chip. Taking advantage of the label-free property, the separation of red blood cells, platelets, T cells, HT-29, and MDA-231 was conducted in the microchannel. By using the ferromagnet structure with double segments and a relatively shorter distance in between, a strong gradient of the magnetic field, i.e., sufficiently large MAP forces acting on the cells, can be generated, leading to a high separation resolution. In order to generate strong DEP forces, the non-uniform electric field gradient is induced by applying the electric voltage through the microchannel across a pair of asymmetric orifices, i.e., a small orifice and a large orifice on the opposite wall of the channel sides. The distribution of the gradient of the magnetic field near the edge of ferromagnet segments, the gradient of the non-uniform electric field in the vicinity of the asymmetric orifices, and the flow field were investigated. In this numerical simulation, the effects of the ferromagnet structure on the magnetic field, the flow rate, as well as the strength of the electric field on their combined magnetophoretic and dielectrophoretic behaviors and trajectories are systemically studied. The simulation results demonstrate the potential of both property- and size-based cell isolation in the microfluidic device by implementing magnetophoresis and dielectrophoresis.

The relationships between spatial production, urbanization and sustainable development are becoming a focus of the international academic cycle. Urbanization dominated by spatial production driven by capital and power often produces and enlarges uneven development, which leads to multiple eco-environmental problems. Thus, the key to development lies in whether the pattern of urbanization is in harmony with the ecological environment. However, previous researches mainly concentrate on spatial production in developed countries or regions. The urbanization and sustainable development of less-developed regions, with complex and fragile ecological environments, are often overlooked. It is a new idea to explain the relationships and interactions between spatial production, urbanization and sustainable development based on less-developed regions by the theory of spatial production. The paper chooses the Hexi Corridor as a typical case, puts forward a conceptual framework and explores the process of spatial production from 2000 to 2017. The results reveal that urbanization in the Hexi Corridor is a multidimensional socio-spatial process: power and capital gave birth to a higher urbanization and accelerated the process of urbanization, however, the urban-rural gap between regions has not narrowed accordingly. Driven by comprehensive interests, local governments often take some extreme measures to forcefully promote the urbanization process, thereby violating the goals and requirements of sustainable development. At present, there is an urgent need to coordinate the relationship between urban and rural regions on different scales and transform the urbanization model from traditional spatial production to a new-type of urbanization with people-oriented and sustainable development.

Background: The objective of this study is to identify independent risks and protective factors and to construct a mortality prediction model for gastrectomy in the Chinese population.Study design: This is a population-based prospective cohort at an institutional level. Seventy-two participating hospitals reported their annual gastrectomy data between 2014 and 2016, while 44 variables covering the institution and surgical information were included in the analysis. We used R software to encode and complete data pre-processing. The first difference model was applied to build the risk model. Data from 2014 and 2015 were assigned to risk model development, while data from 2016 was used for validation.Results: In the included centers with 94,277 gastric cancer cases, the in-hospital mortality rate was 0.32%. The regression model revealed that provinces with low-middle GDP, hospitals with annual gastrectomy volume between 100 and 500, greater volume of urgent surgeries performed, larger proportion of males, and a higher proportion of liver metastasis were independent risk factors for mortality following gastric surgeries, while higher laparoscopic resection volume, greater volume of distal gastrectomy with B2 reconstruction, and larger proportion of palliative surgery were independent protective factors (p < 0.05, respectively). In the prediction test, the mean square error of the training set was 0.948, while that of the test set was 0.728, demonstrating the effectiveness of this model.Conclusions: We constructed the first mortality risk prediction model for gastric cancer surgery in the Chinese population. The identified risk factors will help with the therapy selection, while further informing Chinese medical policy decision-makers.

The M1/M2 phenotypic shift of microglia after spinal cord injury plays an important role in the regulation of neuroinflammation during the secondary injury phase of spinal cord injury. Regulation of shifting microglia polarization from M1 (neurotoxic and proinflammatory type) to M2 (neuroprotective and anti-inflammatory type) after spinal cord injury appears to be crucial. Tryptanthrin possesses an anti-inflammatory biological function. However, its roles and the underlying molecular mechanisms in spinal cord injury remain unknown. In this study, we found that tryptanthrin inhibited microglia-derived inflammation by promoting polarization to the M2 phenotype in vitro. Tryptanthrin promoted M2 polarization through inactivating the cGAS/STING/NF-κB pathway. Additionally, we found that targeting the cGAS/STING/NF-κB pathway with tryptanthrin shifted microglia from the M1 to M2 phenotype after spinal cord injury, inhibited neuronal loss, and promoted tissue repair and functional recovery in a mouse model of spinal cord injury. Finally, using a conditional co-culture system, we found that microglia treated with tryptanthrin suppressed endoplasmic reticulum stress–related neuronal apoptosis. Taken together, these results suggest that by targeting the cGAS/STING/NF-κB axis, tryptanthrin attenuates microglia–derived neuroinflammation and promotes functional recovery after spinal cord injury through shifting microglia polarization to the M2 phenotype.

The thermodynamic behavior and the effects of energy saving in the production of Fe-Si-Ca master alloy from modified molten converter slag using SiO2 as a modifier were investigated by thermodynamic analysis with different additions of the modifier and reductant at various temperatures to fully recycle the physical sensible heat and valuable elements in the metallurgical slag. The results showed that the activity of SiO2 in the slag increased rapidly with the w(SiO2) increase from 40 wt.% to 60 wt.%, but the activity of CaO was low and decreased slightly with the w(SiO2) increase. When the w(SiO2) in the slag was 60 wt.% with an external addition of 35 wt.% of reductant at 1800 °C, the reduction ratios of silicon and calcium reached 90.05 mass % and 52.87 mass %, respectively, and the w[Si] and w[Ca] in the master alloy were 51.60 wt.% and 17.67 wt.%, respectively, resulting in an energy saving of 805.6 kWh per ton of produced ferroalloys.DOI: http://dx.doi.org/10.5755/j01.ms.21.4.9559

BACKGROUND/AIM:The feasibility of using laparoscopic gastrectomy for the treatment of Siewert-type II/III adenocarcinoma of the esophagogastric junction (AEG) has not been addressed. This study aimed to comparatively evaluate the short- and long-term effects on laparoscopic versus open surgery using (propensity score matching) PSM for Siewert-type II/III AEG. METHODS:We retrospectively collected data from the patients with Siewert-type II/III AEG who were treated in our cancer center between January 2013 and December 2015. Patients undergoing laparoscopic gastrectomy and open gastrectomy were matched via PSM. The cumulative 2-year Overall survival (OS) rate of patients in the two cohorts was estimated by Kaplan-Meier plots. Multi-variable analysis using a Cox regression model was conducted to identify independent risk factors. RESULTS:A total of 963 patients with Siewert-type II/III AEG were included, of which 132 cases were in the laparoscopic gastrectomy group, and 831 cases were in the open gastrectomy group. After regrouping with PSM, 132 patients in the laparoscopic gastrectomy group were balanced with 264 similar patients in the open gastrectomy group. As expected, the laparoscopic gastrectomy group had significantly longer operation times, but less blood loss. Furthermore, the two groups showed similar results for post-operative complications, duration of hospital stay and 2-year OS rate. Combined organ resection was an independent risk factor for 2-year OS rate. CONCLUSION:This study suggests that laparoscopic gastrectomy may serve as a safe and feasible treatment for Siewert-type II/III AEG and achieve similar oncologic outcomes as open gastrectomy.

Mineralogical phases of steelmaking slags have significant influences on the carbonation of the slags. In this paper, the effects of temperature and reaction time on the conversion of calcium-related phases and the carbonation degree of a slag sample were studied. The experimental conditions were a liquid-to-solid ratio of 20 mL/g, a carbon dioxide flow rate of 1 L/min and a slag particle size of 38–75 μm. The results show that the optimum carbonation temperature and reaction time are 60 °C and 90 min, respectively, and calcite phase content is about 26.78% while the conversion rates of Ca3Al2O6, CaSiO3, Ca2SiO4 and free CaO are about 40%, 42.46%, 51% and 100%, respectively, and the carbon dioxide sequestration efficiency is about 170 g/kg slag.

Background and Objectives: Non-alcoholic fatty liver disease (NAFLD) has become a worldwide public health problem. Current evidence on the association between dietary iron intake and the risk of NAFLD is limited. The present study aimed to investigate the associations of animal-derived dietary iron (ADDI) intake, plant-derived dietary iron (PDDI) intake, and the ratio of PDDI:ADDI with NAFLD risk among U.S. adult population. Methods and Study Design: This was a repeated cross-sectional study. Data were collected from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. NAFLD was defined as a United States Fatty Lives Index ≥30, and dietary iron intake was assessed through two 24-h dietary recall interviews. Logistic regression and restricted cubic spline models were applied to examine the associations between dietary iron intake from different sources and NAFLD risk. Results: A total of 9478 participants aged ≥20 years were enrolled in the present study. After adjustment for multiple confounding factors, relative to the lowest quartile, the odds ratio (OR) and 95% confidence interval (CI) of NAFLD for the highest quartile was 1.01(95% CI, 0.82-1.24) for ADDI intake, 0.82 (95% CI, 0.64-0.99) for PDDI intake, and 1.00 (95% CI, 0.81-1.24) for the PDDI: ADDI intake ratio. In stratified analysis by sex and age, the significantly negative associations of PDDI intake with NAFLD was observed in women and participants older than 45 years. Dose-response analyses indicated that NAFLD was negatively associated with PDDI intake in a non-linear manner. Conclusions: PDDI intake was negatively associated with NAFLD in U.S. adults. [ABSTRACT FROM AUTHOR]