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Background and Aims: Human studies about short-chain fatty acids (SCFAs), the gut microbiome, and Type 2 diabetes (T2DM) are limited. Here we explored the association between SCFAs and T2DM and the effects of gut microbial diversity on glucose status in rural populations., Methods and Results: We performed a cross-sectional study from the Henan Rural Cohort and collected stool samples. Gut microbiota composition and faecal SCFA concentrations were measured by 16S rRNA and GC-MS. The population was divided based on the tertiles of SCFAs, and logistic regression models assessed the relationship between SCFAs and T2DM. Generalized linear models tested the interactions between SCFAs and gut microbial diversity on glucose indicators (glucose, HbAlc and insulin). Compared to the lowest tertile of total SCFA, acetate and butyrate, the highest tertile exhibited lower T2DM prevalence, with ORs and 95% CIs of 0.291 (0.085-0.991), 0.160 (0.044-0.574) and 0.171 (0.047-0.620), respectively. Restricted cubic spline demonstrated an approximately inverse S-shaped association. We also noted interactions of the ACE index with the highest tertile of valerate on glucose levels (P-interaction = 0.022) and the Shannon index with the middle tertile of butyrate on insulin levels (P-interaction = 0.034). Genus Prevotella_9 and Odoribacter were inversely correlated with T2DM, and the genus Blautia was positively associated with T2DM. These bacteria are common SCFA-producing members., Conclusions: Inverse S-shaped associations between SCFAs (total SCFA, acetate, and butyrate) and T2DM were observed. Valerate and butyrate modify glucose status with increasing gut microbial diversity., Competing Interests: Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Background: High-sodium intake is one of the most important risk factors for hypertension and cardiovascular disease, yet reliable national estimates of sodium intake in Chinese adults have not been reported., Objectives: We estimated 24-h urinary sodium and potassium excretion and population daily sodium and potassium intake of Chinese adults for the first time at a national level., Methods: A nationally representative cross-sectional survey was conducted to collect 24-h urine specimens from Chinese adults aged ≥18 y as part of the China National Nutrition Survey 2015. Finally, 10,114 participants (4932 males and 5182 females) with complete 24-h urine specimens were included in the analysis. Estimates of mean urinary electrolyte excretion and demographic, socioeconomic, and health characteristics were used with weighted coefficients that accounted for sample selection probabilities, poststratification weighting, and nonresponse rates., Results: The estimation of overall weighted mean 24-h urinary sodium excretion was 4121 mg (95% confidence interval [CI]: 3993, 4250), 4155 mg (95% CI: 3993, 4317) in males and 4081 mg (95% CI: 3953, 4209) in females (P for sex difference = 0.36). Overall mean 24-h urinary potassium excretion was 1534 mg (95% CI: 1492, 1577), 1468 mg (95% CI: 1424, 1513) in males and 1614 mg (95% CI: 1569-1660) in females (P for sex difference <0.001). Mean 24-h urinary sodium excretion was significantly higher in rural adults (4350 mg; 95% CI: 4217, 4483) than in urban residents (3909 mg; 95% CI: 3739, 4080; P < 0.001), and in northern residents (4388 mg; 95% CI: 4237, 4539) than in southern residents (3998 mg; 95% CI: 3832, 4163; P = 0.002)., Conclusions: The first nationwide survey with 24-h urine collection confirmed that mean sodium intake in Chinese adults was more than twice the upper limit, whereas mean potassium intake was <60% of the lower limit, recommended by the World Health Organization. Urgent measures should be taken to reduce sodium intake and increase potassium intake in China., (Copyright © 2023 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Backgrounds and Aims: Evidence on the association between habitual snoring, excessive daytime sleepiness (EDS), and cardiovascular diseases (CVDs) remains uncertain and limited. The study aimed to explore the independent and joint association between habitual snoring, EDS, and CVDs in rural Chinese adults., Methods and Results: A total of 28,140 participants from the Henan rural cohort study were included. Sleep status information was obtained by self-reported. Based on their sleep status, the participants were classified into four groups: "no snoring and no EDS (NSNS) (reference group)", "snoring and no EDS (SNS)", "no snoring and EDS (NSS)", "snoring and EDS (SS)." The logistic regression models were used to calculate independent and joint odds ratios (OR) and 95% confidence intervals (CI) between the snoring, EDS status and stroke, CHD, and CVD. Of the 28,140 participants, 740 subjects reported snoring and sleepiness. The ORs and (95% CIs) for CVDs in the adjusted model were 1.31 (1.20-1.43) for participants who snored frequently and 2.44 (1.76-3.39) for frequent sleepiness compared with no snoring and no sleepiness. Individuals with both snoring and sleepiness had higher odds of CVDs compared with no snoring and no sleepiness (OR: 2.18, 95%CI: 1.80-2.62)., Conclusion: Habitual snoring and excessive daytime sleepiness were independently and jointly associated with CVDs in the Chinese rural population. More studies are needed to explore the mechanisms of the relationship., Clinical Trial Registration: The Henan Rural Cohort Study has been registered at the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-52 07-06. http://www.chictr.org.cn/showproj.aspx?proj=11375., Competing Interests: Conflict of interest The authors declare that they have no conflict of interest., (Copyright © 2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Soil quality is essential for maintaining the sustainability of agroecosystems, especially under intensified agricultural activities and rapid land use change. The sampling and analysis of soil properties to assess the status of agricultural land is widely practiced at the field scale; however, the spatiotemporal variations in soil quality and its influencing factors at a large scale remain unclear. Here, we quantified spatiotemporal variations in the soil quality of agricultural land in China during 1980-2018 by using the soil quality index (SQI) area approach, and explored the drivers with a geographical detector method. The results showed that the distribution of the SQI in the two periods had a similar spatial trend, except for that in the southwest (SWC), and the SQI decreased from north to south regardless of land use type. The soil quality of woodland was comparatively good with mean SQI values of 1.55 and 1.53 in 1980 and 2018, respectively, followed by that in grassland and cropland. Soil organic carbon, total nitrogen and cation exchange capacity were the dominant soil indicators explaining the spatial heterogeneity of the SQI in all land uses; moreover, climatic factors (i.e., temperature and precipitation) showed a stronger effect on woodland. From 1980 to 2018, the SQI of grassland decreased deeply, especially in the SWC, which showed a severe decline of 12.5 %. The changes in precipitation and temperature were identified as the largest drivers of SQI temporal changes in woodland and grassland, respectively, and their interaction achieved the highest impact across all land uses. In addition, the bidirectional conversion between cropland and grassland in recent decades has aggravated the deterioration of soil quality. Therefore, quantifying spatiotemporal changes in the SQI and elucidating the role of factors influencing soil quality in agroecosystems can provide a guide for designing sustainable agriculture policies and improving environmental quality., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Immune stress exerts detrimental effects on growth performance and intestinal barrier function during intensive animal production with ensuing serious economic consequences. Chlorogenic acid (CGA) is used widely as a feed additive to improve the growth performance and intestinal health of poultry. However, the effects of dietary CGA supplementation on amelioration of the intestinal barrier impairment caused by immune stress in broilers are unknown. This study investigated the effects of CGA on growth performance, intestinal barrier function, and the inflammatory response in lipopolysaccharide (LPS) mediated immune-stressed broilers. Three hundred and twelve 1-day-old male Arbor Acres broilers were divided randomly into 4 groups with 6 replicates of thirteen broilers. The treatments included: i) saline group: broilers injected with saline and fed with basal diet; ii) LPS group: broilers injected with LPS and fed with basal diet; iii) CGA group: broilers injected with saline and feed supplemented with CGA; and iv) LPS+CGA group: broilers injected with LPS and feed supplemented with CGA. Animals in the LPS and LPS+CGA groups were injected intraperitoneally with an LPS solution prepared with saline from 14 d of age for 7 consecutive days, whereas broilers in the other groups were injected only with saline. LPS induced a decrease in feed intake of broilers during the stress period, but CGA effectively alleviated this decrease. Moreover, CGA inhibited the reduction of villus height and improved the ratio of villus height to crypt depth in the duodenum of broilers 24 and 72 h after LPS injection. In addition, dietary CGA supplementation significantly restored the expression of cation-selective and channel-forming Claudin2 protein 2 h after LPS injection in the ileum. LPS enhanced the expression of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in the small intestine, but this enhancement was blocked by CGA supplementation. The expression of interleukin-10 (IL-10) increased with LPS injection and CGA promoted the production of IL-10. CGA addition downregulated the expression of intestinal interleukin-6 (IL-6) of broilers under normal rearing conditions. However, CGA supplementation upregulated the expression of IL-6 of broilers 72 h after LPS injection. The data demonstrate that dietary supplementation with CGA alleviates intestinal barrier damage and intestinal inflammation induced by LPS injection during immune stress thereby improving growth performance of broilers., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background and Aims: The relationship between reproductive factors and type 2 diabetes (T2D) is controversial; therefore, we explored the causal relationship of age at menarche (AAM), age at natural menopause (ANM), with the risk of T2D and glycemic traits using two-sample Mendelian randomization., Methods and Results: We used publicly available data at the summary level of genome-wide association studies, where AAM (N = 329,345), ANM (N = 69,360), T2D (N = 464,389). The inverse variance weighting (IVW) method was employed as the primary method. To demonstrate the robustness of the results, we also conducted various sensitivity analysis methods including the MR-Egger regression, the weighted median (WM) and the MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test. After excluding IVs associated with confounders, we found a causal association between later AAM and reduced risk of T2D (OR 0.81 [95% CI 0.75, 0.87]; P = 2.20 × 10 -8 ), lower levels of FI (β -0.04 [95% CI -0.06, -0.01]; P = 2.19 × 10 -3 ), FPG (β -0.03 [95% CI -0.05, -0.007]; P = 9.67 × 10 -5 ) and HOMA-IR (β -0.04 [95% CI -0.06, -0.01]; P = 4,95 × 10 -3 ). As for ANM, we only found a causal effect with HOMA-IR (β -0.01 [95% CI -0.02, -0.005]; P = 1.77 × 10 -3 ), but not with T2D., Conclusions: Our MR study showed a causal relationship between later AAM and lower risk of developing T2D, lower FI, FPG and HOMA-IR levels. This may provide new insights into the prevention of T2D in women., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

The established evidence of cooking fuel use and socioeconomic status related to anemia is limited in low- and middle-income countries. The current study aims to examine the independent and combined effects of cooking fuel use and socioeconomic status on anemia risk as well as anemia-related parameters in rural China. A total of 21,050 participants were included from the baseline of the Henan Rural Cohort. Anemia was determined according to the World Health Organization criteria. Data on cooking fuel use (electricity, gas and solid fuel) and socioeconomic status (education and income levels) were collected using a standardized questionnaire by face-to-face interview. Logistic and linear regression models were applied to evaluate the effects of cooking fuel use or socioeconomic indicators on anemia risk, hemoglobin (HGB), red blood count (RBC), and hematocrit (HCT) levels. Using gas or solid fuel for cooking was positively associated with prevalent anemia risk and negatively related to HGB, RBC, and HCT levels compared to using electricity. Significant independent associations were also found between socioeconomic status (education and income levels) and prevalent anemia risk as well as these anemia-related parameters. In general, with decreased socioeconomic status, associations of using gas or solid fuel for cooking with advanced anemia risk as well as lower anemia-related parameters were increased. Furthermore, participants using gas or solid fuel for cooking and with lower education or income level were related to increased high anemia risk as well as low HGB, RBC and HCT levels, compared to those using electricity for cooking and with high education or income level (P <0.05 for all). The finding suggested that lower socioeconomic status strengthens the adverse effect of cooking fuel use on the higher anemia risk and lower HGB, RBC, and HCT levels in rural China., Competing Interests: Declaration of competing interest All authors have read and approved this version of the article, and declared that they had no competing or financial interests to disclosure., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background and Aims: Evidence on the association of snoring, daily sleep duration (daytime napping and night sleep duration) with hyperuricemia (HUA) was limited, especially in the resources-poor areas. This study aimed to investigate the independent effect of snoring frequency and daily sleep duration on HUA prevalence in rural Chinese adults., Methods and Results: 29,643 participants aged 18-79 years were included in the final cross-sectional analysis from the Henan Rural Cohort Study. Multivariate logistic regression and linear regression models with HUA and serum uric acid (SUA) levels as dependent variables were conducted, respectively. Of the 29,643 included adults, 3498 suffered from HUA. Compared to never snoring, the adjusted odds ratio (OR) and 95% confidence interval (CI) of HUA for rare snoring, occasional snoring, and habitual snoring were 1.35 (1.17, 1.56), 1.30 (1.14, 1.47), and 1.59 (1.47, 1.73), respectively (P for trend <0.001). Compared with no napping, participants who had daytime napping of 61-90 and > 91 min were associated with a 29% and 30% increase in the prevalence of HUA, respectively (P for trend <0.001). But in night sleep duration groups, no significant associations were observed. The positive associations between snoring and HUA were attenuated in people aged ≥65 and people with type 2 diabetes mellitus (both P for interaction <0.05)., Conclusion: Habitual snoring or longer daytime napping was independently associated with increased HUA prevalence and SUA levels in rural Chinese adults, which indicates the significance of early intervention and treatment of snoring and longer daytime napping to prevent hyperuricemia., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Microplastics (MPs) cause an increased threat to the freshwater environment by adsorbing pollutants on their large surface area. Considering their adsorption characteristics, non-polar pollutants with high distribution coefficients have been studied extensively. However, comprehensive research on the types of polar pollutants adsorbed by MPs is lacking. In this study, a nontarget screening strategy, including classification and identification, was performed to analyze the pollutants adsorbed by MPs in Tai Lake and the Yangtze River. Compared with the pollutants adsorbed or added to raw plastics, more types of polar pollutants were found on MPs from freshwater. The nontarget classification of 4723 features on MPs from freshwater and 680 features from raw plastics were annotated based on the mass spectrometry spectra. Further identification with multiple platforms identified hundreds of pollutants absorbed by MPs in Tai Lake and Yangtze River, including industrial intermediates, medicines, and surfactants, exceeding those adsorbed by raw plastics, showing an enrichment of the pollutants on MPs in freshwater by secondary adsorption. Our study is the first to use nontarget analysis to comprehensively demonstrate MP adsorption and release of pollutants in freshwater environment, providing a significant reference for the research of MPs and the management of the water environment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Soil microbial richness, diversity, and functional gene abundance are crucial factors affecting belowground ecosystem functions; however, there is still a lack of systematic understanding of their responses to global change. Here, we conducted a worldwide meta-analysis using 1071 observation data concerning the effects of global change factors (GCFs), including warming (W), increased precipitation (PPT+), decreased precipitation (PPT-), elevated CO 2 concentration (eCO 2 ), and nitrogen deposition (N), to evaluate their individual, combined, and interactive effects on soil microbial properties across different groups and ecosystems. Across the dataset, eCO 2 increased microbial richness and diversity by 40.5% and 4.6%, respectively; warming and N addition decreased the abundance of denitrification functional genes (nirS, nirK, and nozS); N addition had a greater impact on soil C-cycling functional genes than on N-cycling ones. Long-term precipitation change was conducive to the increase in soil microbial richness, and fungal richness change was more sensitive than bacterial richness, but the sensitivity of bacteria richness to N addition was positively correlated with experimental duration. Soil microbial richness, diversity, and functional gene abundances could be significantly affected by individual or multiple GCF changes, and their interactions are mainly additive. W×eCO 2 on microbial diversity, and N×PPT+ and W×N on N-cycling functional gene abundance showed synergistic interactions. Based on the limitations of the collected data and the findings, we suggest designing experiments with multiple GCFs and long experimental durations and incorporating the effects and interactions of multiple drivers into ecosystem models to accurately predict future soil microbial properties and functions under future global changes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Thousands of unlined landfills and open dumpsites seriously threatened the safety of soil and groundwater due to leachate leakage with a mass of pollutants, particularly heavy metals, organic contaminants and ammonia. Phytoremediation is widely used in the treatment of cocontaminated soils because it is cost-effective and environmentally friendly. However, the extent to which phytoremediation efficiency and plant physiological responses are affected by the high nitrogen (N) content in such cocontaminated soil is still uncertain. Here, pot experiments were conducted to investigate the effects of N addition on the applicability of legume alfalfa remediation for polycyclic aromatic hydrocarbon‑cadmium (PAHCd) co-/contaminated soil and the corresponding microbial regulation mechanism. The results showed that the PAH dissipation rates and Cd removal rates in the high-contamination groups increased with the external N supply, among which the pyrene dissipation rates in the cocontaminated soil was elevated most significantly, from 78.10% to 87.25%. However, the phytoremediation efficiency weakened in low cocontaminated soil, possibly because the excessive N content had inhibitory effects on the rhizobium Ensifer and restrained alfalfa growth. Furthermore, the relative abundance of PAH-degrading bacteria in the rhizosphere dominated PAH dissipation. As reflected by principal coordinate analysis (PCoA) analysis and hierarchical dendrograms, the microbial community composition changed with N addition, and a more pronounced shift was found in the rhizosphere relative to the endosphere or shoots of alfalfa. This study will provide a theoretical basis for legume plant remediation of dumpsites as well as soil contaminated with multiple pollutants., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background and Aims: Janus kinase 2 (JAK2) play an important role in the energy metabolism. Whether there is a causal relationship between JAK2 methylation levels and obesity remains unclear. Based on the instrumental variables of 5 SNP sites, this study was aimed to explore the causal relationship between JAK2 methylation levels and obesity by Mendelian randomization analysis., Methods and Results: A total of 1021 participants (511 cases and 510 controls defined by body mass index (BMI) ≥ 28.0 kg/m 2 ) was conducted from the Henan Rural Cohort study. SNPscan® was performed to test the SNP genotyping and MethylTarget™ was applied to detect the DNA methylation level. The logistic regression model was used to evaluate the associations between SNP or methylation of JAK2 and obesity (according to BMI). Mendelian randomization analysis was used to assess the potential causal association between JAK2 methylation and obesity. According to the logistic regression model, 1 CpG sit in the promotor was related to an increased risk of obesity (P < 0.05). 10 CpG sites in the exon were associated with decreased risk of obesity (P < 0.05). Mendelian randomization analysis showed a causal association between the methylated level of JAK2 and obesity, based on the instrumental variables of 5 SNPs (P < 0.05)., Conclusions: This study supported that the methylation degree of JAK2 has a complex relationship with obesity, which might be related to the region of methylation. A causal relationship exists between the methylated level of JAK2 and obesity., Competing Interests: Declaration of competing interest All authors had declared no conflict of interest., (Copyright © 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Bacterial chemotaxis can improve the efficiency of aromatic compound degradation, however, knowledge of how bacteria sense high-molecular-weight polycyclic aromatic hydrocarbons (HMW-PAHs), is limited. Here, the chemotactic responses of Novosphingobium pentaromativorans US6-1 to 9 aromatic compounds were investigated. The results showed that US6-1 chemotactically responded to phenanthrene (PHE), pyrene (PYR), benzo[a]pyrene (BaP) and their six metabolites. Six methyl-accepting chemotaxis proteins (MCPs) were annotated from US6-1 genome, four of which contained putative ligand-binding domains (LBDs). To confirm whether these four MCPs were involved in triggering chemotaxis toward PAHs, the MCP mutants were constructed. Observations showed a loss of the chemotactic responses to benzoate, phthalate, PHE and BaP only in the mutant ∆mcp03030. Surface plasmon resonance (SPR) assays further confirmed that MCP03030LBD specifically bound phthalate, PHE, PYR and BaP, while MCP18870LBD bound only PYR. The mutant ∆mcp03030-∆mcp18870 was then constructed and was shown to have lost the chemotactic response to 5 aromatic compounds. Combined with the effects of outer membrane transporter deletion on chemotaxis and MCP deletion on the PAH degradation, our study demonstrated that the chemoreceptors MCP03030 and MCP18870 can recognize PAHs and their metabolites in the periplasm, triggering metabolism-dependent and metabolism-independent chemotaxis, and be linked with HMW-PAH biodegradation., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Sphingomonads are well known for their ability to efficiently degrade polycyclic aromatic hydrocarbons (PAHs), but little is known about the mechanism of PAH uptake and transport across the cell membrane. RNA sequencing analysis of a sphingomonad, Novosphingobium pentaromativorans US6-1 showed that 38 TonB-dependent transporter (TBDT) genes were significantly upregulated under 5-ring PAH-benzo[a]pyrene (BaP) stress. In order to reveal whether TBDTs are involved in uptake and transport BaP in US6-1, the key TBDT genes were deleted to generate mutants. The results showed that the growth status of these mutants was not different from that of the wild-type strains, but the PAH degradation ability decreased, especially for the mutant strain Δtbdt-11, which did not encode the tbdt-11 gene. Meanwhile, the cell surface hydrophobicity (CSH) of Δtbdt-11 was found to be significantly lower than that of the wild-type strain under BaP stress. Furthermore, the transcriptional activity of genes encoding PAH degradative enzymes was found to be greatly reduced in Δtbdt-11. Confocal microscopy observations showed that US6-1 could transport BaP across the outer membrane, but this transport capacity was significantly reduced in Δtbdt-11 and wild-type US6-1 treated with PMF uncoupler, further confirming that the tbdt-11 gene was associated with PAH active transport., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background and Aim: The present study was conducted to explore the stratified and joint effects of age at menopause and body mass index (BMI) with the risk of type 2 diabetes mellitus (T2DM) in Chinese rural adults., Methods and Results: A total of 15,406 postmenopausal Chinese women were included in this study. Multivariable logistic regression analysis was used to quantify the stratified and joint effects of age at menopause and BMI on T2DM. Overall, the mean age at menopause and BMI was 48.8 ± 4.7 years and 25.1 ± 3.6 kg/m 2 , respectively. In general, data suggest that: 1) women with BMI ≥ 24 had a higher risk of T2DM, irrespective of age at menopause; 2) in women with BMI < 24, later menopause had a higher risk of T2DM (OR, 1.52; 95% CI, 1.16-2.01); 3) the risk of T2DM was higher only in patients with early or normal age at menopause and BMI ≥ 24, with 0R (95% CI) of (1.58, 1.28-1.94) and (1.48, 1.31-1.67), respectively., Conclusion: Our findings suggest that: 1) women with BMI ≥ 24 had a higher risk of T2DM, irrespective of age at menopause; 2) in women with BMI < 24, a higher risk of T2DM was found only in those with later menopause; 3) women with later menopause had a higher risk of T2DM, irrespective of BMI; 4) in patients with early or normal age at menopause, a higher risk of T2DM was found only in patients with BMI ≥ 24., The Chinese Clinical Trial Registration: ChiCTR-OOC-1500669(URL:http://www.chictr.org.cn/showproj.aspx?proj=11375)., (Copyright © 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Background and Aims: To assess the associations of sedentary time, suppressor of cytokine signaling (SOCS)-3 DNA methylation with type 2 diabetes mellitus (T2DM), and further identify the role of SOCS3 methylation in mediating the association of sedentary time with T2DM in a Chinese rural population., Methods and Results: A case-control study including 1032 participants from the Henan Rural Cohort study was conducted. Restricted cubic spline analysis and logistic regression model were performed to evaluate the associations between sedentary time, SOCS3 methylation and T2DM. The mediation effect of SOCS3 methylation on the association between sedentary time and T2DM was assessed. Sensitivity analysis was conducted by excluding individuals with diagnosed T2DM. Linear dose-response relationships were found between sedentary time, methylation level of Chr17:76356190 (one novel site on SOCS3) and T2DM. Compared with the first quartile (less than 5 h/d) of sedentary time, the adjusted odds ratio (OR, 95% confidence interval, 95%CI) for those in the third (7-10 h/d) and fourth (≥10 h/d) quartiles were 1.87 (1.22-2.85) and 3.54 (2.14-5.85), respectively. Participants in the fourth quartile of methylation level of Chr17:76356190 had lower risk of T2DM than those in the first quartile (OR (95%CI): 0.23 (0.14-0.38)). Mediation analysis showed 9.66% (6.38%-14.80%) of the association between sedentary time and T2DM was attributable to Chr17:76356190. The comparable effect estimates were observed between sedentary time, methylation level of Chr17:76356190 and undiagnosed T2DM., Conclusion: Sedentary time and methylation level of Chr17:76356190 were both independently associated with T2DM in the Chinese rural population. Furthermore, Chr17:76356190 appeared to partially mediate the effect of sedentary time on T2DM., Chinese Clinical Trial Registration: ChiCTR-OOC-15006699 (URL: http://www.chictr.org.cn/showproj.aspx?proj=11375)., Competing Interests: Declaration of Competing Interest All authors declare no conflict of interest., (Copyright © 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Objectives: intracranial pressure (ICP) monitoring has now been a standard technique for the treatment of severe traumatic brain injury (sTBI), while the effect of ICP monitoring for moderate traumatic brain injury (mTBI) is not clear. Moreover, evidence comparing the two types of ICP monitoring: ventricular drainage (VD) catheter and intraparenchymal (IP) catheter is scarce., Patients and Methods: 91 patients with mTBI were reviewed retrospectively. They were divided into VD, IP and Non-ICP group. Baseline parameters were recorded. The clinical outcome was reflected by Glasgow Outcome Scale (GOS) and mortality at discharge and six months after injury. The rate of surgical decompression, refractory intracranial hypertension, neuroworsening, dose of mannitol and cranial CT were recorded. Meningitis and intracranial hematoma, two major complications of ICP monitoring, were also collected., Results: the three groups showed no significant difference in GOS at discharge and six months after injury. The mortality was similar among the three groups at six months after injury, while the Non-ICP group had the highest mortality at discharge. The Non-ICP group was administered the most mannitol while the VD group was administered the least. The Non-ICP group also received the most cranial CT scans among the three groups. Incidence of meningitis and intracranial hematoma were not significantly different among the VD and IP group., Conclusion: use of ICP monitoring could hardly improve the functional outcome of mTBI, but may possibly reduce the in-hospital mortality. By using ICP monitoring, the dose of mannitol and cranial CT scan for mTBI patients may be decreased., Competing Interests: Declaration of Competing Interest None., (Copyright © 2019. Published by Elsevier B.V.)

Background & Aims: Type 2 diabetes (T2D) is a complex metabolic disease with numerous risk factors, including a growing number of genetic susceptibility variants. The TCF7L2 gene is closely associated with an increased risk of type 2 diabetes, but the association of TCF7L2 with weight-related traits in humans is unclear. The purpose of this study was to determine if TCF7L2 variants and body mass index/waist circumference (BMI/WC) act synergistically to influence the incidence of type 2 diabetes in a Chinese population., Methods: This is a large sample, case-control study. We recruited 1842 Chinese type 2 diabetes patients and 7777 healthy controls and collected demographic and anthropometric characteristics and blood samples. We extracted DNA and genotyped the TCF7L2 single nucleotide polymorphisms rs7903146 and rs290487 in all participants., Results: There were significant linear interactions between rs7903146 and BMI/WC and elevated blood glucose (P < 0.001); rs290487 and BMI/WC also showed a linear interaction with blood glucose levels (P < 0.001). The interaction was stronger at higher BMI (>21.02) and higher WC (>66.77 cm). The additive interaction of rs 290487 and overweight/obesity variables yielded a significant increase in the risk for T2D. RERI (relative excess risk of interaction) was 2.949 (95%CI: 1.700-4.198), AP (attributable proportion due to interaction) was 0.391 (95%CI: 2.281-0.502), and SI (synergy index) was 1.822 (95%CI: 1.463-2.268). Additionally, there was a significant interaction between rs 290487 and abdominal obesity on the risk of T2D (RERI: 2.642, 95%CI: 1.384-3.900; AP: 0.350, 95%CI: 0.231-0.468; SI: 1.675, 95%CI: 1.348-2.083)., Conclusions: These results show that a TCF7L2 gene-BMI interaction or gene-WC interaction may play an important role in the risk for T2D in the Chinese population., (Copyright © 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Oral ingestion is the main exposure pathway through which humans ingest trace metals in the soil, particularly for children. Metals in different soil particle size fractions may vary in terms of concentration and properties. Urban school/kindergarten soil samples were collected from three cities: Lanzhou in northwest China, Wuhan in central China, and Shenzhen in southeast China. Soil samples were classified according to particle size (<63 μm, 63-150 μm, 150-250 μm, and 250-2000 μm) to estimate the effects of soil particle size on the total content and bioaccessibility of metals (Cd, Cr, Cu, Ni, Pb, and Zn). Based on the results, we assessed whether the standard size <150 μm (containing < 63 μm and 63-150 μm), recommended by the Technical Review Workgroup (TRW) of the Environmental Protection Agency (EPA), and <250 μm (containing < 63 μm, 63-150 μm, and 150-250) recommended by the Bioaccessibility Research Group of Europe (BARGE), are suitable where the largest proportion adhering to hands is the finest soil (<63 μm). The results showed that different metals exhibited different relationships between soil particle size and content and between soil particle size and bioaccessibility. Pb and Zn generally exhibited the greatest bioaccessibility in the coarsest particle sizes (250-2000 μm); whereas the highest Ni bioaccessibility occurred in the finest sizes (<63 μm); the bioaccessibility of other metals did not exhibit any obvious relationships with particle size. When assessing health risks using bioaccessible metal content in the recommended soil particle size ranges (<150 μm and <250 μm) and in finer particles (<63 μm), the results for noncarcinogenic risks to children exhibited no obvious difference, while the actual carcinogenic risks may be underestimated with the use of soil particle size ranges < 150 μm and <250 μm. Therefore, when choosing an optimal particle size fraction to evaluate the health risk of oral soil ingestion, we recommend the use of the bioaccessible metal content in <63 μm soil fraction., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: The risk allele frequency of rs1378942 of c-src tyrosine kinase (CSK) gene is much higher in Asians (~ 0.80) than that in Europeans (~ 0.35), and the association between rs1378942 and blood pressure is controversial in Asians. Thus, the review and meta-analysis was performed to explore the effects of rs1378942 polymorphism on systolic blood pressure (SBP), diastolic blood pressure (DBP) levels and hypertension in Asians., Methods: A literature search was conducted in electronic databases up to September 1, 2018. Beta, Odds Ratio (OR) and corresponding 95% confidence intervals (95%CI) were calculated to estimate the effects of rs1378942 on SBP, DBP and hypertension. Quanto software was used to estimate the statistical power., Results: The results showed that the rs1378942 polymorphism significantly affected blood pressure levels in Asians, the C allele carriers had higher SBP and DBP levels: beta (95%CI): 0.71(0.38-1.04), P = 2.579 × 10 -5 , I 2  = 43.5%, and beta (95%CI): 0.33(0.18-0.49), P = 2.092 × 10 -5 , I 2  = 28.3%, respectively. This association was also found in East Asians, but not in South Asians. Furthermore, no significant association was observed with hypertension: OR (95%CI): 1.10 (0.97-1.25), P = .129, I 2  = 81.2%., Conclusion: The meta-analysis demonstrates that the C allele of the CSK rs1378942 is associated with higher SBP and DBP levels in East Asians., (Copyright © 2018 Elsevier B.V. All rights reserved.)

The purpose of the study was to determine if there was a relationship between night sleep duration and hypertension, and to evaluate as to whether blood lipid levels played a role in this relationship. A total of 37,317 participants aged 18-79 years were included in this study. Night sleep duration was classified as <5, 5-, 6-, 7-, 8-, 9-, and ≥10 hours. Logistic regression and restricted cubic spline analysis was carried out to evaluate the association of sleep duration with hypertension. Compared with reference sleep duration (7 hours), in males, the multivariate odds ratios (ORs) (95% confidence interval [95% CI]) of the groups with longest sleep duration (≥10 hours) and shortest sleep duration (<5 hours) for hypertension was 1.52 (1.25-1.84) and 1.07 (0.80-1.44), respectively. Similarly, the longest sleep duration was associated with diagnosed hypertension (1.21, 1.00-1.45) in females. The OR for an indirect effect of sleep duration through low-density lipoprotein cholesterol (LDL-C) on hypertension was 1.085 (95% CI 1.038-1.137). Overall, a 3.5% possibility of hypertension being associated with sleep duration was attributable to LDL-C. In summary, a relationship between sleep duration and hypertension was observed in this rural population. LDL-C appeared to partially mediate the effect of sleep duration on hypertension in males., (Copyright © 2018 American Heart Association. Published by Elsevier Inc. All rights reserved.)

Background: Current surgical therapies for spontaneous intracerebellar hemorrhage (SCH) include suboccipital craniotomy (SC), stereotactic aspiration and thrombolysis (SAT), and endoscopic surgery (ES). Evidence comparing the therapeutic effects of these 3 methods is scarce. The safety and efficacy of SC, SAT, and ES for SCH are still uncertain., Methods: 75 patients with SCH who received SC, SAT, or ES were reviewed retrospectively. Baseline parameters before the operation, evacuation rate, perihematoma edema, postoperative complications, and cumulative case fatalities were collected. Also, 12 months after ictus, the long-term functional outcomes in patients with regard to fourth ventricle compression and age were judged, respectively, by the modified Rankin Scale (mRS)., Results: The SAT was less effective in evacuating hematoma than were SC and ES. The perihematoma edema on postoperative day 7 and surgical complications were highest in the SC group. The functional outcome represented by mRS was better in the SAT group than in the SC and ES groups for patients with fourth ventricle compression grade 1. For patients with fourth ventricle compression grades 2 and 3, the ES group achieved the best functional outcome. Patients older than 60 years benefited less from SC than from ES and SAT., Conclusions: SAT may be suitable for SCH patients with fourth ventricle compression grade 1, and ES may be suitable for SCH patients with fourth ventricle compression grades 2 and 3. Aged patients benefit less from SC than from SAT and ES., (Copyright © 2018. Published by Elsevier Inc.)

Background: We examined the independent and cumulative associations of resting heart rate and pulse pressure with metabolic syndrome in Chinese rural population based on epidemiological research., Methods: A total of 38,708 participants were derived from the Henan Rural Cohort study. Restricted cubic splines and logistic regression model were used to estimate the odds ratios and 95% confidence intervals of metabolic syndrome risk in relation to resting heart rate and pulse pressure., Results: After adjusting for potential confounders, the odds ratio (95% confidence intervals) of resting heart rate and pulse pressure in the highest quartile with the risk of metabolic syndrome were 1.59 (1.48-1.70) and1.81 (1.67-1.95), respectively. Simultaneously, the cumulative effect analysis indicated that the adjusted the odd ratio of resting heart rate and pulse pressure in the highest quartile was 2.89 (2.40-3.47). Furthermore, there was a significantly additive interaction between resting heart rate and pulse pressure on the risk of metabolic syndrome., Conclusion: Increased resting heart rate and pulse pressure are associated with the higher risk of metabolic syndrome as well as the influences of resting heart rate with pulse pressure might cumulatively increase the risk of metabolic syndrome. However, the potential clinical application remains to be determined., (Copyright © 2018. Published by Elsevier B.V.)

The study aimed to explore the association of visceral fat index (VFI) with untreated hypertension in different genders and evaluate the practicability of VFI as a marker for discriminating untreated hypertension in Chinese rural population. A total of 12,536 eligible participants aged 35 years and older were derived from the RuralDiab study in China. VFI was assessed with bioelectrical impendence methods and divided into sex-specific quartiles. Logistic regression and restricted cubic spline regression were performed. Receiver operating characteristic curve was applied to analyze the discriminating performance of VFI. Meanwhile, a meta-analysis was conducted to validate the result of this study. Compared with the lowest VFI quartile, the adjusted odds ratios (ORs) and 95% confidence interval (95% CI) in the highest VFI quartile were 3.68 (2.91-4.66) in male and 2.63 (2.12-3.25) in female (P trend  < .01). Nonlinear increasing trends about the risk of untreated hypertension were observed with the continuously increasing VFI in both genders (P linearity  < .01). The sensitivity and specificity in the optimal cutoff values for VFI were 58.37% and 62.26% in male, and 49.09% and 66.67% in female. The area under the curves (95% CI) were 0.64 (0.63-0.66) in male and 0.61 (0.60-0.62) in female. Meta-analysis results displayed the pooled odds ratios (95% CI) of 2.65 (1.79-3.93) in male and 2.27 (1.74-2.95) in female. VFI was significantly positively correlated with the risk of untreated hypertension, and dose-response relationships were observed in both genders in Chinese rural population. However, VFI as a marker had limited potential for discriminating untreated hypertension., (Copyright © 2018 American Heart Association. Published by Elsevier Inc. All rights reserved.)

Background: We explored the association between serum uric acid (SUA) and metabolic syndrome (MetS) in Chinese rural adults., Methods: A total of 16,577 subjects (6354 men and 10,223 women) were from the RuralDiab study. SUA concentration was measured by the enzymatic colorimetric method. A meta-analysis including 12 eligible studies focused on SUA and MetS was preformed to confirm the findings of the cross-sectional study., Results: After adjustment for age, educational level, and other covariates, the odds ratio (ORs) for MetS increased smoothly with the increasing SUA concentration in both sexes (P for no-linear trend > 0.05). The adjusted ORs of MetS comparing the fourth and firstly quartiles were 3.11 [95% CI: 2.58-3.74] in men and 3.64 [95% CI: 3.22-4.11] in women (P trend  < 0.001). In continuous analysis, each 1 mg/dl increment in SUA concentration was significantly associated with a 41% increased risk of MetS in men and 62% in women. The meta-analysis validated the positive association between SUA and MetS (pooled OR: Men, 1.80 [95% CI: 1.57-2.07]; Women, 2.46 [95% CI: 1.95-3.12])., Conclusion: SUA concentration was positively with the prevalence of MetS in Chinese rural population, and more studies are needed to explore the mechanisms of the relationship. WHAT IS ALREADY KNOWN ON THIS TOPIC?: Previous studies have explored the association between serum uric acid and metabolic syndrome, but evidence on the strength and consistency of the association remains uncertain and limited, especially in rural population. In addition, the epidemiological research and meta-analysis on the association have not been reported. WHAT DOES THIS STUDY ADD?: The results of this study showed that serum uric acid was significantly associated with metabolic syndrome and its components in Chinese rural population. Furthermore, the findings demonstrated that the significant associations varied across sex. In addition, the results of epidemiological research were similar with the meta-analysis, which demonstrates the credible of the results of the epidemiology research., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Three-part white blood cell differentials which are key to routine blood workups are typically performed in centralized laboratories on conventional hematology analyzers operated by highly trained staff. With the trend of developing miniaturized blood analysis tool for point-of-need in order to accelerate turnaround times and move routine blood testing away from centralized facilities on the rise, our group has developed a highly miniaturized holographic imaging system for generating lens-free images of white blood cells in suspension. Analysis and classification of its output data, constitutes the final crucial step ensuring appropriate accuracy of the system. In this work, we implement reference holographic images of single white blood cells in suspension, in order to establish an accurate ground truth to increase classification accuracy. We also automate the entire workflow for analyzing the output and demonstrate clear improvement in the accuracy of the 3-part classification. High-dimensional optical and morphological features are extracted from reconstructed digital holograms of single cells using the ground-truth images and advanced machine learning algorithms are investigated and implemented to obtain 99% classification accuracy. Representative features of the three white blood cell subtypes are selected and give comparable results, with a focus on rapid cell recognition and decreased computational cost., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Ultra-early surgical clot removal relieves mechanical compression on adjacent normal brain tissue and limits the toxic effects of a hematoma, which might improve the outcomes in patients with intracerebral hemorrhage (ICH); however, hematoma expansion frequently occurs within 20 hours after the ictus, and this limits the use of ultra-early surgery. Computed tomography angiography spot sign was recently validated as an important predictor of hematoma expansion in patients with ICH., Methods: Fifty-nine patients with ICH and negative spot sign who received ultra-early stereotactic aspiration (<6 hours after ictus; n = 32 [Ultra-early group]) or routine stereotactic aspiration (≥6 hours after ictus; n = 27 [Routine group]) were included in retrospective analysis., Results: The percentage of rebleeding was not significantly different between the 2 groups. Perihematoma edema 7 days after surgery in the Ultra-early group was significantly less frequent than that in the Routine group. For long-term outcomes, the proportion of patient fatalities and Glasgow Outcome Scale score were not significantly different between the 2 groups; however, for patients with severe symptoms, the rate of good neurological outcome in the Ultra-early group was higher than that in the Routine group., Conclusions: Ultra-early stereotactic aspiration might decrease the volume of perihematoma edema and improve the functional outcomes to some extent, without increasing the recurrence of ICH and patient fatalities. Our findings suggest that using negative spot sign as an indicator for performing ultra-early stereotactic aspiration could be a safe and effective protocol for ICH patients., (Copyright © 2017 Elsevier Inc. All rights reserved.)

The microencapsulation of bioactive neurotrophic factors in biodegradable poly(lactide-co-glycolide) (PLGA) microspheres has been a promising tool in the treatment of various nervous system disorders. However, challenges still exist; the PLGA burst drug release and acidic degradation products often limit clinical application. In this study, cores-shell PLGA-chitosan microparticles (MPs) were fabricated with a single shell of chitosan and multi-cores of PLGA using a re-emulsification method. The glial cell line-derived neurotrophic factor (GDNF) was encapsulated at the PLGA cores of the cores-shell MPs. The cores-shell MPs prepared by different chitosan concentrations showed a rough surface, and the particle mean size varied between 32.3 and 45.2μm. The fluorescence images indicated that Nile red-stained PLGA microspheres were uniformly distributed in the cores-shell MPs. Compared with PLGA microspheres, the cores-shell MPs were able to reduce the initial burst release of GDNF and neutralize the acidity of PLGA degradation products, which could be modulated by changing the chitosan concentrations. Further differentiation of PC12 cells toward a neuronal phenotype in vitro indicated that the cores-shell MPs were capable of maintaining the bioactivity of GDNF during preparation. Taken together, these findings highlight the possibility of using cores-shell PLGA-chitosan MPs for the sustained release of GDNF, which offers potential applications in nerve injury repair., (Copyright © 2017. Published by Elsevier B.V.)

Background: The safety and efficacy of craniotomy, endoscopic surgery, and stereotactic aspiration for surgical evacuation of spontaneous supratentorial lobar intracerebral hemorrhage (ICH) is yet uncertain. The present study analyzed the clinical and radiographic data from 99 patients with spontaneous supratentorial lobar ICH, retrospectively, to address this issue., Methods: Patients who underwent craniotomy, endoscopy surgery, or stereotactic aspiration were assigned to the craniotomy group (n = 31), endoscopy surgery group (n = 32), or stereotactic aspiration group (n = 36), respectively. The characteristics of all the enrolled patients at the time of admission were assimilated. Also, the therapeutic effects of the three surgical procedures were evaluated based on short-term outcomes within 30 days and long-term outcomes at 6 months after the ictus., Results: The results showed that stereotactic aspiration and endoscopic surgery were associated with a superior clinical therapeutic effect in both short-term and long-term outcomes than craniotomy for the treatment of spontaneous supratentorial lobar ICH. Notably, severely affected patients with hematoma volume > 60 mL or Glasgow Coma Scale score 4-8 may benefit more from endoscopic surgery than the two other surgical procedures., Conclusions: The current findings demonstrate that both stereotactic aspiration and endoscopic surgery possess an apparent advantage over craniotomy for the evacuation of spontaneous supratentorial lobar ICH. The endoscopic surgery might be more safe and effective with higher evacuation rate, better functional neurological outcomes, and lower complication and mortality rates., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Proton Magnetic Resonance Spectroscopic Imaging ( 1 H MRSI) has shown great potential in tumor diagnosis since it provides localized biochemical information discriminating different tissue types, though it typically has low spatial resolution. Magnetic Resonance Imaging (MRI) is widely used in tumor diagnosis as an in vivo tool due to its high resolution and excellent soft tissue discrimination. This paper presents an advanced data fusion scheme for brain tumor diagnosis using both MRSI and MRI data to improve the tumor differentiation accuracy of MRSI alone. Non-negative Matrix Factorization (NMF) of the spectral feature vectors from MRSI data and the image fusion with MRI based on wavelet analysis are implemented jointly. Hence, it takes advantage of the biochemical tissue discrimination of MRSI as well as the high resolution of MRI. The feasibility of the proposed frame work is validated by comparing with the expert delineations, giving mean correlation coefficients for the tumor source of 0.97 and the Dice score of tumor region overlap of 0.90. These results compare favorably against those obtained with a previously proposed NMF method where MRSI and MRI are integrated by stacking the MRSI and MRI features., (Copyright © 2016 Elsevier Ltd. All rights reserved.)