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Although the pandemic has ended officially, COVID-19 remains impactful. Booster COVID-19 vaccination is still needed to protect individuals against COVID-19 and the disease's harmful consequences. This study investigated the prevalence of the intention to get booster COVID-19 vaccination after receiving the COVID-19 diagnosis and its associated factors among people reporting prior COVID-19. A population-based anonymous telephone survey was conducted in Hong Kong, China from June to August 2022 among Chinese people reporting prior COVID-1 between February and August 2022 and having taken up ≥2 doses of COVID-19 vaccines prior to COVID-19 diagnosis. The prevalence of the intention to get booster vaccination was 59.2 %. Older age (>60 years), being currently married, not employed full-time, and having chronic diseases were positively associated with the intention to get booster vaccination. Adjusted for the background factors, higher levels of the cognitive factors of perceived susceptibility to COVID-19, perceived acquired moderate-to-strong immunity against COVID-19, and perceived adequate knowledge of COVID-19 were positively associated with the intention to get booster vaccination; stronger perceived severity of prior infection despite vaccination was negatively associated with the intention outcome. In contrast, stronger mental distress due to COVID-19, illness concern, and emotional representation were positively associated with the intention. Self-perceived long COVID status was not a significant factor. The prevalence of the intention to get booster COVID-19 vaccination was limited, especially among younger people reporting prior COVID-19. Health promotion is still required among people reporting prior COVID-19 and may emphasize the significant cognitive factors positively associated with the intention. Future studies are needed to confirm the findings, clarify the role of emotional factors on booster vaccination, and explore other factors of the intention to get booster vaccination among people reporting prior COVID-19. [ABSTRACT FROM AUTHOR]

Previous outbreaks of emerging infectious diseases (e.g., SARS) had increased the uptake of influenza vaccination (IV). It is uncertain whether such was also true for COVID-19. This study hence investigated prevalence of IV behavior/intention prior to and during the COVID-19 pandemic and associated cognitive factors. A self-administered, online, and anonymous cross-sectional survey was conducted among 6,922 university students of five provinces in China during November 1–28, 2020 (response rate: 72.3%). Of all the participants, 35.1% self-reported behavioral intention of IV (next 12 months), while 62.9% reported an increased intention of IV due to COVID-19. However, only 4.7% and 2.9% had taken up IV during the 12-month period prior to the outbreak (1/2019–12/2019) and during the COVID-19 outbreak (1–11/2020), respectively. Adjusted for the background factors, the multivariable logistic regression analysis showed that in general the COVID-19 related perceptions (perceived susceptibility, perceived severity, and perceived chance of having another wave of COVID-19 outbreak) were significantly and positively associated the IV behavior (during the COVID-19 outbreak) and intention of IV uptake in the next 12 months. The COVID-19 pandemic may have influenced actual behavior and intention of IV uptake among university students during the pandemic. Efforts are warranted to reduce the intention-behavior gap of IV uptake; modification of perceived susceptibility and perceived severity regarding COVID-19 may help. Future longitudinal and intervention studies are needed to confirm the findings of this study and explore other factors affecting IV uptake during the COVID-19 period. [ABSTRACT FROM AUTHOR]

• Very low prevalence of intention of free COVID-19 vaccination (11% if 50% effectiveness) was reported. • A low proportion of participants (13%) would like to take up COVID-19 vaccination as soon as it becomes available. • Positive/negative outcome expectancies were associated with intention of COVID-19 vaccination. • In general, the associations involving risk perception/self-efficacy were non-significant. • Health promotion that modifies positive and negative outcomes is greatly warranted. COVID-19 vaccination needs a high population coverage to achieve herd immunity. We investigated prevalence of three scenarios of intention of free COVID-19 vaccination involving: 1) 80% effectiveness and rare and mild side effects (Scenario 1), 2) 50% effectiveness and rare and mild side effect RMSE (Scenario 2), and 3) immediate vaccination (Scenario 3), and their associated factors derived from the pre-intentional motivational phase of the Health Action Process Approach (HAPA). A random population-based telephone survey interviewed 450 Chinese adults in the general population (September 16–30, 2020). The four HAPA constructs included a) risk perception scale, b) overall scale/four subscales of positive outcome expectancy of COVID-19 vaccination, c) overall scale/three subscales of negative outcome expectancy of COVID-19 vaccination, and d) the overall scale/two subscales of self-efficacy of COVID-19 vaccination. The prevalence of intention of COVID-19 vaccination under Scenarios 1 to 3 was 38.0%, 11.1%, and 13.1%, respectively. Logistic regression analyses adjusted for background factors showed that 1) the associations between risk perception and the three scenarios of intention were non-significant; 2) the overall scale/four subscales of positive outcome expectancy were in general positively associated with two scenarios of intention (80% effectiveness and immediate vaccination); 3) the overall scale/three subscales of negative outcome expectancy were in general negatively associated with all three scenarios of intention; 4) the overall scale/two subscales of self-efficacy were only positively associated with the intention that involved 80% effectiveness. When all the four overall scales were entered into an adjusted model, positive and negative outcome expectancy, but not risk perception and self-efficacy, were independently associated with the three scenarios. In this study population, the prevalence of intention of COVID-19 vaccination was very low and might not result in population protection. Health promotion should modify outcome expectancies to increase intention of COVID-19 vaccination. [ABSTRACT FROM AUTHOR]

Perceived benefit of internet gaming was positively associated with gaming time and internet gaming disorder (IGD). Yet, most studies looked at the impact of perceived immediate but not future benefits. The key objectives of this study included the investigation of the independent associations between the overall scales/subscales (mental health, social relationship, and personal achievement) of perceived immediate/future benefits and IGD, and the mediations of such associations via gaming time. A cross-sectional survey was conducted among adolescent internet gamers in Guangzhou and Chengdu, China from October 2019 to January 2020 (n = 1707). The prevalence of IGD was 16.9%. Only 18%–25% and 13%–20% perceived no and strong immediate/future benefits in the three aforementioned domains, respectively. Within individuals, the paired differences in the levels of perceived immediate versus future benefits were of small effect size. The overall scales and all six types of perceived immediate and future benefits were significantly associated with IGD. All (except two) such associations were partially/fully mediated by gaming time. Hence, the participants commonly perceived comparable immediate and future benefits, which may increase gaming time and then increase IGD. Future longitudinal studies are needed to confirm these findings. Innovative interventions modifying perceived immediate/future benefits may reduce gaming time/IGD. • Adolescents perceived multidimensional immediate and future benefits of internet gaming. • The levels of perceived immediate and future benefits were comparable. • Both perceived immediate and future benefits increased the risk of adolescent internet gaming disorder (IGD). • Internet gaming time mediated between perceived immediate/future benefits of internet gaming and IGD. [ABSTRACT FROM AUTHOR]

The long-term associations between multiple metals and incident diabetes are uncertain. We aimed to examine the relationship between plasma concentrations of 23 metals and the incidence of type 2 diabetes among Chinese senior adults. We quantified fasting plasma concentrations of 23 metals by inductively coupled plasma mass spectrometry among 1039 incident diabetes cases and 1039 controls (age and sex matched) nested in a prospective study, the Dongfeng-Tongji cohort. Both cases and controls were free of diabetes at baseline (2008–2010), incident diabetes were identified using the following criteria: fasting glucose ≥ 7.0 mmoL/l; or hemoglobin A1c (HbA1c) ≥ 6.5%; or self-reported physician diagnosis of diabetes or use of anti-diabetic medication during the follow-up visits in 2013. In the conditional logistic regression models, the multivariable adjusted ORs (95% CIs) of diabetes across quartiles (Q1–Q4) of metal concentrations were as follows: titanium, 1.00, 0.92, 1.31, 1.38 (1.00–1.91, P trend  = 0.011); selenium, 1.00, 1.08, 1.45, 1.27 (0.93–1.74, P trend  = 0.05); and antimony, 1.00, 0.79, 0.77, 0.60 (0.44–0.83, P trend  = 0.002). Arsenic was significantly associated with diabetes in the crude model (ORs comparing extreme quartiles 1.30; 1.02–1.65; P trend  = 0.006), but was not significant after adjustment for socio-demographic factors. No significant associations were found for other metals. In conclusion, titanium and selenium were positively while antimony was negatively associated with incident diabetes. [ABSTRACT FROM AUTHOR]

• Reducing gaming time may induce resource losses in adolescents. • An assessment tool of perceived personal and interpersonal resource losses due to reduction of gaming time (RL-RGTS) was developed. • The RL-RGTS demonstrated some satisfactory psychometric properties. • The RL-RGTS could be applied to understand potential obstacles against interventions reducing internet gaming disorder. Adolescent internet gaming disorder (IGD) is prevalent and positively associated with gaming time, a reduction of which is a common means of IGD prevention/treatment. Personal/interpersonal resource losses due to the reduction in gaming time (RL-RGT) are plausible. According to the Conservation of Resource (COR) theory, RL-RGT may cause mental distress and maladaptive behaviors. No study has investigated such relationships, partially due to the lack of validated tools assessing RL-RGT. This study aimed to develop and validate such a scale (RL-RGTS). A cross-sectional survey was conducted in four secondary schools in Guangzhou, China (October to December 2019). Secondary school students who had played internet games in the last 12 months participated in this study (n = 944), irrespective of their IGD status and intention to reduce gaming time. Using a deductive approach, an expert panel generated the 19 scale items. The half-split method was used to conduct exploratory and confirmatory factor analyses. The prevalence of IGD and intention to reduce gaming time were 10.9% and 74.2%, respectively. The exploratory and confirmatory factor analyses identified a 2-factor model (personal loss and interpersonal loss). Psychometric properties (internal consistency, no ceiling effect, and concurrent validity) were satisfactory, but noticeable floor effects were observed. The RL-RGTS could be applied to understand potential side effects and obstacles regarding interventions reducing IGD through reducing gaming time. The findings support the COR theory and extend its applications to internet gaming research. Validations in other populations are warranted. [ABSTRACT FROM AUTHOR]

The significance of Internet gaming time's dosage effect on Internet gaming disorder (IGD) may depend on gamers' characteristics. Majority of the gamers with extensive gaming time do not develop IGD. This study investigated moderation effects of cognitive/psychosocial factors on the association between Internet gaming time and probable IGD among adolescent Internet gamers in China. The cross-sectional, self-administered, and anonymous survey was conducted from October to December of 2018 among seven conveniently selected secondary school students in Chengdu and Guangzhou, China. Probable IGD was measured by using the DSM-5 checklist. The cognitive/psychosocial moderators were assessed by using validated instruments. Of the 2,503 students who had played Internet games (past 12 months), the prevalence of probable IGD was 17.7%. Internet gaming time [adjusted odds ratio (ORa) = 1.06], the three maladaptive cognitions specific to Internet gaming (perceived overvaluation of rewards, perceived urges, and perceived unwillingness to stop playing) (ORa = 1.17 to 1.44), and the two types of psychosocial factors (loneliness and social anxiety) (ORa = 1.09 to 1.13) were independent risk factors of probable IGD. Moderation analyses showed that overall maladaptive cognitions, perceived urges, and loneliness (but not the other two types of cognitions and social anxiety) were significant moderators of the association between Internet gaming time and probable IGD. The dose-effect relationship of Internet gaming time on probable IGD was significantly and slightly stronger among those with higher levels of perceived urges and loneliness. Interventions to reduce the levels of such moderators may reduce probable IGD directly and buffer the dosage effect among adolescents. [ABSTRACT FROM AUTHOR]

Adolescents encounter numerous challenges and need to restructure their social relationships when they enter secondary schools. Relationship adaptation is critical and failure in adaptation may be associated with Internet gaming disorder (IGD). This novel study investigated the association between relationship adaptation and IGD and related mediation mechanisms via social support and loneliness among first-year secondary school students in Shanghai and Xi'an, China in 2018. Of 2573 participants, the prevalence of IGD was 13.1%. Relationship adaptation, social support, and loneliness were all significantly associated with IGD. The association between relationship adaptation and IGD was fully mediated by three indirect paths, including relationship adaptation → social support → IGD (effect size = 35.5%), relationship adaptation → loneliness → IGD (effect size = 34.3%), and relationship adaptation → social support → loneliness → IGD (effect size = 6.1%). In conclusion, the observed high prevalence of IGD among first-year secondary school students in China was associated with poor relationship adaptation. The full mediation effects via social support and loneliness suggest that modification of these two psychosocial attributes may effectively reduce the harmful impacts of poor relationship adaptation on adolescent IGD. Future longitudinal studies are warranted to confirm the findings. [ABSTRACT FROM AUTHOR]

Background: Adolescent males were consistently reported to have a higher prevalence of Internet gaming disorder (IGD) than females. The mechanisms underlying the sex difference were potentially important for designing sex-specific interventions but were under-researched. Maladaptive cognitions were potential mediators between sex and adolescent IGD, as they were positively associated with both sex and adolescent IGD.Methods: A total of 3,075 students participated in a cross-sectional survey that was conducted in Guangzhou and Chengdu, China. IGD was measured by using the DSM-5 checklist and maladaptive cognitions were measured by the validated Chinese version of Revised Internet Gaming Cognition Scale (C-RIGCS). Structural equation modeling was used to test the mediation hypotheses.Results: Adolescent males showed a significantly higher prevalence of IGD than females (19.2% versus 7.8%, p < .05). Significant positive associations were found between sex and both maladaptive cognitions and IGD. The sex difference in IGD prevalence was partially mediated by the overall scale of C-RIGCS and its three subscales (i.e., perceived overvaluation of rewards of Internet gaming, perceived urges for playing Internet games, and perceived unwillingness to stop playing without completion of gaming tasks), with large mediation effect sizes ranging from 35.0% to 60.0% (Sobel test, p < ,01).Conclusions: The higher levels of maladaptive cognitions among adolescent males explained a relatively large part of the substantially higher prevalence of IGD among adolescent males than females. Interventions targeting adolescent males may consider modifying such cognitions to reduce their IGD. [ABSTRACT FROM AUTHOR]

• Changes in academic pressure at T1 positively linked to adolescent social anxiety at T3. • Classmate support at T2 and PSU at T2 as chain mediators. • Chain mediator model vary by changes in leisure time. • Classmate support at T2 → PSU at T2 was stronger in increased leisure time group. • Changes in academic pressure at T1 → PSU at T2 was weaker in increased group. In response to concerns surrounding excessive homework and off-campus tutoring for students undergoing compulsory education in China, the government implemented the "double reduction" policy to alleviate these burdens. This study aims to examine the mechanisms that underlie the longitudinal relationship between changes in academic pressure and social anxiety among Chinese adolescents under the background of this policy. A total of 2,202 valid questionnaires were obtained, and the sample consisted of 1,234 students who reported having a smartphone (age: M = 14.60, SD = 1.57). They were recruited to complete the changes in leisure time and academic pressure at Time 1, classmate support at Time 1 and Time 2, problematic smartphone use at Time 1 and Time 2, and social anxiety at Time 1, Time 2, and Time 3. The findings indicate that classmate support and problematic smartphone use at Time 2 significantly mediated the association between changes in academic pressure at Time 1 and social anxiety at Time 3. Changes in leisure time at Time 1 also affected these relationships. Specifically, compared to those with decreased leisure time, the relationship between classmate support at Time 2 and problematic smartphone use at Time 2 was stronger among adolescents with increased leisure time, while the relationship between changes in academic pressure at Time 1 and problematic smartphone use at Time 2 was weaker among adolescents with increased leisure time. These results highlight the importance of promoting effective stress coping strategies and peer interactions for adolescents, and also the importance of promoting active parental participation in leisure time management and guidance towards positive coping styles. [ABSTRACT FROM AUTHOR]

• This study validated the Psychoactive Substance Refusal Self-Efficacy Questionnaire (PSRSEQ) in Chinese adolescents in Hong Kong. • The psychometric properties of the 1-factor structure performed better than the original 3-factor one of PSRSEQ. • The validated PSRSEQ would facilitate future research and interventions on refusal self-efficacy for psychoactive substance use. Self-efficacy is a key concept in various behavioral theories. Refusal self-efficacy is important in understanding issues related to psychoactive substance use. To facilitate related research, this study translated and validated the Chinese version of the 14-item Psychoactive Substance Refusal Self-efficacy Questionnaire (PSRSEQ) among adolescents. There is a debate about whether such a refusal self-efficacy scale should be unidimensional or multidimensional. A survey was conducted among 601 adolescent case-clients of social workers in Hong Kong from July 2021 to June 2022. Various psychometric properties were examined. The confirmatory factor analysis (CFA) supported the original 3-factor structure of the PSRSEQ (emotional relief, opportunistic, and social facilitation refusal self-efficacy), which showed satisfactory psychometric properties (internal consistency, convergent validity in terms of significant negative correlations with the intention of psychoactive substance use in the next year and psychoactive substance use behavior in the past six months, and the absence of floor effect) but ceiling effect was obvious. Notably, unacceptable discriminant validity of one subscale and strong correlations among the three subscales were observed. In another set of analyses using two split-half subsamples, the exploratory factor analysis identified a 1-factor 14-item structure, which was confirmed by CFA and showed satisfactory psychometric properties. The 1-factor PSRSEQ, instead of the one having a 3-factor structure, was preferred and recommended to assess psychoactive substance refusal self-efficacy among Chinese adolescents. It is warranted to validate the scale in other adolescent and age groups in future studies. [ABSTRACT FROM AUTHOR]

Abstract: Limonium sinense is an endemic medicinal herb used to treat fever, hemorrhage and other disorders. In the present study, population genetic diversity was elucidated using random amplified polymorphic DNA (RAPD), inter simple sequence repeat (ISSR) and amplified fragment length polymorphism (AFLP) primers. Percentage of polymorphic bands, Nei's gene diversity and Shannon's information index revealed a high level of genetic diversity at species level. The analysis of molecular variance revealed that 69.88% (RAPD), 71.19% (ISSR) and 70.97% (AFLP) of variability were partitioned among individuals within populations, which indicated the coherent trend by Gst (0.3849/0.3577/0.3670). Gene flow number (Nm) was 0.581/0.618/0.612, which indicated that there was a limited gene exchange between populations. The UPGMA clustering results showed that the genetic distance had no significant correlation with geographic distance. These results indicate that these markers were reliable tools for the differentiation and determination of the genetic diversity among the populations of L. sinense and the conservation of existing natural population is necessary. [Copyright &y& Elsevier]

Abstract: Phylogenetic relationship of Limonium and other genera of Plumbaginaceae in China were studied using the cp rbcL, matK and the intergene spacer of trnL-trnF. The analysis showed that Plumbaginaceae was strongly supported monophyletic group sister to Polygonacea, and two tribes were comfirmed by phylogenetic analysis in Plumbaginaceae. Preliminary genetic diversity of Limonium sinense in China was also analyzed in this study by nrDNA (ITS) and cp DNA (two regions of intergenic spacers, trnL-trnF and psbA-trnH). The results showed that the population genetic diversity was low perhaps for human activities and breeding system of this species. These results have been used to understand the evolutionary and demographic history of L. sinense, which is a requisite to establish efficient conservation measures for this species. [Copyright &y& Elsevier]

It is common to see fire accidents caused by friction during the storage and transportation of wet granulation sulfur. To study the sulfur ignition mechanism under friction conditions, a new rotating test apparatus is developed to reproduce friction scenes at lab scale. A series of experiments are performed under different normal loads. The SEM-EDS and the XRD were utilized to examine the morphologies and compositions of the tested specimens and the friction products. Experimental results show that these two methods are mostly in agreement with each other. The iron-sulfide compounds are produced and the proportion of iron-sulfide compounds is reduced with normal loads increasing, compared to the total number of the friction products. The facts implied by the integration analysis of friction products with the temperature changes of the near friction surface unveil an underlying mechanism that may explain sulfur ignition by friction in real scenarios. The sulfur ignition may be mainly caused by the spontaneous combustion of iron sulfide compounds produced by friction under low normal load with 200 N. With the increase of normal loads, the resulting iron-sulfide compounds are decreasing and the high temperature from friction heat begins to play a major role in causing fire. [ABSTRACT FROM AUTHOR]

• Vascular calcification (VC) is prevalent in patients with CKD and contributes to their increased risk of all-cause mortality. • DEGs in VC is significantly enriched in the process of ossification, osteoblast differentiation, and Hedgehog signaling pathway. • PPI network analysis identified top 10 key genes involved in the development of VC. • CMAP analysis predicted several small molecular drugs targeting these key genes including SAG and CPN. • Our in vitro experiments confirmed that SAG markedly alleviated VSMC calcification and CPN significantly exacerbated VSMC calcification. Patients with chronic kidney disease (CKD) suffered from vascular calcification (VC), one major contributor for their increased mortality rate. Hedgehog (Hh) signaling plays a crucial role in physiological bone mineralization and is associated with several cardiovascular diseases. However, the molecular changes underlying VC is ill defined and it remains unclear whether Hh signaling intervention affects VC. We constructed human primary vascular smooth muscle cell (VSMC) calcification model and performed RNA sequencing. Alizarin red staining and calcium content assay were conducted to identify the occurrence of VC. Three different R packages were applied to determine differentially expressed genes (DEGs). Enrichment analysis and protein–protein interaction (PPI) network analysis were carried out to explore the biological roles of DEGs. qRT-PCR assay was then applied to validate the expression of key genes. By using Connectivity Map (CMAP) analysis, several small molecular drugs targeting these key genes were obtained, including SAG (Hedgehog signaling activator) and cyclopamine (CPN) (Hedgehog signaling inhibitor), which were subsequently used to treat VSMC. Obvious Alizarin red staining and increased calcium content identified the occurrence of VC. By integrating results from three R packages, we totally obtained 166 DEGs (86 up-regulated and 80 down-regulated), which were significantly enriched in ossification, osteoblast differentiation, and Hh signaling. PPI network analysis identified 10 key genes and CMAP analysis predicted several small molecular drugs targeting these key genes including chlorphenamine, isoeugenol, CPN and phenazopyridine. Notably, our in vitro experiment showed that SAG markedly alleviated VSMC calcification, whereas CPN significantly exacerbated VC. Our research provided deeper insight to the pathogenesis of VC and indicated that targeting Hh signaling pathway may represent a potential and effective therapy for VC. [ABSTRACT FROM AUTHOR]

[Display omitted] • An improved efficient decellularization protocol was identified, and this decellularized matrix could form hydrogels derived from human umbilical cord within 24 h. • HUVECs exhibited abundant cellular behavior in the hydrogels, including efficient adhesion, rapid proliferation, and vascularization. • The hydrogel showed good injectability and in situ molding ability, as well as excellent biocompatibility in vivo. Refractory wounds are frequent and protracted diabetes or postoperative complications that greatly affect the quality of life and mental health of patients. As a result of repeated dressing replacements and local debridement of the existing therapeutic therapies, freshly formed granulation is once more infiltrated by inflammation and eliminated, which delays the healing process. Herein, the improved Fryetes' method, which retained most of the active factors in the extracellular matrix, was developed to prepare injectable decellularized extracellular matrix hydrogels (dECMH) from human umbilical cord tissue. The physical, biochemical, in vivo and in vitro biological properties were analysed in detail. The results showed that the pre-gel exhibited good injectability and could form the hydrogel within 30 min. Biochemical analysis indicated that the prepared decellularized extracellular matrix retained abundant structural proteins and wound healing-related growth factors. In vitro and in vivo experiments confirmed the excellent biocompatibility of dECMH and the extremely high migration and proliferation capacities of human umbilical vein endothelial cells in the hydrogels. Thus, the injectability, gel-forming ability, and excellent biological characteristics of the hydrogel are highly compatible with refractory wounds with various irregular shapes, showing great potential for clinical application in wound repair. [ABSTRACT FROM AUTHOR]

Exposure to metals and metalloids is widely related with human health, and could affect the function of immune system. The complement system links innate and adaptive immunity, and is critically involved in the pathogenesis of inflammatory and immune diseases. The third and fourth components of complement (C3, C4) play key roles in the complement system. However, few studies have examined the relations between multiple metals and complement levels. In this study, based on a total of 2977 participants from the Dongfeng-Tongji cohort, China, we investigated 17 plasma metals and serum C3, C4 levels, and calculated C3/C4-associated genetic risk scores (GRSs) using established single nucleotide polymorphisms. We further explored the potential gene-metal interactions on C3 and C4. After multivariable adjustment, an increment of 10-standard deviation increase in natural log-transformed exposure concentrations of plasma copper was associated with 0.549 (0.489, 0.608) (FDR <0.0001), and 1.146 (0.999, 1.294) (FDR <0.0001) higher natural log-transformed serum C3 and C4 levels, respectively. While each increment of 10-standard deviation of natural log-transformed zinc was associated with a difference of 0.083 (0.024, 0.143) (FDR = 0.049) and 0.007 (−0.138, 0.152) (FDR = 0.935) in log-transformed C3 and C4 levels, respectively. Participants with higher GRS had higher C3 and C4 levels. Furthermore, we found a significant interaction between arsenic exposure and C3-GRS in relation to C3 level (P interaction = 0.0096). Our results suggested that plasma arsenic would modify the association between C3 genetic predisposition and serum C3 level. We provide new insight into metals exposure on the human immune system. These findings require replication in future research. [Display omitted] • We found positive linear relations of plasma Cu level with serum C3, C4 levels. • There was a positive non-linear relation of plasma Zn level with serum C3 level. • We observed an interaction between C3-GRS and plasma As in relation to C3 level. [ABSTRACT FROM AUTHOR]

Metal exposures are ubiquitous around the world, while it is lack of prospective studies to evaluate the associations of exposure to multiple metal/metalloids with incident dyslipidemia. A total of 2947 participants without dyslipidemia at baseline were included in the analyses. We utilized inductively coupled plasma mass spectrometry to measure the baseline plasma metal concentrations. Unconditional logistic regression models were applied to estimate the relations between plasma metals and risk of incident dyslipidemia, and principal component analysis was performed to extract principal components of metals. During 5.01 ± 0.31 years of follow-up, 521 subjects were diagnosed with incident dyslipidemia. After multivariable adjustment, the odds ratios (ORs) of dyslipidemia comparing the highest quartiles to the lowest were 1.58 (95% CI: 1.20, 2.08; P trend = 0.001) for aluminum, 1.34 (95% CI: 1.03, 1.75; P trend = 0.03) for arsenic, 1.44 (1.09, 1.91; P trend = 0.03) for strontium, and 1.47 (95% CI: 1.09, 2.00; P trend = 0.005) for vanadium. The four metals also showed significant associations with the subtypes of dyslipidemia, including low HDL-C and high LDL-C. The first principal component, which mainly represented aluminum, arsenic, barium, lead, vanadium, and zinc, was associated with increased risk of incident dyslipidemia, and the adjusted OR was 1.40 (95% CI: 1.07, 1.84; P trend = 0.02) comparing extreme quartiles. The study indicated that elevated plasma aluminum, arsenic, strontium, and vanadium concentrations were associated with a higher incidence of dyslipidemia. These findings highlight the importance of controlling metal exposures for dyslipidemia prevention. • Plasma metal concentrations could be determinants and predictors of dyslipidemia in Chinese population. • Aluminum, arsenic, strontium, and vanadium exposure may confer risk for incident dyslipidemia. • Principal component analysis enriches the understanding of the role of metal mixtures in the development of dyslipidemia. [ABSTRACT FROM AUTHOR]

• Metals are crucial determinants and predictors of premature death in Chinese adults. • Selenium and thallium may reduce the risks of all-cause and CVD mortality. • Molybdenum and vanadium would confer risks for all-cause and CVD mortality. • Plasma metal score provides in-depth characterization of multiple metal exposures. • Plasma metal score would improve the predictive ability for further mortality risk. Exposure to metals/metalloids from both the natural environment and anthropogenic sources have a complex influence on human health. However, relatively few studies have explored the relations of exposure to multiple metals/metalloids with mortality. Therefore, this prospective study aims to examine the relations of multiple metal/metalloids exposures with all-cause and cardiovascular disease (CVD) mortality. A total of 6155 participants within the Dongfeng-Tongji (DF-TJ) cohort were involved in this analysis, which were followed for mortality until December 31, 2018. We applied inductively coupled plasma mass spectrometry (ICP-MS) to measure baseline plasma concentrations of 23 metals. We utilized Cox regression models to calculate the hazard ratios (HRs) for all-cause and CVD mortality associated with metal concentrations. We proposed plasma metal score to assess the simultaneous exposure to multiple metals through summing each metal concentration weighted by the regression coefficients with all-cause mortality. During the follow-up (mean duration, 9.8 years), we ascertained 876 deaths, including 416 deaths of CVD (157 deaths of coronary heart disease and 259 deaths of stroke). In the multiple-metals model, after adjusting for potential confounders, plasma copper, molybdenum, and vanadium were positively associated with all-cause mortality, whereas manganese, selenium, and thallium were negatively associated with the risk of all-cause mortality, with adjusted HRs (95% Confidence Interval, CI) of the fourth quartiles were 1.73 (1.42–2.11, P-trend < 0.001) for copper, 1.33 (1.09–1.63, P-trend = 0.005) for molybdenum, 1.43 (1.16–1.77, P-trend < 0.001) for vanadium, 0.74 (0.58–0.94, P-trend = 0.005) for manganese, 0.68 (0.56–0.83, P-trend < 0.001) for selenium, and 0.74 (0.59–0.92, P-trend = 0.002) for thallium, respectively. Positive associations were observed between plasma copper, molybdenum, vanadium concentrations and CVD mortality, whereas negative associations were found for plasma selenium and thallium concentrations with CVD mortality in the multiple-metals model. Compared with the first quartiles, the HRs of fourth quartiles were 1.94 (1.45–2.58, P-trend < 0.001) for copper, 1.72 (1.26–2.35, P-trend < 0.001) for molybdenum, 1.81 (1.32–2.47, P-trend < 0.001) for vanadium, 0.67 (0.50–0.89, P-trend = 0.003) for selenium, and 0.58 (0.41–0.81, P-trend < 0.001) for thallium, respectively. The plasma metal score was significantly associated with higher risks of all-cause and CVD death in dose–response fashions. When compared with the first quartiles of plasma metal score, the HRs of fourth quartiles were 2.16 (1.76–2.64; P-trend < 0.001) for all-cause mortality and 3.00 (2.24–4.02; P-trend < 0.001) for CVD mortality. The study indicated that several plasma metals/metalloids were key determinants and predictors of all-cause and CVD death in the Chinese population. Our findings highlighted the importance to comprehensively assess and monitor multiple metals/metalloids exposures. [ABSTRACT FROM AUTHOR]