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Abstract Background In some RCTs comparing triple therapy with dual therapy in COPD, there might be a bias resulting from the use of multiple inhaler devices. This meta-analysis included only RCTs that compared ICS/LABA/LAMA vs. LABA/LAMA or ICS/LABA using a single device. Methods We systematically reviewed randomized controlled trials (RCTs) of single-inhaler triple therapy in patients with COPD. We searched the PubMed, MEDLINE (OvidSP), EMBASE and Cochrane Library databases to investigate the effect of single-inhaler triple therapy in COPD. The primary end points were the effect of single-inhaler triple therapy compared with single-inhaler dual therapy on all-cause mortality, the risk of acute exacerbation of COPD (AECOPD), and some safety endpoints. The Cochrane Collaboration tool was used to assess the quality of each randomized trial and the risk of bias. Results A total of 25,171 patients suffering from COPD were recruited for the 6 studies. This meta-analysis indicated that single-inhaler triple therapy resulted in a significantly lower rate of all-cause mortality than LABA/LAMA FDC (risk ratio, 0.70; 95% CI 0.56‐0.88). Single-inhaler triple therapy reduced the risk of exacerbation and prolonged the time to first exacerbation compared with single-inhaler dual therapy. The FEV1 increased significantly more under single-inhaler triple therapy than under ICS/LABA FDC (mean difference, 103.4 ml; 95% CI 64.65‐142.15). The risk of pneumonia was, however, significantly higher with ICS/LAMA/LABA FDC than with LABA/LAMA FDC (risk ratio, 1.55; 95% CI 1.35–1.80). Conclusions This meta-analysis suggests that single-inhaler triple therapy is effective in reducing the risk of death of any cause and of moderate or severe exacerbation in COPD patients. However, the risk of pneumonia is higher with ICS/LAMA/LABA FDC than with LABA/LAMA FDC. Trial registration PROSPERO #CRD42020186726.

Artemisia ordosica has been applied as a traditional Chinese/Mongolian medicine for treating csertain inflammatory ailments. This study was conducted to investigate the effect of Artemisia ordosica alcohol extract (AOAE) supplemented in diets on growth performance, immune, and inflammatory response in lipopolysaccharide (LPS)-challenged broilers. A total of 240 one-day-old Arbor Acre male broilers were randomly allotted into 5 groups with 6 replicates (n = 8), which were basal diet group (CON), LPS-challenge and basal diet group (LPS), LPS-challenge and the basal diet added with low (500 mg/kg), middle (750 mg/kg), and high (1,000 mg/kg) dose of AOAE groups (AOAE-L, AOAE-M, and AOAE-H), respectively. On d 16, 18, 20, 22, 24, 26, and 28, all broilers were injected intra-abdominally either with LPS or an equivalent amount of saline. Results showed that dietary AOAE alleviated the LPS-induced decrease in average daily gain and average daily feed intake in the broilers (P < 0.05). Dietary AOAE supplementation reversed the increased spleen index and the decreased bursa index in LPS-challenged broilers (P < 0.05). Moreover, feeding AOAE could mitigate the elevation of IL-1β in serum, liver, and spleen, IL-2 in serum and liver, IL-6 in serum and spleen, and the decrease of IgG in spleen, IgM in serum, liver, and spleen, and IL-4 in serum of the LPS-challenged broilers (P < 0.05). This study also showed that AOAE supplementation alleviated the increase of mRNA expression of TLR4, MyD88, TRAF6, NF-κB p65, NF-κB p50, IL-1β, and IL-6, and the decrease of gene expression of IκBα and PPARγ in liver and/or spleen of broilers challenged by LPS (P < 0.05). We speculated that AOAE administration could effectively alleviate LPS-induced inflammation via decreasing over-production of proinflammatory cytokines, ultimately relieving the growth inhibition of broilers caused by LPS. In conclusion, 1,000 mg/kg AOAE has a strong capacity to enhance immunity and inhibit inflammation, and can be used as a potential novel feed additive with applications in treating inflammation-related diseases and bacterial infection in broilers.

Background Chronic cough is a common complaint, but there are no population-based data on its burden in China. We determined the prevalence of chronic cough and its impact on health status in adults stratified by sex, age and the diagnosis of COPD or the presence of small airway dysfunction (SAD). Methods A representative sample of 57 779 Chinese adults aged 20 years or older was recruited and pulmonary function test was measured. Chronic cough was defined as cough lasting for >3 months in each year. Quality of life was assessed by the 12-item Short Form Health Survey (SF-12), and self-reported history of hospital visits was recorded. Results Chronic cough was found in 3.6% (95% CI 3.1–4.1) of Chinese adults, 2.4% (95% CI 1.9–3.1) of those aged 20–49 years and 6.0% (95% CI 5.3–6.8) of those aged 50 years or older. Individuals with chronic cough had an impaired physical component summary (PCS) score of the SF-12 (p

Understanding the designs and performance characterizations of hot interconnects on modern data center and high-performance computing (HPC) clusters is a fruitful research topic in recent years. The rapid and continuous growth of high-bandwidth and low-latency communication requirements for various types of data center and HPC applications (such as big data, deep learning, and microservices) has been pushing the envelope of advanced interconnect designs. We believe this is high time to investigate the performance characterizations of representative hot interconnects with different benchmarks. Hence, this paper presents an extensive survey of state-of-the-art hot interconnects on data center and HPC clusters and the associated representative benchmarks to help the community to better understand modern interconnects. In addition, we characterize these interconnects by the related benchmarks under different application scenarios. We provide our perspectives on benchmarking data center interconnects based on our survey, experiments, and results.

Abstract Background Cognitive leisure activity, such as reading, playing mahjong or cards and computer use, is common among older adults in China. Previous studies suggest a negative correlation between cognitive leisure activity and cognitive impairment. However, the relationship between cognitive leisure activity and all-cause mortality has rarely been reported. Objectives This study aims to explore the relationships between cognitive leisure activity and all-cause mortality in a community-based older people cohort in China. Methods The current study sample comprised 4003 community residents aged ≥60 y who were enrolled in June 2015, and were followed up every year from 2015 to 2018. Reading, playing mahjong or cards and computer use were measured by questionnaires and summed into a cognitive leisure activity index (CLAI) score. Time-Dependent Cox Regression Model and Kaplan-Meier survival analysis were used to examine the association of cognitive leisure activity with all-cause mortality. Results During the 4-year follow-up of 4003 participants, 208 (5.2%) deaths were registered. Of all participants, 66.8, 26.7, 6.1 and 0.35% reported CLAI scores of 0, 1, 2 and 3, respectively. A strong association was noted between the CLA score and all-cause mortality (adjusted hazard ratio [HR] = 0.72, 95% confidence intervals [CI]: 0.54–0.97, P = 0.028). Stratified analysis suggested that a higher CLAI score was significantly associated with a decreased risk of all-cause mortality mainly among those who were male, aged ≥80 y, cognitively impaired, and not diagnosed with cancer (P

This study conducted transcriptome sequencing of goat-mammary-gland tissue at the late lactation (LL), dry period (DP), and late gestation (LG) stages to reveal the expression characteristics and molecular functions of circRNAs during mammary involution. A total of 11,756 circRNAs were identified in this study, of which 2528 circRNAs were expressed in all three stages. The number of exonic circRNAs was the largest, and the least identified circRNAs were antisense circRNAs. circRNA source gene analysis found that 9282 circRNAs were derived from 3889 genes, and 127 circRNAs’ source genes were unknown. Gene Ontology (GO) terms, such as histone modification, regulation of GTPase activity, and establishment or maintenance of cell polarity, were significantly enriched (FDR < 0.05), which indicates the functional diversity of circRNAs’ source genes. A total of 218 differentially expressed circRNAs were identified during the non-lactation period. The number of specifically expressed circRNAs was the highest in the DP and the lowest in LL stages. These indicated temporal specificity of circRNA expression in mammary gland tissues at different developmental stages. In addition, this study also constructed circRNA–miRNA–mRNA competitive endogenous RNA (ceRNA) regulatory networks related to mammary development, immunity, substance metabolism, and apoptosis. These findings help understand the regulatory role of circRNAs in mammary cell involution and remodeling.

Abstract Background Studies report high in-hospital mortality of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) especially for those requiring admission to an intensive care unit. Recognizing factors associated with mortality in these patients could reduce health care costs and improve end-of-life care. Methods This retrospective study included AECOPD patients admitted to the respiratory intensive care unit of a tertiary hospital in Beijing from Jan 1, 2011 to Dec 31, 2018. Patients demographic characteristics, blood test results and comorbidities were extracted from the electronic medical record system and compared between survivors and non-survivors. Results We finally enrolled 384 AECOPD patients: 44 (11.5%) patients died in hospital and 340 (88.5%) were discharged. The most common comorbidity was respiratory failure (294 (76.6%)), followed by hypertension (214 (55.7%)), coronary heart disease (115 (29.9%)) and chronic heart failure (76 (19.8%)). Multiple logistic regression analysis revealed that independent risk factors associated with in-hospital mortality included lymphocytopenia, leukopenia, chronic heart failure and requirement for invasive mechanical ventilation. Conclusions The in-hospital mortality of patients with acute COPD exacerbation requiring RICU admission is high. Lymphocytes

Abstract Background Type 1 diabetes mellitus (T1DM) is associated with an increased risk for cardiovascular disease (CVD) related morbidity and premature mortality. Regular physical activity plays an important role in the primary and secondary prevention of CVD, improving overall health and wellbeing. Previous observational studies have examined the associations between self-reported physical activity and CVD risk factors in largely adult Caucasian populations. However, limited work has evaluated the relationship between objectively measured physical activity and CVD risk factors in other ethnicities, particularly Chinese youth living with T1DM. Methods This cross-sectional study assessed CVD risk factors, physical activity, and aerobic fitness (and their associations) in Chinese youth living with T1DM (n = 48) and peers (n = 19) without T1DM. Primary outcomes included blood pressure, lipid profiles, and physical activity (accelerometry). Statistical differences between groups were determined with chi-square, independent-samples t-tests, or analysis of covariance. The associations between aerobic fitness, daily physical activity variables, and CVD risk factors were assessed with univariate and multivariate linear regression analyses. Results Results were summarized using means and standard deviation (SD) for normally distributed variables and medians and 25–75th quartile for non-normally distributed variables. In comparison to peers without diabetes, youth living with T1DM showed higher levels of total cholesterol (3.14 ± 0.67 vs. 4.03 ± 0.81 mmol·L-1, p = 0.001), low-density lipoprotein cholesterol (1.74 ± 0.38 vs. 2.31 ± 0.72 mmol·L-1, p = 0.005), and triglycerides (0.60 ± 0.40 vs. 0.89 ± 0.31 mmol·L-1 p = 0.012), and lower maximal oxygen power (44.43 ± 8.29 vs. 35.48 ± 8.72 mL·kg-1·min-1, p = 0.003), total physical activity counts (451.01 ± 133.52 vs. 346.87 ± 101.97 counts·min-1, p = 0.004), metabolic equivalents (METs) (2.41 ± 0.60 vs. 2.09 ± 0.41 METs, p = 0.033), moderate-to-vigorous intensity physical activity [MVPA: 89.57 (61.00–124.14) vs (53.19 (35.68–63.16) min, p = 0.001], and the percentage of time spent in MVPA [11.91 (7.74–16.22) vs 8.56 (6.18–10.12) %, p = 0.038]. The level of high-density lipoprotein cholesterol was positively associated with METs (β = 0.29, p = 0.030, model R2 = 0.168), and the level of triglycerides was negatively associated with physical activity counts (β = − 0.001, p = 0.018, model R2 = 0.205) and METs (β = − 0.359, p = 0.015, model R2 = 0.208), and positively associated with time spent in sedentary behaviour (β = 0.002, p = 0.041, model R2 = 0.156) in persons living with T1DM. Conclusions Chinese youth with T1DM, despite their young age and short duration of diabetes, present early signs of CVD risk, as well as low physical activity levels and cardiorespiratory fitness compared to apparently healthy peers without diabetes. Regular physical activity is associated with a beneficial cardiovascular profile in T1DM, including improvements in lipid profile. Thus, physical activity participation should be widely promoted in youth living with T1DM.

Abstract Background Inter-limb asymmetry above a certain threshold in functional performance indicates increased injury risk in sports. Fatigue has been found to increase bilateral asymmetry in lower-limb jumping performance among high-school and adult athletes, whereas this impact has not been examined in child athletes. This study aimed to examine the effect of fatigue on inter-limb asymmetry in functional performances in elite Taekwondo athletes aged between 9 and 11 years. Methods Performance of single-leg jumps, Star Excursion Balance Test (SEBT), and muscle (hamstring and gastrocnemius) flexibility were measured for 13 elite male child Taekwondo athletes (aged 9.85 ± 0.80 years) at both the rested and fatigued states to examine the inter-limb asymmetry. A two-way repeated measures ANOVA was conducted to examine for difference and the interaction between limb (dominant, non-dominant leg) and state (rested, fatigued state) for each test. Paired t test or Wilcoxon signed-rank test was used to compare the asymmetry magnitude at the rested vs. fatigued state for each test, and the variation of performance post fatigue in the dominant vs. non-dominant leg when appropriate. Results The inter-limb asymmetry in triple-hop distance significantly (p = 0.046) increased with fatigue, whereas the asymmetry significantly (p = 0.004) decreased with fatigue in anterior (ANT) reach distance in SEBT. A significant (p = 0.027) limb by state interaction was shown for posterolateral (PL) reach distance in SEBT, wherein a significant (p = 0.005) bilateral difference was only shown at the rested state. The PL reach distance showed a significantly greater decrease (p = 0.028) post fatigue when using the dominant leg for support compared to using the non-dominant leg. Conclusions Fatigue significantly impacts inter-limb asymmetry in jump performances and dynamic balance for child athletes, while the variation of inter-limb asymmetry post fatigue may be different across tests. For the purpose of injury prevention, practitioners should consider assessing the inter-limb asymmetry for children at both the rested and fatigued state and be mindful of the fatigue response of each leg in functional tests.

BackgroundPatients with features of both asthma and chronic obstructive pulmonary disease (COPD) are seen commonly in the clinic but less is known in the general population. We investigated the prevalence and the heterogeneity of COPD with concomitant features of asthma in Chinese adult population.MethodsCOPD was defined as post-bronchodilator ratio of forced expiratory volume in 1s (FEV1) to forced vital capacity of less than the lower limits of normal. COPD with concomitant features of asthma was defined as either COPD with asthma diagnosed by self-reported physician-diagnosis or by presence of current wheeze, or as COPD with high bronchodilator response (HBR) defined as an increase in FEV1 >15% and >400 ml after bronchodilator.ResultsCOPD with concomitant features of asthma was found in 1.62% (95% CI 1.31–2.00) of adults (≥20 years) or in 15.2% (95% CI 13.0–17.7) of COPD patients. Compared with COPD with HBR, COPD with asthma diagnosis or wheeze were older (61.8 ± 1.1 years vs. 47.4 ± 2.8 years, P < 0.001), and with a lower post-bronchodilator FEV1%pred (68.2 ± 2.3 vs. 96.6 ± 3.4, P < 0.001). Age, smoking status, biomass use and allergic rhinitis were associated with increasing prevalence of COPD with asthma diagnosis or wheeze, and had greater impaired health status, more comorbidities and more acute exacerbations in the preceding 12 months.ConclusionsCOPD with concomitant features of asthma is common in people with COPD and those with COPD with asthma diagnosis or wheeze experience worse clinical severity than COPD with HBR. These findings will help toward the definition of the asthma-COPD overlap condition.

Bond dissociation enthalpies are key quantities in determining chemical reactivity, their computations with quantum mechanical methods being highly demanding. Here the authors develop a machine learning approach to calculate accurate dissociation enthalpies for organic molecules with sub-second computational cost.

Abstract Background It is important to clarify the transitions and related factors of frailty for prevention of frailty. We evaluated the transitions of frailty among community-dwelling older adults and examined the predictors of the transitions. Methods A cohort study was conducted among 3988 community residents aged ≥60 years during 2015 and 2017. A multiple deficits approach was used to construct the Frailty Index (FI) according to the methodology of FI construction, and sociodemographic characteristics and lifestyles were also collected in 2015. After 2-year follow-up, the transitions of frailty between baseline and were evaluated. Multinomial logistic regressions were used to examine associations between predictors and the transitions of frailty. Results The proportion of robust, prefrail, and frail was 79.5, 16.4, and 4.1% among 3988 participants at baseline, which changed to 68.2, 23.0, and 8.8% after 2 years with 127 deaths and 23 dropped out. Twelve kinds of transitions from the three frailty statuses at baseline to four outcomes at follow-up (including death) significantly differed within each of gender and age group, as well between genders and age groups. Among these, 7.8% of prefrail or frail elders improved, 70.0% retained their frailty status, and 22.2% of robust or prefrail elders worsened in frailty status. In multivariable models, age was significantly associated with changes in frailty except for in the frail group; higher educational level and working predicted a lower risk of robust worsening. Of the lifestyle predictors, no shower facilities at home predicted a higher risk of robust worsening; more frequent physical exercise predicted a lower risk of robust worsening and a higher chance of frailty improvement; more frequent neighbor interaction predicted a lower risk of robust worsening and prefrail worsening; and more frequent social participation predicted a higher chance of prefrail improvement. Conclusions The status of frailty was reversible among community-dwelling elderly, and sociodemographic and lifestyle factors were related to changes in frailty. These findings help health practitioners to recognize susceptible individuals in a community and provide health promotional planning to target aged populations.

Abstract Background Retinal blood vessel segmentation has an important guiding significance for the analysis and diagnosis of cardiovascular diseases such as hypertension and diabetes. But the traditional manual method of retinal blood vessel segmentation is not only time-consuming and laborious but also cannot guarantee the accuracy and efficiency of diagnosis. Therefore, it is especially significant to create a computer-aided method of automatic and accurate retinal vessel segmentation. Methods In order to extract the blood vessels’ contours of different diameters to realize fine segmentation of retinal vessels, we propose a Bidirectional Symmetric Cascade Network (BSCN) where each layer is supervised by vessel contour labels of specific diameter scale instead of using one general ground truth to train different network layers. In addition, to increase the multi-scale feature representation of retinal blood vessels, we propose the Dense Dilated Convolution Module (DDCM), which extracts retinal vessel features of different diameters by adjusting the dilation rate in the dilated convolution branches and generates two blood vessel contour prediction results by two directions respectively. All dense dilated convolution module outputs are fused to obtain the final vessel segmentation results. Results We experimented the three datasets of DRIVE, STARE, HRF and CHASE_DB1, and the proposed method reaches accuracy of 0.9846/0.9872/0.9856/0.9889 and AUC of 0.9874/0.9941/0.9882/0.9874 on DRIVE, STARE, HRF and CHASE_DB1. Conclusions The experimental results show that compared with the state-of-art methods, the proposed method has strong robustness, it not only avoids the adverse interference of the lesion background but also detects the tiny blood vessels at the intersection accurately.

As a predominant phenolic compound in apple fruits, chlorogenic acid (CGA) benefits human health due to its various antioxidant properties. However, little has been known regarding the molecular mechanism underlying the CGA accumulation in apple fruits. In this study, we measured the CGA content and relative enzymes’ activities during fruit development in two different flesh-colored cultivars ‘Huashuo’ and ‘Red Love’. The CGA content in both cultivars decreased sharply from 30 days after full bloom (DAFB) to 60 DAFB. Notably, the CGA content in fruit flesh was relatively higher than that in the peel. Further, the activities of C3H and HCT enzymes downstream of the CGA biosynthesis showed the similar changing trend as CGA content. Based on the transcriptome data of ‘Huashuo’ fruit at 30 DAFB and 60 DAFB, 23 differentially expressed CGA synthesis-related genes were screened. Gene expression analyses further showed that MdHCT1/2/4/5/6 and MdC3H1/2/3 were positively correlated to the variation of CGA content in two cultivars. These findings establish a theoretical foundation for further mechanism study on CGA biosynthesis and provide guidance for nutrient improvement in apple breeding programs.

Background: Chronic obstructive pulmonary disease (COPD) is a public health challenge globally. The burden of COPD is high in never-smokers but little is known about its causes. We aimed to find the prevalence and correlates of COPD in never-smokers, with a special focus on solid fuel exposure.Methods: We conducted a cross-sectional study in Western China. COPD was defined by FEV1/FVC < lower limits of normal (LLN). Descriptive statistics and multivariable logistic regression were used for analyses.Results: Six thousand two hundred and seventy one patients were enrolled between June 2015 and August 2016. The prevalence of COPD in never-smokers was 15.0% (95% confidence interval 14.1–15.9). The common independent predictors of COPD in never-smokers included age ≥60 years, exposure to solid fuel, living in a rural area and a history of tuberculosis. Participants with solid fuel exposure were 69% more likely to have COPD (adjusted odds ratio 1.69, 95% CI 1.41–2.04) than those without such exposure. In addition, we found a positive association between small airway dysfunction and solid fuel exposure (OR 1.35, 95% CI 1.18–1.53).Conclusions: This study confirmed the substantial burden of COPD among never-smokers and also defined the risk factors for COPD in never-smokers. Furthermore, we found a positive association between solid fuel exposure and COPD or small airway dysfunction.

The associations of long-term exposure to various constituents of fine particulate matter (≤2.5 μm in aerodynamic diameter, PM2.5) air pollution with lung function were not clearly elucidated in developing countries. The aim was to evaluate the associations of long-term exposure to main constituents of PM2.5 with lung function in China. This is a nationwide, cross-sectional analysis among 50,991 study participants from the China Pulmonary Health study. Multivariable linear regression models were used to obtain differences of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, peak expiratory flow (PEF), and forced expiratory flow at 25–75% of exhaled FVC (FEF25-75%) associated with an interquartile range (IQR) change of PM2.5 or its constituents. Residential annual PM2.5 levels varied from 26 μg/m3 to 92 μg/m3 (average: 53 μg/m3). An IQR increase of PM2.5 concentrations was associated with lower FEV1 (19.82 mL, 95% CI: 11.30–28.33), FVC (17.45 mL, 95% CI: 7.16–27.74), PEF (86.64 mL/s, 95% CI: 59.77–113.52), and FEF25-75% (31.93 mL/s, 95% CI: 16.64–47.22). Black carbon, organic matter, ammonium, sulfate, and nitrate were negatively associated with most lung function indicators, with organic matter and nitrate showing consistently larger magnitude of associations than PM2.5 mass. This large-scale study provides first-hand epidemiological evidence that long-term exposure to ambient PM2.5 and some constituents, especially organic matter and nitrate, were associated with lower large- and small- airway function.

In this study, soybean protein isolate (SPI) and pectin emulsion gels were prepared by thermal induction, and the effects of high intensity ultrasound (HIU) at various powers (0, 150, 300, 450 and 600 W) on the structure, gel properties and stability of emulsion gels were investigated. Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) showed that the interaction between SPI and pectin was enhanced and the crystallinity of the emulsion gels was changed due to the HIU treatment. Confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM) observations revealed that the particle size of the emulsion gels was decreased significantly by HIU treatment. The emulsion gel structure became more uniform and denser, which was conducive to storage stability. In addition, according to the low field nuclear magnetic resonance (LF-NMR) analysis, HIU treatment had no obvious impact on the content of bound water as the power increased to 450 W, while the content of free water decreased gradually and became immobilized water, which indicated that the water holding capacity of the emulsion gels was enhanced. Compared with untreated emulsion gel, differential scanning calorimetry (DSC) analysis showed that the denaturation temperature reached 131.9 ℃ from 128.2 ℃ when treated at 450 W. The chemical stability and bioaccessibility of β-carotene in the emulsion gels were improved significantly after HIU treatment during simulated in vitro digestion.

Interleukin-1 (IL-1) plays an essential role in the immune pro-inflammatory process, which is regarded as one of many factors in the development of type 2 diabetes mellitus (T2DM). Several case-control studies have illustrated the association of the IL-1B (-511) (rs16944, Chr 2:112,837,290, C/T Intragenic, Transition Substitution) and IL-1RN (VNTR) (gene for IL-1 receptor antagonist, IL-1RA, 86 bp tandem repeats in intron 2) polymorphisms with T2DM risk. However, the results were inconsistent and inconclusive. We performed a meta-analysis (registry number: CRD42021268494) to assess the association of the IL-1B (-511) and IL-1RN (VNTR) polymorphisms with T2DM risk. Random-effects models were applied to calculate the pooled ORs (odds ratios) and 95% CIs (confidence intervals) to test the strength of the association in the overall group and subgroups stratified by ethnicity, respectively. Between-study heterogeneity and publication bias were evaluated by the Q-test, I2 statistic, Harbord test, and Peters test accordingly. Sensitivity analyses were also performed. A total of 12 publications evaluating the association of IL-1B (-511) and IL-1RN (VNTR) polymorphisms with the risk of T2DM development were included. The meta-analysis showed that IL-1RN (VNTR) was related to the increasing development of T2DM risk in the recessive model (OR = 1.62, 95% CI [1.09–2.42], Phet = 0.377, Pz = 0.018) and in the homozygous model (OR = 2.02, 95% CI [1.07–3.83], Phet = 0.085, Pz = 0.031), and the IL-1RN 2* allele was found a significant association with evaluated T2DM risk in all ethnicities (OR = 2.08, 95% CI [1.43–3.02], Phet

Artemisia ordosica has been applied as a traditional Chinese/Mongolian medicine for the treatment of certain inflammatory ailments. This study was conducted to investigate the effect of Artemisia ordosica total flavonoids (ATF) supplemented in diets on growth performance, oxidative stress, and antioxidant status in lipopolysaccharide (LPS)-challenged broilers. A total of 240 one-day-old Arbor Acre broilers were randomly allotted into 5 groups with 6 replicates (n = 8), which were the basal diet group (CON), LPS-challenged and basal diet group (LPS), and the LPS-challenged and basal diet added with low (500 mg/kg), middle (750 mg/kg), and high (1000 mg/kg) doses of ATF groups (ATF-L, ATF-M, and ATF-H), respectively. On day 16, 18, 20, 22, 24, 26, and 28, broilers were injected intra-abdominally either with LPS or an equivalent amount of saline. Results showed that dietary ATF alleviated the LPS-induced decrease in BW, ADG, and ADFI in broilers. Dietary ATF supplementation reversed the increased serum oxidative damage indexes (reactive oxygen species, protein carbonyl, and 8-hydroxy-2-deoxyguanosine) and the decreased serum antioxidant indexes [total superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and total antioxidant capacity (TAC)] in LPS-challenged broilers. Moreover, ATF alleviated the decreased antioxidase activity and the over-production of malondialdehyde (MDA) in the liver and spleen induced by LPS. This study also showed that ATF alleviated the increased mRNA expression of Kelch-like ECH-associated protein 1 (Keap1) and the decreased mRNA expression of nuclear factor erythroid 2-related factor 2 (Nrf2), CAT, SOD, and GPx in the liver and spleen of broilers challenged with LPS. In conclusion, ATF has a strong capacity to enhance antioxidant enzyme activity and relieve oxidative stress and can be used as a potential novel feed additive in poultry diets to improve growth performance and antioxidant capacity.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Abstract Background Anemia and frailty contribute to poor health outcomes in older adults; however, most current research in lower income countries has concentrated on anemia or frailty alone rather than in combination. The aim of the present study was to investigate the association between anemia and frailty in community-dwelling adults aged 50 years and older in China. Methods The study population was sourced from the 2007/10 SAGE China Wave 1. Anemia was defined as hemoglobin less than 13 g/dL for men and less than 12 g/dL for women. A Frailty Index (FI) was compiled to assess frailty. The association between anemia and frailty was evaluated using a 2-level hierarchical logistic model. Results The prevalence of anemia was 31.0% (95%CI: 28.4, 33.8%) and frailty 14.7% (95%CI: 13.5, 16.0%). In the univariate regression model, presence of anemia was significantly associated with frailty (OR = 1.62, 95% CI: 1.39, 1.90) and the effect remained consistent after adjusting for various potential confounding factors including age, gender, residence, education, household wealth, fruit and vegetable intake, tobacco use, alcohol comsumption and physical activity (adjusted OR = 1.31, 95% CI:1.09, 1.57). Each 1 g/dL increase in hemoglobin concentration was associated with 4% decrease in the odds of frailty after adjusting for several confounding variables (adjusted OR = 0.96, 95% CI: 0.93, 0.99). Conclusion Anemia and low hemoglobin concentrations were significantly associated with frailty. Therefore, health care professionals caring for older adults should increase screening, assessment of causes and treatment of anemia as one method of avoiding, delaying or even reversing frailty.

With the rapid development of big data and artificial intelligence technology, computer-aided pulmonary nodule detection based on deep learning has achieved some successes. However, the sizes of pulmonary nodules vary greatly, and the pulmonary nodules have visual similarity with structures such as blood vessels and shadows around pulmonary nodules, which make the quick and accurate detection of pulmonary nodules in CT image still a challenging task. In this paper, we propose two kinds of 3D multi-scale deep convolution neural networks for nodule candidate detection and false positive reduction respectively. Among them, the nodule candidate detection network consists of two parts: 1) the backbone network part Res2SENet, which is used to extract multi-scale feature information of pulmonary nodules, it is composed of the multi-scale Res2Net modules of multiple available receptive fields at a granular level and the squeeze-and-excitation units; 2) the detection part, which uses a region proposal network structure to determine region candidates, and introduces context enhancement module and spatial attention module to improve detection performance. The false positive reduction network, also composed of the multi-scale Res2Net modules and the squeeze-and-excitation units, can further classify the nodule candidates generated by the nodule candidate detection network and screen out the ground truth positive nodules. Finally, the prediction probability generated by the nodule candidate detection network is weighted average with the prediction probability generated by the false positive reduction network to obtain the final results. The experimental results on the publicly available LUNA16 dataset showed that the proposed method has a superior ability to detect pulmonary nodules in CT images.

Aim of Study: Four hundred million people live at high altitude worldwide. Prevalence and risk factors for COPD in these populations are poorly documented. We examined the prevalence and risk factors for COPD in residents living at an altitude of 2,100–4,700 m.Methods: We performed a cross-sectional survey in Xinjiang and Tibet autonomous region. A multistage stratified sampling procedure was used to select a representative population aged 15 years or older from eight high altitude regions. All participants underwent pre- and post-bronchodilator measurement of forced expiratory volumes. COPD was diagnosed according to 2019 Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria.Results: Between June, 2015 and August 2016, 4,967 subjects were included. Median age was 38.0 years (range: 15–91 years; inter-quartile range: 28–49 years); 51.4% participants were female. Overall prevalence of spirometry-defined COPD was 8.2% (95% CI 7.4–8.9%): 9.3% in male (95% CI 8.2–10.4%), and 7.1% in female (95% CI 6.1–8.2%). By multivariable logistic regression analysis, COPD was significantly associated with being aged ≥40 years (odds ratio: 2.25 [95% CI 1.72–2.95], P < 0.0001), exposure to household air pollution (OR: 1.34 [95% CI 1.01–1.79], P = 0.043), and a history of tuberculosis (OR: 1.79 [95% CI 1.23–2.61], P = 0.030), while living at a higher altitude (OR: 0.45 [95% CI 0.33–0.61], P < 0.0001) and having a higher educational level (OR: 0.64 [95% CI 0.43–0.95], P = 0.025) were associated with a lower prevalence of COPD.Conclusions: Our results show that the spirometry-defined COPD is a considerable health problem for residents living at high altitudes and COPD prevalence was inversely correlated with altitude. Preventing exposure to household air pollution and reducing the incidence of tuberculosis should be public health priorities for high altitude residents.

Background Long-term exposure to ambient air pollution leads to respiratory morbidity and mortality; however, the evidence of the effect on lung function and chronic obstructive pulmonary disease (COPD) in older adult populations is inconsistent.Objective To address this knowledge gap, we investigated the associations between particulate matter (PM), nitrogen dioxide (NO2) exposure and lung function, as well as COPD prevalence, in older Chinese adults.Methods We used data from the WHO Study on global AGEing and adult health (SAGE) China Wave 1, which includes 11, 693 participants from 64 townships in China. A cross-sectional analysis explored the association between satellite-based air pollution exposure estimates (PM with an aerodynamic diameter of ≤10 µm [PM10], ≤2.5 µm [PM2.5] and NO2) and forced expiratory volume in one second (FEV1), forced vital capacity (FVC), the FEV1/FVC ratio and COPD (defined as post-bronchodilator FEV1/FVC

In the absence of an effective treatment to alter the progressive course of cognitive decline and dementia, identification of modifiable risk factors that could promote healthy cognitive aging has become a public health research priority. This study seeks to comprehensively determine the contemporaneous associations of a broad spectrum of time-varying modifiable lifestyle factors with age-related cognitive decline in a large population-based cohort of older adults. A total of 5,711 subjects aged 50 and older from the WHO Study on global AGEing and adult health (SAGE) in Shanghai were studied. Repeated measures of lifestyle factors and cognitive performance were conducted in 2009–2010 and 2014–2015. Linear random slope models were used to evaluate the contemporaneous associations between time-varying lifestyle factors and cognitive performance. Person-mean centering method was used to disaggregate the between- and within-person effects in the time-varying lifestyle factors in the random slope models. We found that higher vegetable and fruit consumption, as well as higher level of physical activity were positively associated with all cognitive domains. Body mass index (BMI) was negatively associated with all cognitive domains, whereas waist-to-hip ratio (WHR) was negatively associated with verbal fluency score only. Sedentary time was negatively associated with digit span score but positively associated with verbal fluency score. The between-person effects seem to be more dominant than within-person effects. Overall, our findings suggest better management of multiple lifestyle factors may protect against cognitive decline in later life. Higher vegetable and fruit consumption and physical activity are protective, whereas obesity is detrimental to cognitive decline in older adults. This study underpins the development of multi-domain lifestyle recommendations to promote healthy cognitive aging.

Inconsistent results exist regarding the treatment effectiveness of immediate versus deferred percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). This meta-analysis aimed to evaluate the efficacy and safety of immediate versus deferred PCI in ACS patients. PubMed, EMBASE, and Cochrane Library electronic databases were systematically searched from their inception up to August 2019. Random-effects models were employed to calculate pooled relative risks (RRs) and weight mean differences (WMDs) with 95% confidence intervals (CIs). A total of 10 randomized controlled trials (RCTs) that recruited 3350 patients were selected for inclusion in the final meta-analysis. Four trials included patients with non-ST elevation ACS (NSTEACS), whereas the remaining six trials included patients with ST elevation myocardial infarction (STEMI). There were no significant differences between immediate versus deferred PCI for the risk of major adverse cardiovascular events (NSTEACS patients: RR, 0.76, 95%CI, 0.33-1.75, P = 0.513; STEMI patients: RR, 1.24, 95%CI, 0.80-1.92, P = 0.335), myocardial infarction (NSTEACS patients: RR, 0.88, 95%CI, 0.27-2.81, P = 0.826; STEMI patients: RR, 0.86, 95%CI, 0.43-1.74, P = 0.678), all-cause mortality (NSTEACS patients: RR, 0.85, 95%CI, 0.38-1.88, P = 0.686; STEMI patients: RR, 1.16, 95%CI, 0.82-1.66, P = 0.407), target vessel revascularisation (NSTEACS patients: RR, 1.26, 95%CI, 0.29-5.43, P = 0.756; STEMI patients: RR, 1.01, 95%CI, 0.51-1.97, P = 0.988), or major bleeding (NSTEACS patients: RR, 0.99, 95%CI, 0.64-1.54, P = 0.972; STEMI patients: RR, 0.90, 95%CI, 0.45-1.77, P = 0.753). Although patients who underwent immediate PCI may experience increased incidences of cardiac death (RR, 1.19, 95%CI, 0.69-2.07, P = 0.525) and no or slow reflow (RR, 1.60, 95%CI, 0.91-2.84, P = 0.105), these increases were not statistically significant. We noted that immediate versus deferred PCI was associated with a reduced incidence of myocardial brush grade 3 (RR, 0.70, 95%CI, 0.56-0.88, P = 0.002); however, no significant differences were observed between immediate and deferred PCI for TIMI III flow (RR, 0.98, 95%CI, 0.93-1.03, P = 0.453), complete ST-segment resolution (RR, 0.93, 95%CI, 0.75-1.17, P = 0.548), and ejection fraction (WMD, -1.05, 95%CI, -2.58 to 0.49, P = 0.182). The findings of this study suggested that deferred PCI did not yield significant benefits for clinical endpoints. Further large-scale RCTs should be conducted to verify the findings of this study.

Abstract Background Cardiovascular disease (CVD) is one of the leading causes of death worldwide. Our study aimed to investigate the prevalence of two conditions, angina and stroke, and relevant risk factors among older adults in six low- and middle- income countries(LMICs). Methods The data was from World Health Organization (WHO) Study on global AGEing and adult Health (SAGE) Wave 1 in China, Ghana, India, Mexico, Russian Federation and South Africa. Presence of CVD was based on self-report of angina and stroke. Multivariate logistic regression was performed to examine the relationship between CVD and selected variables, including age, sex, urban/rural setting, household wealth, and risk factors such as smoking, alcohol drinking, fruit/vegetable intake, physical activity and BMI. Results The age standardized prevalence of angina ranged from 9.5 % (South Africa) to 47.5 % (Russian Federation), and for stoke from 2.0% (India) to 6.1 % (Russia). Hypertension was associated with angina in China, India and Russian Federation after adjustment for age, sex, urban/rural setting, education and marital status (OR ranging from 1.3 [1.1-1.6] in India to 3.8 [2.9-5.0] in Russian Federation), furthermore it was a risk factor of stroke in five countries except Mexico. Low or moderate physical activity were also associated with angina in China, and were also strongly associated with stroke in all countries except Ghana and India. Obesity had a stronger association with angina in Russian Federation and China(ORs were 1.5[1.1-2.0] and 1.2 [1.0-1.5] respectively), and increased the risk of stroke in China. Smoking was associated with angina in India and South Africa(ORs were 1.6[1.0-2.4] and 2.1 [1.2-3.6] respectively ), and was also a risk factor of stroke in South Africa. We observed a stronger association between frequent heavy drinking and stroke in India. Household income was associated with reduced odds of angina in China, India and Russian Federation, however higher household income was a risk factor of angina in South Africa. Conclusion While the specific mix of risk factors contribute to disease prevalence in different ways in these six countries – they should all be targeted in multi-sectoral efforts to reduce the high burden of CVD in today’s society.

Background and objective Results of studies on genetic polymorphisms of ERCC1 gene in DNA repair pathway which may affect response to platinum-based chemotherapy and survival in patients with non-small cell lung cancer are conflicting. The aim of this study is to prospectively assess the association between single nucleotide polymorphisms of C8092A and codon118 in ERCC1 and drug response in 90 patients with advanced non-small cell lung cancer treated with cisplatin-based chemotherapy. Methods All patients were treated with cisplatin-based chemotherapy. Genotypes of ERCC1 C8092A and codon118 were examined by sequencing, and the association between genotypes and response was evaluated. Results Genotype frequencies of ERCC1 C8092A were CC 40.0% (36/90), CA 48.9% (44/90) and AA 11.1% (10/90), frequencies of codon118 were CC 58.9% (53/90), CT 34.4% (31/90) and TT 6.7% (6/90). There was no significant difference in response rate of patients carrying with CC, compared with CA plus AA in C8092A (33.3% vs 29.6%, P=0.71). Response rate of patients carrying with CC in ERCC1 118 was 32.1%, 24.3% with CT plus CC (P=0.43). There was no difference in progression free survival between patients carrying with CC and CT plus TT in C8092A (5.2 months vs 5.4 months, P=0.62). There was no difference in progression free survival between patients carrying with CC and CA plus AA (5.5 months vs 5.3 months, P=0.59). Conclusion The results suggest that there is no association between polymorphisms in ERCC1 C8092A and codon118 and response in patients with advanced non-small cell lung cancer receiving cisplatin-based chemotherapy. [ABSTRACT FROM AUTHOR]

Background: Patients diagnosed with chronic obstructive pulmonary disease (COPD) in China are commonly prescribed ipratropium plus theophylline (I+T) therapy. Studies have shown that an inhaled corticosteroid (ICS)/long-acting β 2 -agonist (LABA) combination is also efficacious in reducing symptoms and exacerbations. This study evaluated the efficacy and tolerability of adding budesonide/formoterol (BUD/FORM) to I+T in Chinese patients with severe COPD. Methods: A randomized, parallel-group, open-label, multicenter phase IV study (Clinical Trials.gov identifier: NCT01415518) was conducted in China. Patients received either BUD/FORM (160/4.5 µg; two inhalations twice daily [bid] via Turbuhaler ® ) + I (20 µg per inhalation, two inhalations four times daily) + T (100 mg bid) or I+T alone for 12 weeks. The primary efficacy variable was change from baseline in predose forced expiratory volume in 1 s (FEV 1 ). Results: A total of 584 patients were randomized equally between treatment groups. At the end of the study, the BUD/FORM plus I+T group displayed significant improvements in predose FEV 1 versus the I+T group (between-group difference 6.9%; 95% confidence interval [CI]: 4.3, 9.6; p < 0.0001). Forced vital capacity, inspiratory capacity, peak expiratory flow and health-related quality of life (HRQoL) scores were significantly improved (all p

Similar material model test and numerical simulation method were used to study the reinforcement effect of isolation piles on the existing shield tunnel structure in the adjacent building construction for analyzing foundation pit excavation and new building construction approaching existing shield tunnel engineering. The numerical simulation orthogonal experiment was used to optimize four isolation pile parameters. The conclusions were obtained as follows: (1) Isolation piles could share horizontal load of the soil at the rear side of the support structure and reduce horizontal displacement of the soil. As a result, maximum horizontal displacement of the tunnel structure and differences in horizontal displacement between the tunnel structure roof and the floor after foundation pit excavation and building loading were decreased. The horizontal displacement and torsional deformation of the tunnel structure toward the direction of the foundation pit were controlled, and the increase in internal forces of the transverse tunnel structure was also restrained. (2) At the elevation above the tunnel roof, the increase in burial depth of the isolation pile top slightly affected the reinforcement effect on the tunnel structure. The increase in burial depth of the isolation pile bottom could improve the reinforcement effect. Thus, burial depth of the isolation pile bottom should be properly increased in the engineering practice. The reduction in pile spacing could improve the reinforcement effect. Accordingly, pile spacing should be properly selected in the engineering practice. With the increase of diameter of the isolation pile, the reinforcement effect of isolation piles increased obviously. (3) Pile diameter had the greatest influence on the reinforcement effect of isolation piles, followed by burial depth of the pile bottom, pile spacing, and burial depth of the pile top. Orthogonal experiments indicated the following optimal parameter values: a pile diameter of 1.2 m, a burial depth of the pile bottom of 2H, a pile spacing of 1.6 m, and a burial depth of the pile top of 0.75Z.

Evidence suggests that cognitive decline in older adults is influenced by cardiovascular health (CVH), with metabolic and vascular mechanisms hypothesized to underlie the etiology of cognitive impairment. Research in high-income nations suggests that improved CVH is linked with decreased cognitive impairment risk, but it is unclear if this pattern is evident in low-income countries. Nationally-representative data collected in China were drawn from the World Health Organization's Study on global AGing and adult health Wave 1 (2007–2010; n = 11,295). Seven CVH factors were classified as “ideal” or “not ideal”: smoking and drinking frequency, body mass index, physical activity level, blood pressure, diet, and self-reported anxiety. Additionally, scores from five cognitive performance tests (immediate and delayed verbal recall, forward and backward digit span, verbal fluency) were used to create a composite cognitive function variable. Linear regression analyses tested whether ideal CVH measures were associated with higher composite cognitive performance, controlling for sociodemographic factors. As hypothesized, ideal CVH was generally associated with higher cognitive performance. Low anxiety levels and reliable access to sufficient food (including produce) were particularly associated with higher cognitive function. These results suggest early detection and controlling modifiable CVH risks may protect aging individuals in China from cognitive decline.

The demand for buildings constructed along subway lines is increasing, and analysis of the impact of foundation excavation and building construction on adjacent tunnels is critical. This study investigated the variation law of tunnel deformation and surrounding earth pressure on an existing tunnel resulting from deep foundation excavation and the load of buildings. Four groups of scale model tests and corresponding numerical simulation calculations were conducted in four different modes: over unloading-loading, shallow-side unloading-loading, middle-side unloading-loading, and deep-side unloading-loading, which are according to the different relative position of the foundation pit and the tunnel. The results show that when the tunnel stretches across different areas, corresponding deformation occurs owing to the different mechanical mechanisms during excavation and loading. The results can provide evidence for the further study on the impact of adjacent construction process on the tunnels.

Background: Local renin-angiotensin system (RAS) activation has been shown to play an important role in the pathogenesis of idiopathic pulmonary fibrosis (IPF). It has been reported that angiotensin-converting enzyme 2 (ACE2) could inhibit RAS-mediated epithelial injury and fibrogenesis and that ACE2 deficiency could aggravate acute and chronic lung injury. Through research, it could be deduced that ACE2 could protect against pulmonary fibrosis as a therapeutic target. Methods: Time-course analysis of the pathological characteristics of bleomycin-induced lung fibrosis was undertaken in a mouse model, and the effect of exogenous ACE2 on lung fibrosis was studied. Immunohistchemistry (IHC) staining and western blot (WB) testing for AGT and ACE2 were performed to evaluate the regulation of local RAS. TUNEL staining was used to observe epithelial apoptosis. Leukocyte common antigen (LCA) and pulmonary surfactant-associated protein A (SP-A) IHC staining and WB testing were performed to assess the inflammatory response and epithelial regeneration. Masson's staining and a hydroxyproline assay were performed to examine collagen deposition. IHC staining and WB testing for TGF-β1 and α-SMA were performed to investigate the regulation of pro-fibrotic cytokines and the activation of fibroblasts. Results: Exogenous ACE2 attenuated bleomycin-induced lung fibrosis by reversing the reduction of local ACE2 and by suppressing the elevation of AGT. ACE2 decreased the apoptosis index and LCA levels and ameliorated the dynamic change in SP-A level, thus protecting against epithelial injury. Reductions of TGF-β1 and α-SMA were also found in ACE2-treated mice, indicating the inhibition of fibrogenesis. Conclusion: ACE2 attenuated bleomycin-induced lung fibrosis as an anti-inflammatory anti-apoptotic and anti-fibrotic agent, and it might be a promising therapeutic target for IPF.

Approximately 400 million people live at high altitudes worldwide, yet reference equations for spirometry in these populations are inadequately documented. This study aims to develop reference equations for spirometry and assess their applicability to residents at altitudes ranging from 2,100 to 4,700 metres above sea level. This extensive cross-sectional study encompassed healthy non-smokers aged 15 years or older living at Xinjiang and Tibet autonomous region, which covered eight high-altitude areas by a multistage stratified sampling procedure. All individuals underwent pre- and post-bronchodilator measurement. We used the Lambda-Mu-Sigma (LMS) method to establish reference equations for various spirometry parameters. We assessed model fit using mean absolute error (MAE), mean absolute percentage error (MAPE), and residual values (standard deviation), relative to established benchmarks such as GLI, ECSC, and NHANES III, to evaluate the applicability of our equations to high-altitude residents. Between June 2015 and August 2016, 3174 healthy subjects were included. The reference equations utilise age and height as independent variables, with improved accuracy achieved through spline functions. Our spirometry reference equations demonstrate minimal MAE, MAPE, and residual values (standard deviation) for most of the analysed spirometry parameters, stratified by gender. Our spirometry reference equations are more applicable to residents of high-altitude regions.

Numerous population-based studies have suggested that socio-economic status (SES) is associated with cognitive performance, but few nationally representative epidemiological studies on cognitive performance with a large sample of older adults are available in China. And many studies explore the factors associated with cognitive performance, mainly focusing on individual level and more rarely on multiple levels that include the individual and community.This study uses SAGE-China Wave 1 data which consisted of 13,157 adults aged 50 years and older to explore socioeconomic inequalities in the cognitive performance from a multilevel perspective (individual and community levels). The overall cognition score was based on the seven separate components of the cognition tests, including the four verbal recall trials, the verbal fluency test, the forward digit span test and the backward digit span test. Factor analysis was applied to evaluate and generate a single overall score. A two-level hierarchical linear model was used to evaluate the association between SES at these two levels and the overall cognition score adjusted for age, sex and marital status.At individual level, years of education was significantly associated with overall cognition score for both urban and rural dwellers. At the community level, a positive association was obtained between median household income and median years of education and overall cognition score among urban participants.A significant association between SES at both individual-level and community-level (only for urban area) and cognitive performance were found in this study of a national sample of 13,157 Chinese aged 50 years and older, even after adjusting for demographic characteristics. Identifying community-based SES variables that are associated with cognitive performance in the older population provides further evidence for the need to address community characteristics associated with deprivation.

Occupational hearing loss is an increasingly prevalent occupational condition worldwide, and has been reported to occur in a wide range of workplaces; however, its prevalence among workers from municipal solid waste landfills (MSWLs) remains less clear. This study aimed to investigate the occupational hearing loss among Chinese MSWL workers.A cross-sectional study of 247 workers from 4 Chinese MSWLs was conducted. Noise and total volatile organic compounds (TVOCs) levels at worksites were determined. We conducted hearing examinations to determine hearing thresholds. A worker was identified as having hearing loss if the mean threshold at 2000, 3000 and 4000 Hz in either ear was equal to or greater than 25 dB. Prevalence of occupational hearing loss was then evaluated. Using unconditional Logistic regression models, we estimated the odds ratios (ORs) of MSWL work associated with hearing loss.According to the job title for each worker, the study subjects were divided into 3 groups, including group 1 of 63 workers without MSWL occupational hazards exposure (control group), group 2 of 84 workers with a few or short-period MSWL occupational hazards exposure, and group 3 of 100 workers with continuous MSWL occupational hazards exposure. Both noise and TVOCs levels were significantly higher at worksites for group 3. Significantly poorer hearing thresholds at frequencies of 2000, 3000 and 4000 Hz were found in group 3, compared with that in group 1 and group 2. The overall prevalence rate of hearing loss was 23.5%, with the highest in group 3 (36.0%). The OR of MSWL work associated with hearing loss was 3.39 (95% confidence interval [CI]: 1.28-8.96).The results of this study suggest significantly higher prevalence of hearing loss among MSWL workers. Further studies are needed to explore possible exposure-response relationship between MSWL occupational hazards exposure and hearing loss.

The likely corresponding increase in prevalence of chronic disease will be a major challenge for the health care system. Few nationwide epidemiological studies include a large enough sample of older adults to provide estimates of chronic conditions in the older adult population. This study aimed to estimate the prevalence of eight common chronic health conditions and examine socioeconomic inequalities in the diseases among older adults in China.Data are from SAGE-China Wave 1, including 13,157 people aged 50-plus years. Respondents were asked if they had been diagnosed with any of the following chronic medical conditions: angina, arthritis, asthma, stroke, diabetes, depression, chronic lung disease and hypertension. A set of validated symptom-based questions and related diagnostic algorithms were also used to estimate disease prevalence for angina, arthritis, asthma and depression. Multivariate logistic regression was performed to examine the probability of developing chronic conditions in relation to sociodemographic variables such as gender, age, urban/rural setting and household wealth level.Fifty percent of respondents reported having one of the selected chronic conditions, 18.9% two conditions, 5.8% three conditions, and 1.4% reported having four or more chronic conditions. Self-reported prevalence was generated for angina (8%), arthritis (22%), asthma (2%), stroke (3%), diabetes (7%), depression (0.3%), chronic lung disease (8%) and hypertension (27%). The symptom-based prevalence of angina, arthritis, asthma and depression was 10%, 20%, 4% and 2%, respectively.This study provides the best available prevalence estimates for major chronic health conditions among older Chinese adults. Findings from this study indicated that major chronic conditions were common, so prevention and early intervention targeting adults aged 50 years and older should be prioritized.

BACKGROUND: Both insufficient and excess iodine may produce thyroid disease. After salt iodization in China, the median urine iodine concentration (UIC) of children aged 8-10 years appeared adequate. However, it is unknown whether dietary changes due to rapid economic development in Shanghai have affected whole population iodine nutrition. OBJECTIVE: To assess dietary iodine intake, UIC and the prevalence of thyroid disease in the general population of Shanghai. DESIGN: A cross-sectional survey was conducted with general participants aged 5-69 years (n = 7,904) plus pregnant and lactating women (n = 380 each) selected by stratified multistage sampling. The iodine concentrations in their salt, drinking water and urine were measured. Daily iodine intake was estimated using the total diet study approach. Serum thyroid hormone concentrations and thyroid-related antibodies were measured and thyroid ultrasonography was performed. RESULTS: The median iodine concentration in salt was 29.5 mg/kg, and 12.8 µg/L in drinking water. Iodized salt, used by 95.3% of participants, contributed 63.5% of total dietary iodine. Estimated daily iodine intake was 225.96 µg. The median UIC of general participants was 146.7 µg/L; UIC 300 µg/L (iodine excess) in 10.1%. Pregnant women had a median UIC of 135.9 µg/L, with UIC