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Due to the wireless nature of wireless sensor networks (WSN), the network can be deployed in most of the unattended environment, which makes the networks more vulnerable for attackers who may listen to the traffic and inject their own nodes in the sensor network. In our work, we research on a novel machine learning algorithm on intrusion detection based on reinforcement learning (RL) strategy using generative adversarial network (GAN) for WSN which can automatically detect intrusion or malicious attacks into the network. We combine Actor-Critic Algorithm in RL with GAN in a simulated WSN. The GAN is employed as part of RL environment to generate fake data with possible attacks, which is similar to the real data generated by the sensor networks. Its main aim is to confuse the adversarial network into differentiating between the real and fake data with possible attacks. The results that is from the experiments are based on environment of GAN and Network Simulator 3 (NS3) illustrate that Actor-Critic&GAN algorithm enhances security of the simulated WSN by protecting the networks data against adversaries and improves on the accuracy of the detection.

Objective More than 200 million individuals have been diagnosed with carotid atherosclerosis (CAS) in China. We aimed to investigate the incidence and potential predictors of CAS progression in a low-income rural area in China that has a high prevalence of stroke. Methods A population-based cohort study was conducted on individuals aged ≥45 years from 2014 to 2019. Multivariable analyses were used to investigate the predictors of carotid plaque (CP) formation, plaque number, and carotid intima-media thickness (CIMT). Results A total of 1479 participants were finally enrolled in this study. The incidence rate of CP was 42.9 cases per 1000 person-years, and the progression of median CIMT was 137.50 μm over five years. The risk of CP formation increased 2-fold in participants aged ≥75 years (P = 0.002) compared with those aged 45-54 years. The corresponding risk was 59% higher in participants with hypertension (P = 0.001) and 72% higher in alcohol drinkers (P = 0.006). With each 1- standard deviations (SD) increase in high- and low-density lipoprotein cholesterol levels, the risk of CP occurrence decreased by 16% (P = 0.016) and increased by 29% (P = 0.002), respectively. Participants aged ≥75 years exhibited a 3.3-fold higher risk of having a high number of plaques than those aged 45-54 years (P = 0.014). Moreover, older age and the waist-to-hip ratio were independent predictors of CIMT progression. Conclusions This is the first longitudinal study to explore the incidence and predictors of CAS progression in a low-income rural population in China with a high prevalence of stroke. More detailed and precise strategies for prevention and intervention of CAS progression are necessary, especially in low-income rural areas in China.

China is undergoing great social changes, and its demographic makeup is shifting every year along with those changes. China released key indicators from the seventh national population census on 12 May 2021. The total population of China’s mainland increased to 1.41178 billion in 2020 from 1.33972 billion in 2010 (sixth national population census) with an average annual growth rate of 0.53%. In the past 10 years, the share of the population aged above 60 and 65 years increased by 5.44% (from 13.26% in 2010 to 18.70% in 2020) and 4.6% (from 8.9 to 13.5%), respectively. The share of the population with a college education or above rose from 8.93% in 2010 to 15.47% in 2020, and the illiteracy rate dropped from 4.08% in 2010 to 2.67% in 2020. In the next decade, China is likely to face many changes, including the increasing proportion of older adults in the population, declining births, and economic transformation. In an effort to respond to the changed demographic landscape, the authorities should adopt new laws and strategies to improve government services for older adults and consider ways to support women and families and make childbearing more attractive to and feasible for women.

Considering safety management systems are composed of a coal mine enterprise and a manager, incentive contracts for coal mine production are designed to improve the safety level of coal mine production. Managers must devote costly efforts in terms of both safety and production to increase the output of mines. Based on principal–agent theory, we designed an incentive contract considering moral hazard and a menu of contracts considering moral hazard and adverse selection. The results showed that when an enterprise cannot observe the manager’s efforts, the manager’s risk aversion reduces their production and safety efforts, and the enterprise needs to share its output risk with the manager. When the enterprise cannot observe the manager’s efforts and the cost type of the safety effort, a menu of contracts can be used to screen the manager’s cost type. However, high-cost contracts fail to motivate a high-cost manager and allow the high-cost manager to reduce safety and production efforts. A low-cost manager can obtain positive information rent from an enterprise without changing safety or production efforts. We provide some suggestions and references for the safety management of coal transportation in mines.

The stroke burden in China has increased during the past 40 years. The present study aimed to determine the recent trends in the prevalence of stroke from 2013 to 2019 stratified by sociodemographic characteristics, including sex, age, residence, ethnicity, and province within a population-based screening project in China.We made use of data generated from 2013 to 2019 in the China Stroke High-risk Population Screening Program. All living subjects with confirmed stroke at interview were considered to have prevalent stroke. All analyses of prevalence of stroke were weighted and results were presented as percentage and 95% confidence interval (CI).A total of 4229,616 Chinese adults aged ≥40 years from 227 cities in the 31 provinces were finally included. The enrollment rate ranged from 58.8% (2017) to 67.8% (2013). The weighted prevalence of stroke increased annually from 2013 to 2019, being 2.28% (95% CI: 2.28-2.28%) in 2013, 2.34% (2.34-2.35%) in 2014, 2.43% (2.43-2.43%) in 2015, 2.48% (2.48-2.48%) in 2016, 2.52% (2.52-2.52%) in 2017, 2.55% (2.55-2.55%) in 2018, and 2.58% (2.58-2.58%) in 2019 (The prevalence of stroke in China and most provinces has continued to increase in the past 7 years (2013-2019). These findings, especially in provinces with high stroke prevalence, can help public health officials to increase province capacity for stroke and related risk factors prevention.This study was supported by grants from the National Major Public Health Service Projects.

This paper provides a novel perspective to the nexus of oil prices and stock markets by examining the impact of oil price shocks on stock market anomalies. After decomposing oil price shocks into three types (Kilian, 2009), we find that aggregate demand shocks have the strongest influence on stock market anomalies. In contrast, oil supply shocks and oil specific demand shocks have little impact. Similar results are also found in the industry analysis. Interestingly, the link between aggregate demand shocks and anomalies are the strongest among firms with either small size or high idiosyncratic risks. The documented effects are robust after controlling for investor sentiment as well as several well-known macroeconomic or market factors. Our findings are consistent with but also extend the results of Stambaugh, Yu, and Yuan (2012) in that we show that uncertainty also plays a role in explaining stock market anomalies.

Background. Although recent studies have focused on the use of metformin in treating ischemic stroke, there is little literature to support whether it can treat intracerebral hemorrhage (ICH). Therefore, this study is aimed at evaluating the possible effects of prestroke metformin (MET) on ICH patients with type 2 diabetes. Methods. From January 2010 to December 2019, all first-ever ICH patients with type 2 diabetes from our hospitals were included. All discharged patients would receive a one-time follow-up at 1 year after admission. Death, disability, and recurrence events were recorded. Results. We included 730 patients for analysis (the median age: 65 [IQR, 56-72] years and 57.7% was men). Of those patients, 281 (38.5%) had received MET before ICH (MET+), whereas 449 (61.5%) had not (MET−). MET (+) patients had a lower median baseline hematoma volume than did MET (-) patients (9.6 ml [IQR, 5.3-22.4 ml] vs. 14.7 ml [IQR, 7.9-28.6 ml]; P < 0.001 ). The inhospital mortality events were not significantly reduced in the MET (+) group compared with the MET (-) group (6.4% vs 8.9%, respectively; absolute difference, −2.5% [95% CI, −3.9% to −0.7%]; OR, 0.70 [95% CI, 0.39 to 1.27]; P = 0.22 ). The 1-year mortality events were not significantly reduced in the MET (+) group compared with the MET (-) group (14.1% vs 17.4%, respectively; absolute difference, −3.3% [95% CI, −5.1% to −1.8%]; OR, 0.73 [95% CI, 0.47 to 1.14]; P = 0.16 ). The 1-year disability events were not significantly reduced in the MET (+) group compared with the MET (-) group (28.4% vs 34.1%, respectively; absolute difference, −5.7% [95% CI, −8.2% to −3.3%]; OR, 0.77 [95% CI, 0.52 to 1.13]; P = 0.18 ). Finally, the recurrence rates in those two groups were not significantly different (MET [+] vs. MET [-]: 6.4% vs. 5.9%; absolute difference, 0.5% [95% CI, 0.2% to 1.3%]; OR, 1.08 [95% CI, 0.51 to 2.28]; P = 0.84 ). Conclusions. Pre-ICH metformin use was not associated with inhospital mortality and 1-year prognosis in diabetic ICH patients.

To evaluate whether shorter door-to-needle times (DNT) with intravenous tissue plasminogen activator (tPA) for acute ischemic stroke are associated with improved 1-year outcomes in Chinese patients. From August to September 2019, all first-ever ischemic stroke patients who were treated with intravenous tPA within 4.5 h of the time they were last known to be well from 232 hospitals in China were included. Patients were divided into four groups according to DNT time (≤ 45 min; 45–60 min; 60–90 min; > 90 min). All discharged patients would receive a telephone follow-up at 12-month after admission. Death and disability events were recorded. Finally, 2370 patients were analyzed. The median age was 65 years, 66.6% were male, and 2.4% were of ethnic minorities. In the 1-year follow-up, 211 patients died (8.9%; 95%CI: 7.8–10.0%). The patients (53.1%) had DNT times of longer than 45 min, compared with those treated within 45 min, did not have significantly higher 1-year mortality (8.9% vs 8.9% [absolute difference, 0.03% {95% CI, − 0.05% to − 0.10%}, odd ratio {OR}, 1.00 {95% CI, 0.75 to 1.33}]). In addition, 385 patients (16.2%; 14.8–17.3%) out of those survivors had disability events. The patients had DNT times of longer than 45 min, compared with those treated within 45 min, did not have significantly higher 1-year disability rate (18.9% vs 16.7% [absolute difference, 1.9% {95% CI, 1.1% to 3.0%}, odd ratio {OR}, 1.22 {95% CI, 0.89 to 1.43}]). The results did not show that shorter DNT for tPA administration was significantly associated with better 1-year outcomes.

Jing Han,1,&ast; Jie Liu,1– 4,&ast; Yakun Wu,1,5,&ast; Qiuxing Lin,1– 3,5 Dandan Guo,1 Xin Zhang,1 Jun Tu,1– 3,5 Xianjia Ning,1– 3,5 Jinghua Wang1– 3,5 1Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 2Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China; 3Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of China; 4Center of Clinical Epidemiology & Evidence-Based Medicine, The Jizhou People’s Hospital, Tianjin, 301999, People’s Republic of China; 5Department of Neurology, Tangshan Gongren Hospital, Tangshan, 063000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jinghua Wang; Xianjia Ning Email jwang3@tmu.edu.cn; xning@tmu.edu.cnObjective: Although stroke mortality has remained stable over the past decade, the long-term trends of stroke burden are scarce in China, especially in low-income populations. Thus, we aimed to explore the secular trends in the prognosis of stroke in a low-income population in China.Methods: This was a population-based stroke surveillance study that included all of the participants in the Tianjin Brain Study. Stroke management and outcomes were evaluated for all stroke patients. Trends in the burden of stroke were assessed as annual percentage changes.Results: Overall, 1462 stroke cases occurred from 1992 to 2018, and 58.7% of patients were male. The rates of diagnosis by neuroimaging and of hospitalization increased noticeably across sexes and ages for all stroke types, and the greatest increases were observed among elderly women; diagnosis by neuroimaging increased by 4.7% and the rate of hospitalization increased by 12.4% (all P< 0.001). Stroke fatality decreased by 3.7% annually among those aged < 65 years and by 3.1% among patients aged ≥ 65 years; the corresponding rates were 7.4% and 3.5%, respectively, for women. The recurrence rate of ischemic stroke significantly decreased among all men, by 9.6% for those aged < 65 years and by 3.1% for those aged ≥ 65 years; however, for women, this rate only significantly decreased for those aged ≥ 65 years.Conclusion: Our findings suggest that the allocation of medical resources has improved over the past decades. However, it is crucial to enhance secondary stroke prevention for women aged < 65 years by controlling risk factors in low-income populations.Keywords: stroke burden, case fatality, recurrence, trends, low-income population

Xiaobing Tian,1,&ast; Yan Li,2,3,&ast; Jie Liu,1,2,4,5,&ast; Qiuxing Lin,1,2,4,5 Qiaoxia Yang,6 Jun Tu,1,2,4,5 Jinghua Wang,1,2,4,5 Jidong Li,2,7 Xianjia Ning1,2,4,5 1Department of Neurology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 2Center of Clinical Epidemiology & Evidence-Based Medicine, The Jizhou People’s Hospital, Tianjin, People’s Republic of China; 3Department of Anesthesiology, The Jizhou People’s Hospital, Tianjin, People’s Republic of China; 4Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, People’s Republic of China; 5Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, People’s Republic of China; 6Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 7Department of Neurosurgery, The Jizhou People’s Hospital, Tianjin, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xianjia Ning; Jidong Li Email xning@tmu.edu.cn; jd_li_doctor@163.comIntroduction: Isolated impaired glucose tolerance (i–IGT) is a subtype of prediabetes in which an individual demonstrates elevated 2-h post-glucose load glucose levels but normal fasting plasma glucose levels. However, few studies have explored the prevalence and risk factors of i–IGT among adults in rural China. Thus, we aimed to explore the prevalence and risk factors of i–IGT among adults ≥ 50 years old in a low-income, rural population in China.Materials and Methods: Individuals aged ≥ 50 years with normal fasting plasma glucose levels were included in the final analysis. Fasting and 2-h venous blood samples were collected to assess the selected parameter measurements.Results: A total of 2175 individuals were included in this study. The i–IGT prevalence was 22.9% and significantly higher among females than among males (P< 0.05). Older age [odds ratio (OR), 1.606; 95% confidence interval (CI), 1.101– 2.342; P=0.014), hypertension (OR, 1.554; 95% CI, 1.152– 2.019; P=0.004), and central obesity (OR, 1.395; 95% CI, 1.099– 1.771; P=0.006) were associated with i–IGT. Moreover, white blood cell (OR, 1.089; 95% CI, 1.009– 1.175; P=0.029), high-sensitivity C-reactive protein (OR, 1.049; 95% CI, 1.020– 1.078; P=0.001), serum uric acid (OR, 1.0003; 95% CI, 1.001– 1.004; P=0.001), triglyceride (OR, 1.540; 95% CI, 1.105– 2.147; P=0.011), and alanine aminotransferase (OR, 1.012; 95% CI, 1.004– 1.021; P=0.004) levels were also linked to i–IGT in the analyzed population.Conclusion: Health promotion education and a standardized approach to managing body weight, BP, and lipid and uric acid levels would benefit this low-income population in rural China for reducing the risk of cardiovascular disease.Keywords: impaired glucose tolerance, prevalence, risk factors, normal fasting plasma glucose, epidemiology

In the context of the information age, due to the development trend of information technology and the increasingly prominent position of economic activities, Internet of Things technology, as an important part of the new generation of information technology, stands out in the management of municipal solid waste collection and transportation management. At the same time, it has also become an efficient management means to realize waste treatment and construct high-quality urban green infrastructure in the environmental protection industry. Under this reality, environmental non-governmental organizations are becoming increasingly important as an organized social force in limiting national environmental power. It has become a crucial force in municipal solid waste management. Within this context, this study aimed to evaluate the strategic choice relationship among environmental non-governmental organizations, local governments, and garbage disposal enterprises, as well as the impact of environmental non-governmental organizations participating in the supervision of the implementation of information waste classification and management systems. In this study, the game theory method is used to construct the tripartite evolutionary game model of local governments, garbage disposal enterprises, and environmental non-governmental organizations, and the Matlab simulation model is established. The results of model analysis and simulation show that direct supervision, financial support, and punishment from non-governmental organizations, as well as pressure measures by non-governmental organizations, can promote the implementation of Internet of Things technology behavior. High-intensity financial support, low-intensity punishment and pressure measures, and moderate direct supervision have the most significant effect on the implementation of Internet of Things technology.

The present study investigated the anti-oxidative and anti-apoptotic effects and molecular mechanisms of catalpol on the H_2O_2-induced pancreatic β-cells(INS-1 cells).The oxidative damage model of INS-1 cells was induced and optimized by the stimulation of H_2O_2 of different concentrations for different time.CCK-8 assay was used to detect cell viability after catalpol intervention(1, 5, 10, 20, 40, 80, and 160 μmol·L~(-1)) for 24 h.Intracellular reactive oxygen species(ROS), superoxide dismutase(SOD), and lipid peroxide malondialdehyde(MDA) were measured by DCFH-DA fluorescent probe, WST-1, and TBA respectively.Moreover, the apo-ptotic effect was detected by AO-EB and Annexin V-FITC/PI staining.In addition, the protein expression levels were detected by Wes-tern blot, and intracellular insulin concentration was measured by ELISA.The results showed that the oxidative damage model of INS-1 cells was stably induced by 50 μmol·L~(-1) H_2O_2 treatment for 2 h, and catalpol at 1-80 μmol·L~(-1) did not affect cell viability of INS-1 cells.Compared with the conditions in the model group, 1, 5, and 10 μmol·L~(-1) catalpol intervention for 2 h could protect INS-1 cells from oxidative damage(Plt;0.001), reduce ROS and MDA, increase SOD, and inhibit excessive cell apoptosis.Moreover, 1, 5, and 10 μmol·L~(-1) catalpol could also up-regulate the phosphorylation of nuclear transcription factor NF-E2 related factors, negatively regulate Kelch-like ECH-associated protein 1(Keap1), phosphorylation of extracellular signal-regulated kinase(ERK), and heme oxyge-nase 1(HO-1), and promote the protein expression of pancreatic-duodenal homeobox factor-1(PDX-1) and glucose transporter 2(GLUT2).In addition, 1, 5, and 10 μmol·L~(-1) catalpol increased insulin secretion of INS-1 cells under oxidative damage in the high-glucose culture medium, indicating function recovery of pancreatic β cells.PDX-1 is a key nuclear transcription factor of pancreatic β cell function that directly regulates GLUT2 and insulin synthesis, and affects glucose homeostasis.In conclusion, catalpol can reduce the oxidative damage and apoptosis of INS-1 cells, activate antioxidant pathway, protect the function of pancreatic β cells, and improve insulin synthesis and secretion.

Metabolic programming and mitochondrial dynamics along with T cell differentiation affect T cell fate and memory development; however, how to control metabolic reprogramming and mitochondrial dynamics in T cell memory development is unclear. Here, we provide evidence that the SUMO protease SENP1 promotes T cell memory development via Sirt3 deSUMOylation. SENP1-Sirt3 signalling augments the deacetylase activity of Sirt3, promoting both OXPHOS and mitochondrial fusion. Mechanistically, SENP1 activates Sirt3 deacetylase activity in T cell mitochondria, leading to reduction of the acetylation of mitochondrial metalloprotease YME1L1. Consequently, deacetylation of YME1L1 suppresses its activity on OPA1 cleavage to facilitate mitochondrial fusion, which results in T cell survival and promotes T cell memory development. We also show that the glycolytic intermediate fructose-1,6-bisphosphate (FBP) as a negative regulator suppresses AMPK-mediated activation of the SENP1-Sirt3 axis and reduces memory development. Moreover, glucose limitation reduces FBP production and activates AMPK during T cell memory development. These data show that glucose limitation activates AMPK and the subsequent SENP1-Sirt3 signalling for T cell memory development., Memory T cells are particularly reliant on fatty acid oxidation as a source of energy. Here the authors show this reliance is controlled by AMPK sensing of glucose deprivation that triggers SENP1-Sirt3 signalling, driving fatty acid oxidation and memory differentiation in T cells via deacetylation of YME1L1 to induce mitochondrial fusion.

The problem of carbon emissions in transportation is an increasing concern, and consumers need to be encouraged towards green modes of travel to achieve low-carbon travel. To compete with non-green travel companies, green travel companies have considered implementing expensive green efforts to attract consumers. Decisions on travel prices, the green efforts of green travel companies to maintain their competitiveness, and the role of governmental subsidies in promoting green travel must be thoroughly investigated. To consider travel competitiveness and the role of governmental subsidies that support the increased expenses of green travel, this study defined four different decision-making scenarios. The Nash game model without governmental subsidies and the Stackelberg–Nash game model with governmental subsidies were built and solved to understand the effects on the pricing and green efforts of travel companies. The equilibrium results and the role of governmental subsidies were analyzed theoretically and numerically. The results showed that governmental subsidies could boost green efforts while increasing green and non-green travel prices. The competition between green and non-green travel companies both undermined the role of the governmental subsidies and reduced the green and non-green travel prices. A sufficiently large cost-sharing coefficient from the government caused the green travel demand to be higher than the non-green travel demand.

To assess whether stroke patients admitted to stroke units (SU) have a better short-term outcome than those treated in conventional wards (CW). A total of 20 hospitals from 16 provinces in China were initially selected in this study. Finally, 24,090 consecutive admissions in 2013–2015 treated in CW and 21,332 consecutive entries in 2017–2019 treated in SU were included. The primary endpoint of this study was the all-cause death or dependency condition three months after admission. Patients in the SU group were more likely receiving thrombolytic therapy (3.9 vs 2.1%) and intravascular treatment (1.2 and 0.7%). In-hospital death were lower in the SU group than the CW group (SU vs CW: 2.93 vs 4.58% [absolute difference, − 2.28% {95% CI, − 3.32% to − 0.93%}, odd ratio {OR}, 0.72{95% CI, 0.61 to 0.82}]. Death after discharge was also lower in the SU group than the CW (SU vs CW: 5.07 vs 6.72% [absolute difference, − 2.33% {95% CI, − 3.39% to − 0.90%}, odd ratio {OR}, 0.75{95% CI, 0.68 to 0.84}]. In addition, patients who received SU care were less likely to be dead or disabled than those patients who received CW care after adjusting for other variability (SU vs CW: 36.20 vs 44.33% [absolute difference, − 11.33% {95% CI, − 15.32% to − 7.14%}, odd ratio {OR}, 0.78{95% CI, 0.80 to 0.85}]. Among patients with stroke, admission to a designated SU was associated with modestly lower mortality at discharge, reduced probability of death, or being disabled at the end of follow-up.

Changqing Zhan,1 Qiao Wang,2 Jie Liu,3– 5 Lei Wang,1 Zongsheng Chen,1 Hongbo Pang,1 Jun Tu,3– 5 Xianjia Ning,3– 5 Jinghua Wang,3– 5 Shizao Fei1 1Department of Neurology, The Second People’s Hospital of Wuhu, Wuhu, Anhui, People’s Republic of China; 2Department of Pathology, The Second People’s Hospital of Wuhu, Wuhu, Anhui, People’s Republic of China; 3Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 4Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, 300052, People’s Republic of China; 5Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, People’s Republic of ChinaCorrespondence: Shizao FeiDepartment of Neurology, The Second People’s Hospital of Wuhu, 259 Jiuhuazhong Road, Wuhu, 241000, Anhui Province, People’s Republic of ChinaTel +86-553-3909017Fax +86-553-3832545Email feishizao@163.comJinghua WangLaboratory of Epidemiology, Tianjin Neurological Institute, Department of Neurology, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, People’s Republic of ChinaTel +86-22-60817504Fax +86-22-60817448Email jwang3@tmu.edu.cnIntroduction: To explore the relationship between metabolic syndrome (MetS) and cognitive impairment in a low-income and low-education population.Methods: All residents aged ≥ 45 years in a low-income population in Tianjin, China, were eligible to participate in this study. The Mini-Mental State Examination (MMSE) scale was used to conduct a preliminary screening and assessment of the participants’ cognitive statuses. The MMSE components are orientation, registration, attention and calculation, recall, and language.Results: In this population, the prevalences of MetS and cognitive impairment were 54.1% and 44.5%, respectively. In the overall population, the registration score was 0.105 points lower in the elevated triglycerides (TG) group than in the normal TG group (β, − 0.105; 95% confidence interval [CI]: − 0.201, − 0.010; P=0.030). In men, high TG was associated with registration scores that were 0.152 points lower than those in the normal TG group (95% CI: − 0.281, − 0.022; P=0.022), while larger WC and lower HDL-C had positive effects on cognitive scores (all P< 0.05). However, in women, there were no significant differences between cognitive scores and MetS or its components.Conclusion: In this population, first, TG had a great impact on cognition, even greater than the impact of MetS on cognition. Second, the impact of MetS components on cognition was more obvious in men, and not all of the effects were negative. Therefore, the effect of MetS on cognition may need to be analyzed separately for different populations, and it may be that the effect of a single component is greater than the overall effect. When formulating prevention strategies for cognitive impairments, population differences must also be taken into consideration.Keywords: cognitive impairment, MMSE, metabolic syndrome, aging, population-based study

Salmonella typhimurium (S. typhimurium) infection of macrophage induces NLRC4 inflammasome-mediated production of the pro-inflammatory cytokines IL-1β. Post-translational modifications on NLRC4 are critical for its activation. Sirtuin3 (SIRT3) is the most thoroughly studied mitochondrial nicotinamide adenine dinucleotide (NAD+) -dependent deacetylase. We wondered whether SIRT3 mediated-deacetylation could take part in NLRC4 inflammasome activation. Methods: We initially tested IL-1β production and pyroptosis after cytosolic transfection of flagellin or S. typhimurium infection in wild type and SIRT3-deficient primary peritoneal macrophages via immunoblotting and ELISA assay. These results were confirmed in SIRT3-deficient immortalized bone marrow derived macrophages (iBMDMs) which were generated by CRISPR-Cas9 technology. In addition, in vivo experiments were conducted to confirm the role of SIRT3 in S. typhimurium-induced cytokines production. Then NLRC4 assembly was analyzed by immune-fluorescence assay and ASC oligomerization assay. Immunoblotting, ELISA and flow cytometry were performed to clarify the role of SIRT3 in NLRP3 and AIM2 inflammasomes activation. To further investigate the mechanism of SIRT3 in NLRC4 activation, co-immunoprecipitation (Co-IP), we did immunoblot, cellular fractionation and in-vitro deacetylation assay. Finally, to clarify the acetylation sites of NLRC4, we performed liquid chromatography-mass spectrometry (LC-MS) and immunoblotting analysis. Results: SIRT3 deficiency led to significantly impaired NLRC4 inflammasome activation and pyroptosis both in vitro and in vivo. Furthermore, SIRT3 promotes NLRC4 inflammasome assembly by inducing more ASC speck formation and ASC oligomerization. However, SIRT3 is dispensable for NLRP3 and AIM2 inflammasome activation. Moreover, SIRT3 interacts with and deacetylates NLRC4 to promote its activation. Finally, we proved that deacetylation of NLRC4 at Lys71 or Lys272 could promote its activation. Conclusions: Our study reveals that SIRT3 mediated-deacetylation of NLRC4 is pivotal for NLRC4 activation and the acetylation switch of NLRC4 may aid the clearance of S. typhimurium infection.

The aim of this nationwide study was to assess the impact of the COVID-19 pandemic on cerebrovascular disease hospitalization rates, out-of-pocket rates, and in-hospital case fatality rates.All hospitalizations for cerebrovascular disease from 1599 hospitals from 2019 to 2020 were selected using the International Classification of Diseases, 10th revision, in the Hospital Quality Monitoring System (HQMS). We defined 2019 as the pre-pandemic group and 2020 as the post-pandemic group. Multivariate analyses were done to assess the association between the pandemic and patient outcomes and out-of-pocket rate with odds ratios (OR) and 95% CIs presented.In total, 9 640 788 patients with the cerebrovascular disease were recruited (mean age was 65.7[SE.0.004] years, and 55.7% were male), and data is available for 5145358 patients in 2019 (pre-epidemic) and 4495430 patients in 2020(post-pandemic), indicating a 12.6% decrease. Out-of-pocket rate increase of 9.3% (2020 vs 2019: 34.1%% vs 31.2% [absolute difference, 2.9% {95% CI, 1.3% to 4.5%}, odd ratio {OR}, 1.1{95% CI, 1.0 to 1.1}]. The epidemic has led to an 18.0% increase in in-hospital mortality (2020 vs 2019: 1.1%% vs 0.9% [absolute difference, 0.2% {95% CI, 0.1% to 0.2%}, odd ratio {OR}, 1.1{95% CI, 1.1 to 1.2}]. The epidemic has led to significantly increased in-hospital mortality for patients with stroke but had no significant impact on other cerebrovascular diseases.During the COVID-19 pandemic lockdown, patients hospitalized for stroke fell by 12.6%, and there were substantial increases in out-of-pocket rates (9.3%) and in-hospital case fatality rates (18.0%).

Depression is a prevalent psychiatric disorder with a significant health impact and economic burden worldwide. Unfortunately, the exact pathogenesis of depression is not well understood. Neuroinflammation and microglial activation play an essential role in the pathogenesis of depression. Previous studies have shown that polydatin has anti-inflammatory and antioxidant properties. However, the link between polydatin and depression remains unclear. Therefore, the objective of this study was to investigate the antidepressant effect of polydatin in lipopolysaccharide (LPS)-induced depression in mice and its possible mechanism. Adult male C57BL/6 J mice were used in this study. The polydatin and LPS were injected intraperitoneally daily for 5 days. In addition, the EX527, an inhibitor of Sirt1, was injected intraperitoneally daily and 1 h before the polydatin injection. The behavior tests were performed to elucidate the depression-like behaviors. The Sirt1/HMGB1/NF-κB pathway expression was detected by western blot, ELISA, and immunofluorescence staining. Polydatin can significantly improve LPS-induced depression-like behavior in mice. Treatment with polydatin increased the expression of the Sirt1 but decreased the expression of the HMGB1, p-NF-κB, IL-1b, and TNF-α in the LPS-induced depression mice. In addition, the EX527 abolished the anti-depressive effects of the polydatin and the levels of Sirt1 protein. These findings suggested that the polydatin reversed the depressive effects through the Sirt1/HMGB1/NF-κB signaling in the LPS-induced depression mice. Therefore, polydatin can be used in the treatment of depression.