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Preterm birth (PTB) is an important cause of infant morbidity and mortality around the world. A good understanding of its associations with relevant factors is essential for an effective reduction ...

BACKGROUND Posterior scleritis is one of the most easily missed and misdiagnosed diseases in ophthalmology. In this case we treated a patient with intravitreal dexamethasone implant that has not been extensively studied before. CASE SUMMARY A 40-year-old female patient who had anxiety, palpitation, and insomnia presented with eye pain and decreased vision in the left eye. An eye examination indicated that her visual acuity (VA) was 40/100. Her left eye presented conjunctival edema, mild exophthalmos, clear cornea, KP(-), and clear aqueous humor. In the fundus, there was a cinerous retinal protuberance. Ultrasonography showed “T-sign” and no systemic association was detected in laboratory examination. One month after injection of dexamethasone implant, the patient exhibited VA of 20/20, fundus serous retinal detachment disappeared, and intraocular pressure of both eyes was at the normal level. CONCLUSION Intravitreal injection of dexamethasone implant may be a safe and effective treatment for patients with idiopathic posterior scleritis.

Background: Although the protective effects of alcohol consumption against future cardiovascular disease have been published, the effects of alcohol on stroke risk remain controversial. Method: We assessed the effects of alcohol consumption on stroke risk in a poorly educated, low-income population in rural China. Between 1991 and 2018, a population-based cohort study was conducted in rural Tianjin, China, to examine stroke risk. All registered stroke events were clinically verified using available computed tomography or MRI scans. The stroke risk was analyzed, according to the extent of alcohol consumption, using Cox regression analyses. Results: We identified 352 incident stroke events among male participants during the study period. The stroke incidences (per 100,000 person-years) were 965.3 overall, 575.9 for ischemic stroke events, 208.4 for hemorrhagic stroke events, and 181.0 for undefined stroke events. Overall, alcohol consumption provided a 32% reduction in the total stroke risk. Low-dose alcohol consumption (≤12 g/day) showed a negative association with total (hazard ratio [HR], 0.64; 95% confidence interval [CI], 0.46–0.88; p = 0.008) and ischemic (HR, 0.66; 95% CI, 0.44–0.98; p = 0.039) strokes. Alcohol consumption was not significantly associated with hemorrhagic strokes. After age stratification, alcohol consumption was protective against total and ischemic strokes in men aged ≥55 years old, with the risk of each stroke type decreasing by 46 and 49%, respectively. Low-dose alcohol consumption was inversely associated with both total and ischemic stroke risks, with the risks decreasing by 56 and 65%, respectively. Alcohol consumption was not significantly associated with strokes among men aged Conclusions: These findings suggest that low-dose alcohol consumption may decrease the risk of ischemic strokes among men. Even so, the adverse effects of alcohol on the liver and pancreas cannot be ignored. Additionally, the effects of alcohol consumption on stroke risk vary with age, protecting against ischemic and total strokes among males ≥55 years old. Nevertheless, recommending light drinking and its potential health benefits should not be generalized to men of all ages.

Airport detection in synthetic aperture radar (SAR) images has attracted much concern in the field of remote sensing. Affected by other salient objects with geometrical features similar to those of airports, traditional methods often generate false detections. In order to produce the geometrical features of airports and suppress the influence of irrelevant objects, we propose a novel method for airport detection in SAR images. First, a salient line segment detector is constructed to extract salient line segments in the SAR images. Second, we obtain the airport support regions by grouping these line segments according to the commonality of these geometrical features. Finally, we design an edge-oriented region growing (EORG) algorithm, where growing seeds are selected from the airport support regions with the help of edge information in SAR images. Using EORG, the airport region can be mapped by performing region growing with these seeds. We implement experiments on real radar images to validate the effectiveness of our method. The experimental results demonstrate that our method can acquire more accurate locations and contours of airports than several state-of-the-art airport detection algorithms.

Expansions were carried out in finite element (FE) models of disc hernia including symmetric (median, lateral, paramedian) and asymmetric types. In all models, lubricous disk bulging that applied a linear compression to the anterior part of the cord was observed at the posterior surfaces of the expansion zone, respectively. The shape and position of protrusions varyed with the temperature, magnitude, and location of expanding elements. The geometric deformation and stress distribution of the spinal cord increased as the extent of compression grew. This method is in possession of enormous potential in promoting further individualized research of cervical spondylotic myelopathy.

The electromagnetic acoustic transducer (EMAT) is widely used in In-Line Inspection of gas pipeline. However, the transduction efficiency of the EMAT transmitter is lower compared with the traditional piezoelectric transducer and needs improving. To enhance the amplitude of the received signal, an improved periodic-permanent-magnet EMAT is provided as well as its construction method to generate shear horizontal guided waves propagating in the circumferential direction. By designing a racetrack coil and magnetic array with the same radian of the annular pipeline, the EMAT is more suitable to generate the circumferential wave in the pipeline. The performance of the EMAT transmitter has been assessed with the validated finite element model.

Objective: Over the past few decades, the prevalence of hearing impairment (HI) has rapidly increased, making HI one of the most common causes of disability, globally. The burden of HI is particula...

The axial stress of high strength bolts for bridges affects the service life directly, it is necessary to measure it regularly. Based on the theory of acoustic elasticity and combination of longitudinal and shear waves, a new theoretical analysis method is proposed. The stressed and non-stressed areas of bolt are separated, and the derived formula only use the flight time and difference of acoustoelastic coefficients to get axial stress. Further, the preload experiments with high strength bolts of grade 8.8S and 10.9S is designed, the experimental results show that the proposed method is applicable to the axial stress of the bridge bolts with any specifications, material and different screwing depth used in this paper, the effect of elastic deformation on the flight time is eliminated, and the measuring error is within 5%.

Mitochondria play a central role in biological oxidation that inevitably generates reactive oxygen species (ROS) as by-products. Maintenance of mitochondrial redox balance status requires NADPH, which is primarily generated by the mitochondrial matrix protein isocitrate dehydrogenase 2 (IDH2). The activity of IDH2 is regulated by post-translational modifications (PTMs). In this study, we found IDH2 is modified by small ubiquitin-like modifier 1 (SUMO1) at lysine 45. SUMO specific protease 1 (SENP1) is responsible for deSUMOylation of IDH2. SUMOylation of IDH2 is induced by oxidants and enhances the antioxidant activity of IDH2 to protect cells against oxidative stress. Mutation of the SUMOylation site impairs the enzymatic activity of IDH2 and hence decreases levels of α-ketoglutarate (α-KG), NADPH and GSH. Cells with SUMOylation deficient IDH2 suffer more apoptosis than that with wild type IDH2 under oxidative stress. These results indicate that SUMOylation is an important way to regulate IDH2 activity to maintain mitochondrial redox balance.

Background Adiponectin plays role in multiple metabolic pathways. Previous studies in cardiovascular disease evaluated the association between adiponectin and clinical outcomes, yielding conflicting results. The aim of this study was to investigate the association of adiponectin with major adverse cardiovascular and cerebrovascular events (MACCE) and mortality in Chinese patients with first-ever acute ischemic stroke (AIS). Methods This was a prospective, multicenter cohort study. From September 2009 through October 2015, all patients with AIS from 3 stroke centers in Shandong were included. Serum levels of adiponectin at admission were tested. The prognostic role of adiponectin to predict the MACCE and mortality within 3 years was evaluated by multivariable-adjusted Cox proportional hazards models. Results This study included 4274 patients (median age 68 years [interquartile ranges {IQR}: 61–76]; 53.2% men). There were 794 deaths and 899 MACCE events. Higher serum levels of adiponectin on admission were found in patients with MACCE events and nonsurvivors (P vs. Q1, Hazard ratio[HR] = 4.95 [95% confidence interval {CI}: 3.03–7.06]) and mortality (Q4 vs. Q1, HR = 5.63 [95% CI 3.15–7.99]). Adiponectin improved the prognostic value of the National Institutes of Health Stroke Scale (NIHSS) to predict MACCE (combined areas under the curve [AUC], 0.76; 95% CI 0.68–0.88; P = 0.001) and mortality (0.78[0.69–0.91]; P Conclusions Elevated serum levels of adiponectin were associated with a higher risk of MACCE and mortality independent of traditional risk factors in ischemic stroke patients.

This paper evaluates the effectiveness of a joint strategy that exploits fundamental‐based momentum and return‐based reversal anomalies. This joint strategy is motivated by two considerations. First, reversal can serve as a natural hedge to momentum. Second, both fundamental and price‐related information can contribute to stock return predictability. Consequently, we propose a new joint strategy that synthesises both earnings momentum and short‐term reversal. We find that this joint strategy generates considerable economic gains and outperforms the sum of profits from two individual anomalies. Moreover, the proposed strategy appears to be quite robust, generating stable and persistent profits across different market conditions.

Adipose‐derived stem cells (ASC) are said to have a pivotal role in wound healing. Specifically, ASC‐secreted extracellular vesicles (EV) carry diverse cargos such as microRNAs (miRNAs) to participate in the ASC‐based therapies. Considering its effects, we aimed to investigate the role of ASC‐EVs in the cutaneous wound healing accompanied with the study on the specific cargo‐medicated effects on wound healing. Two full‐thickness excisional skin wounds were created on mouse dorsum, and wound healing was recorded at the indicated time points followed by histological analysis and immunofluorescence staining for CD31 and α‐SMA. Human skin fibroblasts (HSFs) and human microvascular endothelial cells (HMECs) were co‐cultured with EVs isolated from ASC (ASC‐EVs), respectively, followed by the evaluation of their viability and mobility using CCK‐8, scratch test and transwell migration assays. Matrigel‐based angiogenesis assays were performed to evaluate vessel‐like tube formation by HMECs in vitro. ASC‐EVs accelerated the healing of full‐thickness skin wounds, increased re‐epithelialization and reduced scar thickness whilst enhanced collagen synthesis and angiogenesis in murine models. However, miR‐486‐5p antagomir abrogated the ASC‐EVs‐induced effects. Intriguingly, miR‐486‐5p was found to be highly enriched in ASC‐EVs, exhibiting an increase in viability and mobility of HSFs and HMECs and enhanced the angiogenic activities of HMECs. Notably, we also demonstrated that ASC‐EVs‐secreted miR‐486‐5p achieved the aforesaid effects through its target gene Sp5. Hence, our results suggest that miR‐486‐5p released by ASC‐EVs could be a critical mediator to develop an ASC‐based therapeutic strategy for wound healing.

Stem cell transplantation has shown promising regenerative effects against neural injury, and photobiomodulation (PBM) can aid tissue recovery. This study aims to evaluate the therapeutic effect of human umbilical cord mesenchymal stem cells (hUCMSCs) and laser alone or combined on spinal cord injury (SCI). The animals were divided into SCI, hUCMSCs, laser treatment (LASER) and combination treatment (hUCMSCs + LASER) groups. Cell-enriched grafts of hUCMSCs (1 × 106 cells/ml) were injected at the site of antecedent trauma in SCI model rats. A 2 cm2 damaged area was irradiated with 630 nm laser at 100 mW/cm2 power for 20 min. Locomotion was evaluated using Basso-Beattie-Bresnahan (BBB) scores, and neurofilament repair were monitored by histological staining and diffusion tensor imaging (DTI). First, after SCI, the motor function of each group was restored with different degrees, the combination treatment significantly increased the BBB scores compared to either monotherapy. In addition, Nissl bodies were more numerous, and the nerve fibers were longer and thicker in the combination treatment group. Consistent with this, the in situ expression of NF-200 and glial fibrillary acidic protein in the damaged area was the highest in the combination treatment group. Finally, DTI showed that the combination therapy optimally improved neurofilament structure and arrangement. These results may show that the combination of PBM and hUCMSCs transplantation is a feasible strategy for reducing secondary damage and promoting functional recovery following SCI.

We aimed to assess the age-dependent association of obesity with the risk of developing diabetes mellitus (DM) among a low-income population in China.In this prospective cohort study, we estimated the hazard ratios (HR) for the association of body mass index (BMI) with DM risk from 1991 to 2014, after adjusting for other possible risk factors, using Cox-regression analysis.A total of 971 participants were followed up for 23 years in this study. The incidence of DM in this population was as high as 467.0/100,000 person-years. Compared with normal weight, the HR (and 95% confidence interval [CI]) for overweight affecting DM risk was 2.23 (1.45-3.41) overall, including 2.43 (1.05-5.63) for men and 2.17 (1.31-3.59) for women. The HR associated with the impact of obesity was 3.59 (2.06-6.27) overall, including 6.04 (1.84-19.81) for men and 3.23 (1.69-6.16) for women. Being overweight had a significant association with DM for people aged 40-49 years (HR, 1.99; 95% CI, 1.03-3.84); the HR for an association between DM and obesity was the highest among individuals aged 30-39 years (HR, 4.43; 95% CI, 1.84-10.67). There was no statistical significance between BMI and DM among individuals aged ≥50 years.These findings suggest that obesity is associated with developing DM in rural China, especially among adults aged50 years. Weight management is the highest priority for reducing the heavy burden of DM.

In China, stroke is a major cause of mortality, and long-term physical and cognitive impairment. To meet this challenge, the Ministry of Health China Stroke Prevention Project Committee (CSPPC) was established in April 2011. This committee actively promotes stroke prevention and control in China. With government financial support of 838.4 million CNY, 8.352 million people from 536 screening points in 31 provinces have received stroke screening and follow-up over the last seven years (2012–2018). In 2016, the CSPPC issued a plan to establish stroke centers. To shorten the pre-hospital period, the CSPPC established a stroke center network, stroke map, and stroke “Green Channel” to create three 1-h gold rescue circles, abbreviated as “1-1-1” (onset to call time

The COVID-19 disease caused by the SARS-CoV-2 virus first identified in December 2019 has resulted in millions of deaths so far around the world. Controlling the spread of the disease requires a good understanding of the factors (e.g. air pollutants) that influence virus transmission and the conditions under which it spreads. This study analyzed the relationships between COVID-19 cases and both short-term (6-month) and long-term (60-month) exposures to eight air pollutants (NO, NO

In this work, we report that copper ion-centered hybrid nanoflowers (HNFs) can directly act as high-performance redox indicator via a facile one-step coprecipitation methodology. By altering the bovine serum albumin (BSA) concentration in the coprecipitation synthesis system, the nucleation, growth and electrochemical activities of BSA-Cu

ImportanceStroke is the leading cause of death in China. However, recent data about the up-to-date stroke burden in China are limited.ObjectiveTo investigate the urban-rural disparity of stroke burden in the Chinese adult population, including prevalence, incidence, and mortality rate, and disparities between urban and rural populations.Design, Setting, and ParticipantsThis cross-sectional study was based on a nationally representative survey that included 676 394 participants aged 40 years and older. It was conducted from July 2020 to December 2020 in 31 provinces in mainland China.Main Outcomes and MeasuresPrimary outcome was self-reported stroke verified by trained neurologists during a face-to-face interviews using a standardized protocol. Stroke incidence were assessed by defining first-ever strokes that occurred during 1 year preceding the survey. Strokes causing death that occurred during the 1 year preceding the survey were considered as death cases.ResultsThe study included 676 394 Chinese adults (395 122 [58.4%] females; mean [SD] age, 59.7 [11.0] years). In 2020, the weighted prevalence, incidence, and mortality rates of stroke in China were 2.6% (95% CI, 2.6%-2.6%), 505.2 (95% CI, 488.5-522.0) per 100 000 person-years, and 343.4 (95% CI, 329.6-357.2) per 100 000 person-years, respectively. It was estimated that among the Chinese population aged 40 years and older in 2020, there were 3.4 (95% CI, 3.3-3.6) million incident cases of stroke, 17.8 (95% CI, 17.5-18.0) million prevalent cases of stroke, and 2.3 (95% CI, 2.2-2.4) million deaths from stroke. Ischemic stroke constituted 15.5 (95% CI, 15.2-15.6) million (86.8%) of all incident strokes in 2020, while intracerebral hemorrhage constituted 2.1 (95% CI, 2.1-2.1) million (11.9%) and subarachnoid hemorrhage constituted 0.2 (95% CI, 0.2-0.2) million (1.3%). The prevalence of stroke was higher in urban than in rural areas (2.7% [95% CI, 2.6%-2.7%] vs 2.5% [95% CI, 2.5%-2.6%]; P = .02), but the incidence rate (485.5 [95% CI, 462.8-508.3] vs 520.8 [95% CI, 496.3-545.2] per 100 000 person-years; P P Conclusions and RelevanceIn a large, nationally representative sample of adults aged 40 years or older, the estimated prevalence, incidence, and mortality rate of stroke in China in 2020 were 2.6%, 505.2 per 100 000 person-years, and 343.4 per 100 000 person-years, respectively, indicating the need for an improved stroke prevention strategy in the general Chinese population.

Rhinoplasty is one of the most common operations in plastic and aesthetic surgery. Both solid silicone material and autologous cartilage (AC) tissue have their individual advantages and disadvantages. In this meta-analysis, the efficacy, complication rate of rhinoplasty with AC and silicone material were comprehensively analyzed and compared.The databases Medline, Embase, PubMed, China National Knowledge Infrastructure (CNKI) and Wanfang were searched by rapid matching of keywords to obtain randomized controlled trials related to AC rhinoplasty or silicone filled rhinoplasty, which were analyzed using the software Stata 16.0 after screening and quality assessment.A total of 1,233 patients undergoing rhinoplasty from 7 articles were included in the study. Meta-analysis showed that rhinoplasty with AC would gain more satisfaction [risk ratio (RR) =1.11; 95% confidence interval (CI): (1.02, 1.21); Z=2.413; P=0.016]. would reduce the complication rate [RR =0.34; 95% CI: (0.22, 0.52); Z=-5.010; P0.0001], and resulting in less secondary surgery rate [RR =0.34; 95% CI: (0.18, 0.64); Z=-3.363; P=0.001] comparing to silicone prosthesis (SP) material.In rhinoplasty, the use of AC material gains more satisfaction, has less total complication rate, and results in less secondary surgery rate than silicone material. But based on the heterogeneity and publication bias in the studies, this topic still needs to be further explored by including more high-quality studies.

The main reasons for disability and death in aneurysmal subarachnoid hemorrhage (aSAH) may be early brain injury (EBI) and delayed cerebral ischemia (DCI). Despite studies reporting and progressing when DCI is well-treated clinically, the prognosis is not well-improved. According to the present situation, we regard EBI as the main target of future studies, and one of the key phenotype-oxidative stresses may be called for attention in EBI after laboratory subarachnoid hemorrhage (SAH). We summarized the research progress and updated the literature that has been published about the relationship between experimental and clinical SAH-induced EBI and oxidative stress (OS) in PubMed from January 2016 to June 2021. Many signaling pathways are related to the mechanism of OS in EBI after SAH. Several antioxidative stress drugs were studied and showed a protective response against EBI after SAH. The systematical study of antioxidative stress in EBI after laboratory and clinical SAH may supply us with new therapies about SAH.

Although there is no shortage of research on the markers for stroke, to our knowledge, there are no clear markers that can meet the needs of clinical prediction and treatment. The inflammatory cascade is a critical process that persists and functions throughout the stroke process, ultimately worsening stroke outcomes and increasing mortality. Numerous inflammatory factors, including tumor necrosis factor (TNF), are involved in this process. These inflammatory factors play a dual role during stroke, and their mechanisms are complex. As one of the representatives, TNF is the primary regulator of the immune system and plays an essential role in the spread of inflammation. In researches done over the last few years, tumor necrosis factor-alpha (TNF

BackgroundMicroRNAs, as small non-coding RNAs, play an important role in tumorigenesis. MiR-483-5p was found to have a significant increase as a diagnostic biomarker of nasopharyngeal carcinoma (NPC), not only in plasma from NPC patients but also in tumor cell lines and biopsy tissues in our previous study. However, its function and mechanism in NPC are still unclear.MethodsTissue microarray including 178 primary NPC and 35 adjacent non-cancerous nasopharyngeal mucosal tissues was used to further validate the overexpression of miR-483-5p. Wound healing and invasion assays were conducted to verify its biological function. RNA sequencing (RNA-seq) and dual-luciferase reporter assay was performed to explore its target, and it was verified in fresh biopsy tissues from 23 NPC patients and 9 patients with chronic nasopharyngitis.ResultsMiR-483-5p was highly expressed in NPC tissues than in adjacent non-cancerous tissues. It was found to have a significant correlation with poor overall survival (OS) [hazard ratio (HR) = 2.89, 95% confidence interval (CI) = 1.00–8.35, p = 0.041] and progression-free survival (PFS) (HR = 1.95, 95%CI = 1.06–3.60, p = 0.029) of NPC patients. Silencing of its expression inhibited the migratory and invasive capacities of NPC cells in vitro. EGR3 (early growth response 3) was identified as a direct target, and inhibiting miR-483-5p expression markedly enhanced the expression of EGR3 at both the mRNA and protein levels. Besides, a significant decrease of EGR3 expression was found in fresh biopsy tissues from NPC patients, in contrast to miR-483-5p expression. Furthermore, directly decreasing the expression of EGR3 could enhance the migration and invasion of NPC cells.ConclusionThe newly identified miR-483-5p/EGR3 pathway provides further insights into the development and metastasis of NPC and may provide a potential therapeutic target for NPC treatment in order to improve survival of NPC patients.

This study explored the molecular mechanism underlying the Gegen Qinlian Decoction(GQD) promoting the differentiation of brown adipose tissue(BAT) to improve glucose and lipid metabolism disorders in diabetic rats. After the hypoglycemic effect of GQD on diabetic rats induced by high-fat diet combined with a low dose of streptozotocin was confirmed, the total RNA of rat BAT around scapula was extracted. Nuclear transcription genes Prdm16, Pparγc1α, Pparα, Pparγ and Sirt1, BAT marker genes Ucp1, Cidea and Dio2, energy expenditure gene Ampkα2 as well as BAT secretion factors Adpn, Fndc5, Angptl8, IL-6 and Rbp4 were detected by qPCR, then were analyzed by IPA software. Afterward, the total protein from rat BAT was extracted, and PRDM16, PGC1α, PPARγ, PPARα, SIRT1, ChREBP, AMPKα, UCP1, ADPN, NRG4, GLUT1 and GLUT4 were detected by Western blot. The mRNA expression levels of Pparγc1α, Pparα, Pparγ, Ucp1, Cidea, Ampkα2, Dio2, Fndc5, Rbp4 and Angptl8 were significantly increased(Plt;0.05) and those of Adpn and IL-6 were significantly decreased(Plt;0.05) in the GQD group compared with the diabetic group. In addition, Sirt1 showed a downward trend(P=0.104), whereas Prdm16 tended to be up-regulated(P=0.182) in the GQD group. IPA canonical pathway analysis and diseases-and-functions analysis suggested that GQD activated PPARα/RXRα and SIRT1 signaling pathways to promote the differentiation of BAT and reduce the excessive lipid accumulation. Moreover, the protein expression levels of PRDM16, PGC1α, PPARα, PPARγ, SIRT1, ChREBP, AMPKα, UCP1, GLUT1, GLUT4 and NRG4 were significantly decreased in the diabetic group(Plt;0.01), which were elevated after GQD intervention(Plt;0.05). Unexpectedly, the expression of ADPN protein in the diabetic group was up-regulated(Plt;0.01) as compared with the control group, which was down-regulated after the administration with GQD(Plt;0.01). This study indicated that GQD promoted BAT differentiation and maturity to increase energy consumption, which reduced the glucose and lipid metabolism disorders and thereby improved diabetes symptoms.

Aims/Introduction The worldwide prevalence of diabetes mellitus has been increasing over the past decades, particularly in developing countries. Because of the lack of information regarding changes in diabetes mellitus prevalence, awareness, treatment and control in rural China, we assessed these trends – overall and in the context of related health conditions – to explore the impact of these primary health issues on these rates in a poorly educated, rural population. Materials and Methods Diabetes mellitus prevalence, awareness, treatment and control rates were compared between two surveys carried out in 1992 and 2011. The residents of three villages, aged 35–64 years, were recruited for this study. Results In 1992, 1,091 individuals were interviewed and, in 2011, 2,338 individuals were interviewed. Between the two surveys, the overall diabetes mellitus prevalence in the study population was lower in 1992 than that in 2011 (P 6 years of education, stage I hypertension and being overweight, had a higher prevalence of diabetes mellitus in 2011 than in 1992. Similarly, for the same time periods, there was also a higher diabetes mellitus prevalence among women aged 55–64 years, with 1–6 years of education, stage III hypertension and who were overweight. However, there were no significant changes in diabetes mellitus awareness, treatment or control in this population. Conclusions These results suggest that particular efforts must be made to enhance diabetes mellitus prevention, control and public awareness in rural communities in China., The overall prevalence of diabetes mellitus increased significantly both in men and in women over the past two decades. In men, the prevalence of diabetes mellitus increased most significantly for those aged 35–44 years, with >6 years of education, having stage I hypertension and being overweight; but for those aged 55–64 years, with 1–6 years of education, having stage III hypertension and being overweight in women. However, there were no significant changes in diabetes mellitus awareness, treatment or control in this population.

In this article, the authors propose a simple and novel measure of relative strength over investment horizons that synthesizes short- and intermediate-term price information. The relative-strength measure compares the short-term price trend with the intermediate-term price trend. The relative strength strategy generates substantial profits, which are greater than a simple sum of traditional short-term reversal and momentum profits. The superior performance of the relative strength strategy is evident after risk adjustments for various factor models and is robust across subperiods and different market conditions. These findings seem consistent with investor conservatism and the idea that investors are slow to adjust to new information. TOPICS:Analysis of individual factors/risk premia, factor-based models, style investing Key Findings • A novel relative-strength measure over investment horizons that synthesizes short- and intermediate-term price information can significantly predict subsequent short-term returns. • The relative-strength strategy generates substantial profits, which are greater than a simple sum of traditional short-term reversal and momentum profits. • The superior performance of the relative-strength strategy is evident after risk adjustments for various factor models and is robust across subperiods and different market conditions.

The Baishan Mo deposit in the eastern Tianshan Mountains is representative of the local metallogenic Triassic Mo belt. In this study, the geological characteristics, petrography, and geochemistry of the granite porphyry and the Mo deposit were examined using zircon U-Pb dating, molybdenite Re-Os isotope dating, whole-rock geochemistry, and fluid inclusions. Results show that the crystallisation age of the Baishan granite porphyry is 229.8 +/- 1.4 Ma and the Re-Os age of molybdenite in the ore body quartz vein is 225.0 +/- 1.2 Ma. Therefore, the ore formed basically at the same time as diagenesis in the Late Triassic. The Baishan granite porphyry has high levels of Si, Al, and alkalis (K2O + Na2O = 5.72-8.88%) and low levels of Mg. The differentiation index is high (81.68-91.20), while the aluminium saturation index is low, indicating that the pluton belongs to metaluminous-weak peraluminous highly fractionated I-type granite. The rock is also enriched in light rare earth elements (LREE) and large-ion lithophile elements but depleted in heavy rare earth elements (HREE) and high-field-strength elements, with a distinct differentiation between LREEs and HREEs. delta Eu is weakly negative. The high Sr/Y and La/Yb ratios indicate geochemical characteristics similar to adakite rocks. The formation of the deposit is closely related to Mo-rich, low-salinity (1.23- to 9.73-wt.% NaCl eqv.), and medium- to low-temperature (91-280 degrees C) magmatic fluid in the plate extension setting. The magma was derived from partial melting of thickened lower crust and possibly mixed with intrusive mantle-derived magma. The ore-forming fluids were uplifted, transported, mixed with meteoric water, and precipitated to form the Mo ore.

We investigate an outsourcing logistics risk management problem under a principal-agency framework. A fourth-party logistics firm (4PL) deputes a third-party logistics firm (3PL) to complete the tasks received from clients. The 4PL cannot observe the effort/investment level of the 3PL on the delivery quality but only on the ex post delivery quality. Thus, a contract based on delivery quality is proposed to stimulate the 3PL to exert optimal effort/investment for the outsourced task. First, we derive the optimal contract contents both in symmetric and asymmetric information settings and show that in the asymmetric information setting, although a menu of contracts can induce the 3PL to tell the truth, asymmetric efficiency information can lead to a drop in delivery quality as well as in system-wide welfare. Then, to deal with this issue in the asymmetric information setting, we introduce two contracts: noncooperative bargaining and cooperative bargaining contracts. We find that the cooperative bargaining contract can ensure the 3PL exerts the maximum effort/investment level and achieves high-quality delivery and system-wide welfare. Finally, we extend our study to a case with discrete efficiency distribution and analyze various types of contracts as well as their implications.

In this article, the authors use machine learning tools to analyze industry return predictability based on the information in lagged industry returns. Controlling for post-selection inference and multiple testing, they find significant in-sample evidence of industry return predictability. Lagged returns for the financial sector and commodity- and material-producing industries exhibit widespread predictive ability, consistent with the gradual diffusion of information across economically linked industries. Out-of-sample industry return forecasts that incorporate the information in lagged industry returns are economically valuable: Controlling for systematic risk using leading multifactor models from the literature, an industry-rotation portfolio that goes long (short) industries with the highest (lowest) forecasted returns delivers an annualized alpha of over 8%. The industry-rotation portfolio also generates substantial gains during economic downturns, including the Great Recession. TOPICS:Big data/machine learning, analysis of individual factors/risk premia, portfolio construction, performance measurement

This paper investigates the relation between short selling and momentum. We document that a consistent momentum strategy that buys lightly shorted winners and sells heavily shorted losers exhibits strong short-term momentum and no long-term reversal. In contrast, an inconsistent momentum strategy that buys heavily shorted winners and sells lightly shorted losers experiences weak short-term momentum and persistent long-term reversal. Our results are robust after controlling for firm characteristics, proxy for short-sale constraints, and investor sentiment, as well as an exogenous shock (the Taxpayer Relief Act of 1997). These findings present a new challenge to existing theories of momentum that rely solely on investor underreaction and overreaction.

Recent data on the incidence and trends for recurrent strokes in China are scarce. We assessed the temporal trends in recurrent stroke incidence using in rural China. The age-standardized incidences of recurrent stroke, within 5 years of the incident stroke event, were estimated for 3 time periods: 1992–1998, 1999–2005, and 2006–2012. Among the 768 documented incident stroke cases, 26.3% of the patients experienced recurrent stroke within 5 years. The overall age-adjusted recurrent stroke incidence was 43.93 per 100,000 person-years (1992–2012). During the 2006–2012 period, the recurrent stroke incidence per 100,000 person-years was 107.79 in men, and 557.76 in individuals ≥65 years old. There were significant upward tendencies observed in this population across sex, age, or type of stroke (except for among individuals ≥65 years old with incident intracerebral hemorrhages). Compared with the recurrent stroke incidence observed in the 1992–1998 period, that observed during the 2006–2012 period was more than 3-fold higher; the greatest increase (6.8-fold) was observed in women. These findings suggest an urgent need to improve risk factor management and implement appropriate medical resources to contain this upward trend in recurrent stroke incidence and reduce the overall stroke burden in China.

ObjectiveTo explore the association between serum retinoic acid (RA) level in patients with acute ischemic stroke (AIS) and mortality risk in the 6 months after admission.MethodsFrom January 2015 through December 2016, patients admitted to 3 stroke centers in China for first-ever AIS were screened. The primary endpoint was all-cause mortality or cardiovascular disease (CVD) mortality in the 6 months after admission. The significance of serum RA level, NIH Stroke Scale score, and established risk factors in predicting mortality were determined. The integrated discrimination improvement (IDI) and net reclassification improvement (NRI) statistics were applied in statistical analysis.ResultsOf the 1,530 patients enrolled, 325 died within 6 months of admission, with an all-cause mortality of 21.2% and CVD-related mortality of 13.1%. In multivariable analysis, RA levels were expressed as quartiles with the clinical variables. The results of the second to fourth quartiles (Q2–Q4) were compared with the first quartile (Q1); RA levels showed prognostic significance, with decreased all-cause and CVD mortality of 55% and 63%, respectively. After RA was added to the existing risk factors, all-cause mortality could be better reclassified, in association with only the NRI statistic (p = 0.005); CVD mortality could be better reclassified with significance, in association with both the IDI and NRI statistics (p < 0.01).ConclusionsLow circulating levels of RA were associated with increased risk of all-cause and CVD mortality in a cohort of patients with first-incidence AIS, indicating that RA level could be a predictor independent of established conventional risk factors.

Liming Fan,1,&ast; Qiaoxia Yang,2,&ast; Xin Zhang,3,&ast; Qiuxing Lin,3– 5 Dandan Guo,3 Jie Liu,2– 4 Jun Tu,3– 5 Jinghua Wang,3– 5 Yan Li,6 Xianjia Ning3– 5 1Department of Medical Clinical Laboratory, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 2Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, 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 China; 6Department of Anesthesiology, Tianjin Jizhou People’s Hospital, Tianjin, 301900, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xianjia NingDepartment of Neurology, Tianjin Medical University General Hospital, Laboratory of Epidemiology, Tianjin Neurological Institute & Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, 154 Anshan Road, Heping District, Tianjin, 300052, People’s Republic of ChinaTel +86-22-60817505Fax +86-22-60817448Email xning@tmu.edu.cnYan LiDepartment of Anesthesiology, Tianjin Jizhou People’s Hospital, 18 Nanhuan Road, Jizhou District, Tianjin, 301900, People’s Republic of ChinaTel/Fax +86-22- 60733586Email drliyan@163.comIntroduction: Carotid atherosclerosis is a well-established biomarker associated with future cardiovascular disease and stroke. We explored the influence of sex on the relationship between metabolic syndrome (MetS) and its components with carotid intima-media thickness (CIMT) among a low-income population in China, which has a high incidence of stroke.Methods: This population-based study recruited participants aged ≥ 45 years from rural areas of Tianjin, China between April 2014 and January 2015. Anthropometric characteristics and biochemical profiles were measured. CIMT was assessed using ultrasonography. Diagnosis of MetS and its components was made using the modified International Diabetes Federation criteria for the Asian population. A multivariate linear regression model was used to evaluate the effects of sex on the relationship between the presence of MetS and its components and CIMT.Results: A total of 3583 individuals (men, 41.4%; women, 58.6%) were included in the analyses. MetS was prevalent in 54.5% (men, 42.3%; women, 63.2%) of the participants. Mean CIMT was 0.57 ± 0.09 mm. In the multivariate analysis, for both sexes, CIMT increased significantly when MetS was present compared with when it was not (both P < 0.001). A common trend was observed in both sexes, in that CIMT increased as the number of MetS components increased, with β (95% confidence interval [CI]) = 0.021 (0.000, 0.042) for men and 0.014 (0.002, 0.026) for women (both P < 0.05). Of the five MetS components, elevated blood pressure was an independent risk factor for increased CIMT in both sexes (men: β = 0.013; 95% CI: 0.003, 0.023; P = 0.008; women: β = 0.024; 95% CI: 0.016, 0.033; P < 0.001). Moreover, abdominal obesity was also an independent risk factor for increased CIMT in men (β = 0.013; 95% CI: 0.003, 0.023; P = 0.008) but not in women.Conclusion: The presence and number of components of MetS were associated with CIMT in both men and women. Sex differences were found in the impact of individual components of MetS on CIMT. Early identification and management of MetS according to sex-specific risk of MetS should be considered to reduce the prevalence and burden of carotid atherosclerosis in rural China, which has a high incidence of stroke, a known consequence of carotid atherosclerosis.Keywords: atherosclerosis, carotid intima-media thickness, metabolic syndrome, components, sex differences

Background MicroRNAs, as small non-coding RNAs, play an important role in tumorigenesis. MiR-483-5p was found to have a significant increase as a diagnostic biomarker of nasopharyngeal carcinoma (NPC), not only in plasma from NPC patients but also in tumor cell lines and biopsy tissues in our previous study. However, its function and mechanism in NPC are still unclear. Methods Tissue microarray including 178 primary NPC and 35 adjacent non-cancerous nasopharyngeal mucosal tissues was used to further validate the overexpression of miR-483-5p. Wound healing and invasion assays were conducted to verify its biological function. RNA sequencing (RNA-seq) and dual-luciferase reporter assay was performed to explore its target, and it was verified in fresh biopsy tissues from 23 NPC patients and 9 patients with chronic nasopharyngitis. Results MiR-483-5p was highly expressed in NPC tissues than in adjacent non-cancerous tissues. It was found to have a significant correlation with poor overall survival (OS) [hazard ratio (HR) = 2.89, 95% confidence interval (CI) = 1.00–8.35, p = 0.041] and progression-free survival (PFS) (HR = 1.95, 95%CI = 1.06–3.60, p = 0.029) of NPC patients. Silencing of its expression inhibited the migratory and invasive capacities of NPC cells in vitro. EGR3 (early growth response 3) was identified as a direct target, and inhibiting miR-483-5p expression markedly enhanced the expression of EGR3 at both the mRNA and protein levels. Besides, a significant decrease of EGR3 expression was found in fresh biopsy tissues from NPC patients, in contrast to miR-483-5p expression. Furthermore, directly decreasing the expression of EGR3 could enhance the migration and invasion of NPC cells. Conclusion The newly identified miR-483-5p/EGR3 pathway provides further insights into the development and metastasis of NPC and may provide a potential therapeutic target for NPC treatment in order to improve survival of NPC patients.

Self-organizing feature map (SOFM) neural network is a kind of competitive unsupervised learning neural network, which has strong self-organizing and self-learning capabilities. It has been widely used in the fields of data classification and data clustering. A crucial step for SOFM neural network is to set its weight parameters correctly because the output accuracy and efficiency of the network depend much on these parameters. Most of current methods for parameter setting are based on static data. However, in a dynamic environment, the statistical characteristics of the generated data will change unpredictably over time. If the SOFM network cannot react to the changes of the environment, its performance will degrade. To deal with this problem, a more powerful multi-swarm artificial bee colony algorithm (MABC) is proposed. In the algorithm, the classic ABC algorithm is improved with multi-swarm and exclusive operation strategies to make it suitable for tracking optimal parameter settings of the SOFM network, so that the SOFM network can be applied to a dynamic environment. Two real data streams, which are regarded as coming from dynamic environments, are used to evaluate the effectiveness of the algorithm. Results show that the proposed algorithm is superior to the classic SOFM algorithm in terms of clustering purity and effectiveness. It is a promising method for the classification of data streams from dynamic environments.

Background To assess the impact of the health care reform on stroke prognoses among low-income Chinese residents. Methods Stroke events and all-cause deaths were registered during 1992-2018 in Tianjin, China. Trends in stroke management and prognoses were compared during the study periods1992-2008 and 2009-2018. Results A total of 1462 patients were diagnosed with first-ever stroke during the study periods. For patients aged ≥45 years, the rates of neuroimaging-based diagnoses and hospitalization were greater in 2009-2018 than in 1992-2008, regardless of patient sex or stroke type. Overall, the one-year case fatality rate was significantly lower in 2009-2018 than in the earlier period; the case fatality rate for women aged ≥65 years decreased by 30.0%. Between both periods, the stroke recurrence rate increased 1.9-fold, including a 2.5-fold increase in men (all P

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.