Search

BackgroundWe aimed to evaluate the association between depression and major cardiovascular events and test whether the relationship between depression and cardiovascular events is influenced by lifestyle or metabolic risk factors.MethodsThe China Cardiometabolic Disease and Cancer Cohort (4C) Study was a nationwide, multicenter, prospective cohort study. About 92,869 participants without cardiovascular disease or cancer at baseline were included. Depression status was evaluated by the Patient Health Questionnaire-9 (PHQ-9). Lifestyle information was collected by the questionnaire, and metabolic risk factors including waist circumference, blood pressure, lipid profiles, and plasma glucose were measured. Major cardiovascular events including cardiovascular death, myocardial infarction, stroke, and hospitalized or treated heart failure events were validated based on medical records.ResultsDuring an average of 3.8 years of follow-up, we detected 2,076 cardiovascular events and showed that participants with depressive symptoms had an increased risk for cardiovascular events after adjustments [hazard ratio (HR): 1.29; 95% confidence index (CI): 1.08–1.53]. Stratified on metabolic risk status, the relationship between depression and cardiovascular events tended to be stronger according to the increasing numbers of metabolic risk factors, with HR (95% CI) of 0.98 (0.72–1.35) in the category with 0–2 metabolic risk factors, 1.36 (0.996–1.87) and 1.47 (1.13–1.92) for those with 3, and 4–5 metabolic risk factors, respectively, indicating an interaction effect (P = 0.039).ConclusionDepression was independently associated with an increased risk of major cardiovascular events. The effect was particularly prominent among populations at higher metabolic risk.

BackgroundAlbuminuria has been widely considered a risk factor for cardiovascular diseases (CVDs), which is associated with hypertension (HTN), type 2 diabetes mellitus (T2DM), HTN with T2DM, and dyslipidemia. However, the associations between albuminuria and HTN, T2DM, HTN with T2DM, dyslipidemia, and CVDs are still unclear. Thus, this study aimed to explore the association of albuminuria thoroughly, especially within the normal range, with the abovementioned diseases in the Chinese population.MethodsThis study included 40,188 participants aged over 40 years from seven centers across China. Urinary albumin–creatinine ratio (UACR) was firstly divided into the ≥30-mg/g group, indicating kidney damage, and

The integration of renewable energy sources (RESs) remains growing rapidly in recent years. At the same time, security problems after contingencies were attracting great attention, due to deficiencies for the stable operation, even could induce the collapse of integrated energy systems with the deep interconnection of such RESs. To existing issues, the hyper-plane (HP) expression is proved to be an excellent tool for power system situational awareness and stability-constrained operation in practical dynamic security stability regions (PDSSR). In this study, a concept and model were proposed for a high renewable energy penetration of integrated electricity-natural gas system (HRE-IENGS) based on the N - 1 security guideline. The scheme instruction and system evaluation processes as follows: in order to improve the accuracy of the IENGS system, simulation fitting solutions of PDSSR boundary were presented according to a hybrid algorithm, including dynamic self-adaptive differential evolution algorithm (DSADE), and a least square support vector machine (LSSVM) algorithm. The adopted algorithm approach was applied to rapid approximating of the PDSSR boundary by HP expression in power injection spaces. Simultaneously, different renewable energy permeabilities (DREPs) were set from 5 to 50 %, and active power injections of DREPs under short circuit fault on IEEE 118 bus system simulated by using DIgSLENT/power factory software. As the consequence, this mentioned method effectively described the security stability boundary of HRE-IENGS, and realized the three-dimensional visualization space of DREPs-PDSSR. In addition, the behavior of operation points and PDSSR under DREPs were carefully investigated, and unstable runs were accurately exposed. Through the PDSSR, the state analysis could be conducted rapidly on several parameters, including security and stability assessment with various energy supply capabilities. Meanwhile, these indexes were calculated offline and applied on-line. The results of this study verified the accuracy and effectiveness of the proposed modeling for the considered system, and thus could provide technical support for the stability of the HRE-IENGS system.

Large-scale voltage collapse incidences, which result in power outages over large regions and extensive economic losses, are presently common occurrences worldwide. To avoid voltage collapse and operate more safely and reliably, it is necessary to analyze the voltage security operation region (VSOR) of power systems, which has become a topic of increasing interest lately. In this paper, a novel improved particle swarm optimization and recursive least square (IPSO-RLS) hybrid algorithm is proposed to determine the VSOR of a power system. Also, stability analysis on the proposed algorithm is carried out by analyzing the errors and convergence accuracy of the obtained results. Firstly, the voltage stability and VSOR-surface of a power system are analyzed in this paper. Secondly, the two algorithms, namely IPSO and RLS algorithms, are studied individually. Based on this understanding, a novel IPSO-RLS hybrid algorithm is proposed to optimize the active and reactive power, and the voltage allowed to identify the VSOR-surface accurately. Finally, the proposed algorithm is validated by using a simulation case study on three wind farm regions of actual Hami Power Grid of China in DIgSILENT/PowerFactory software. The error and accuracy of the obtained simulation results are analyzed and compared with those of the particle swarm optimization (PSO), IPSO and IPSO-RLS hybrid algorithms.

In this paper, a new approach has been introduced for optimal parameter estimation of a proton exchange membrane fuel cell (PEMFC) model. The main purpose is to minimize the total error between the empirical data and the proposed method by optimal parameter selection of the model. The methodology is based on using a newly introduced developed version of the Coyote Optimization Algorithm (DCOA) for determining the value of the unknown parameters in the model. Two different PEMFC models including 2 kW Nexa FC and 6kW NedSstack PS6 FC are adopted for validation and the results are compared with the empirical data and some well-known methods including conventional COA, Seagull Optimization Algorithm, and (N + λ) - ES algorithm to show the proposed method’s superiority toward the literature methods. The final results declared a satisfying agreement between the proposed DCOA and the empirical data. The results also declared the excellence of the presented method toward the other compared methods.

This paper proposes a new optimal method for the parameter identification of a proton exchange membrane fuel cell (PEMFC) for increasing the model accuracy. In this research, a new improved version based on deer hunting optimization algorithm (DHOA) is applied to the Convolutional neural network for the PEMFC parameters identification purpose. Indeed, the method is implemented to develop the method performance for estimating the PEMFC model parameters. The method is then validated based on 4 operational conditions. Experimental results declared that utilizing the proposed method gives a prediction with higher accuracy for the parameters of the PEMFC model.

This paper proposes a new methodology for the optimal selection of the parameters for proton exchange membrane fuel cell (PEMFC) models. The proposed method is to optimal parameter selection of the circuit-based model of the PEMFC model to minimize the sum of squared error (SSE) value between the estimated and the actual output voltage of the PEMFC stack. For minimizing the SSE, a newly developed model of the Sunflower Optimization Algorithm (DSFO) is proposed. Performance analysis is performed based on two practical models including NedSstack PS6 PEMFC and Horizon 500-W PEMFCs from the literature and the results have been compared with the empirical data and also some state of art methods including Seagull Optimization Algorithm (SOA), Multi-verse optimizer (MVO), and Shuffled Frog-Leaping Algorithm (SFLA). Final results indicate 2.18 and 0.014 SSE value for NedSstack PS6 PEMFC and Horizon 500-W open cathode PEMFC, respectively which are the minimum values compared with the other compared methods.

Lipoprotein (a) [Lp(a)] is a well-known risk factor for cardiovascular disease, but analysis on Lp(a) and renal dysfunction is scarce. We aimed to investigate prospectively the association of serum Lp(a) with the risk of reduced renal function, and further investigated whether diabetic or hypertensive status modified such association. Six thousand two hundred and fifty-seven Chinese adults aged ≤40 years and free of reduced renal function at baseline were included in the study. Reduced renal function was defined as estimated glomerular filtration rate 25 mg/dl), indicating a combined effect of diabetes and high Lp(a) on the reduced renal function risk. An elevated Lp(a) level was independently associated with risk of incident reduced renal function, especially in diabetic or hypertensive patients.

The gut microbiome affects systemic metabolism and is a therapeutic target for type 2 diabetes. Here the authors demonstrate in a randomized controlled trial that effects of berberine, a plant alkaloid known to lower blood glucose, may be explained by the inhibition of Ruminococcus bromii mediated biotransformation of the bile acid deoxycholic acid.

Abstract Background Both lipid and glucose abnormalities are associated with hypertension (HTN). However, it is unclear whether the triglyceride-glucose (TyG) index is associated with HTN. Therefore the aim of this study is to investigate the association of the TyG index and HTN and to compare the discriminative power of the TyG index, lipid, glycemic parameters for the risk of HTN in elderly individuals. Methods The present study was nested in a longitudinal (REACTION) study from May 2011 to December 2011, which was designed to demonstrate the association of abnormal glucose metabolism with the risk of cancer in the Chinese population. In total, 47,808 participants were recruited in this cross-sectional study. The TyG index was divided into five groups: the

Summary: Background: Some circulating proteins are linked to central adiposity. Gremlin 2 (GREM2) functions as a secreted factor involved in osteogenesis and adipogenesis. Here, we investigated the association of blood GREM2 levels and central adiposity, and the biological roles of GREM2 in the browning program of visceral preadipocytes. Methods: Three independent cohorts were applied to detect circulating GREM2 levels. Recombinant Grem2 protein, Grem2 overexpression and knockout mouse models, and preadipocyte-specific Bmpr2 knockout mice were used to assess the roles of Grem2 in the browning program. Findings: We detected the presence of GREM2 protein in human serum using an ELISA approach. We revealed elevated GREM2 levels in severely obese subjects and validated this finding in a large-scale community population involving 10,327 subjects. Notably, serum GREM2 was positively associated with visceral fat volume, as quantified by 3D reconstruction methods. In mice, Grem2 was highly expressed in visceral fat and liver tissues, while surgical removal of visceral fat lowered circulating Grem2 levels. Visceral fat secreted more Grem2 in obese mice. Grem2-overexpressed mice exhibited a reduced browning ability of visceral fat, whereas Grem2 ablation enhanced the browning capacity and reduced visceral fat content. Mechanistically, Grem2 attenuated the browning program of visceral preadipocytes partially by antagonizing BMP4/7-SMAD1/5/8 signaling pathway. Further, genetic deletion of Bmpr2 in Pdgfrα+ preadipocytes abolished the antagonistic effect of Grem2. Interpretation: These findings indicate that GREM2 might function as a circulating protein factor associated with human visceral adiposity, and Grem2 inhibits the browning capacity of visceral preadipocytes partially by BMP4/7-BMPR2 signaling pathway. Funding: The complete list of funders can be found in the Acknowledgement section.

ObjectiveUnilateral primary aldosteronism (PA) includes aldosterone-producing adenoma (APA), unilateral adrenal hyperplasia, and unilateral multiple nodules. The correlation of multiple nodules, especially genotypic and pathological characteristics, remains unknown. KCNJ5 mutation accounts for 60–80% of unilateral PA, so we aimed to explore the correlation of KCNJ5 somatic mutation and CYP11B1/CYP11B2 staining in multiple nodules in unilateral PA.Design and MethodsA total of 56 microdissected nodules from 24 patients with unilateral PA were included. We assessed somatic KCNJ5 mutations, immunohistochemistry for aldosterone synthase (CYP11B2)/cortisol synthase (CYP11B1), and histological cellular composition of nodules together with adjacent adrenal cortical statements.ResultsKCNJ5 mutations were identified in 17 (17/56, 30.4%) nodules from 11 adrenals (11/24, 45.8%). All KCNJ5-mutant nodules were positive for CYP11B2 staining, 6 cases (6/11) had only one KCNJ5-mutant nodular, and the other 5 cases (5/11) had more than one KCNJ5-mutant nodules. Three cases (3/11) had different KCNJ5 mutations in individual nodules. Compared with KCNJ5-positive adrenals, the cortices adjacent to the nodules in KCNJ5-negative adrenals showed significant proliferation (p = 0.004). CYP11B2/CYP11B1 expression patterns revealed great heterogeneity in intensity and range both in KCNJ5-mutant nodules and KCNJ5-WT ones.ConclusionThere is great heterogeneity among nodules from patients with unilateral PA. Countable nodules could be considered as multiple APAs, featuring somatic KCNJ5 mutation, positive CYP11B2 staining, and lack of adjacent cortical proliferation in unilateral multiple nodules.

Time-restricted feeding (TRF) has been recently reported as an effective dietary intervention for losing body weight, implying a negative energy balance, without restricting nutrient intake. However, the detailed energy balance alteration caused by TRF remains unclear. This study was a randomized controlled clinical trial using a within-subject cross-over design. Twelve healthy, normal-weighted volunteers (age: 24 ± 2.3 years; BMI: 21.9 ± 1.71 kg/m2; 7 females) were studied under a rigorous control for calorie intakes, physical activities as well as sleep-wake cycle to evaluate the energy balance systematically. Each participant consumed an isocaloric diet within either a 5.5-hour TRF or 11-hour control schedule. All energy intake and excretion were traced and collected and accessed by bomb calorimetry. Energy expenditure and substrates oxidation were monitored in a metabolic chamber. TRF compared with control schedule is associated with a 22.7% increase in fecal energy loss (Δ = 32.25 ± 9.33 Kcal, p = 0.005) and a trend in increasing 14.5% urine energy loss (Δ = 6.67 ± 3.14 Kcal, p = 0.058) without change energy expenditure. In total, a negative energy balance (Δ = -45.95 ± 19.00 Kcal, p = 0.034), which was equal to -2.6% of total energy intake, has been observed during TRF interventions. In the meantime, glycemic profiles, heart rate, respiration rate as well as metabolic flexibility were also improved during TRF intervention. Taken together, our findings unravel the mystery of how TRF regulates energy balance, supporting the use of TRF as an alternative dietary strategy for weight loss.

Summary: Background: The updated definition of hypertension by the American College of Cardiology (ACC) and the American Heart Association (AHA) is an important paradigm shift and has lead to extensive discussion. We aimed to examine the association between the updated blood pressure (BP) categories and the risk of cardiovascular diseases (CVDs) with potential modifications from other cardiovascular health metrics (CVHMs). Methods: This prospective study included 91,204 participants ≥40 years recruited from 20 community sites across mainland China. Participants were followed up during 2010-2016 for CVD events including nonfatal myocardial infarction, stroke, heart failure, and cardiovascular death. BP categories were defined according to the 2017 ACC/AHA guideline and CVHMs included smoking, physical activity, diet, body-mass index, total cholesterol, and fasting glucose. Findings: Overall, 1,985 major CVD events occurred during a mean follow-up of 3.7 years. Having more ideal CVHMs significantly reduced the risk of CVD events in both stage 1 and stage 2 hypertension. Compared with participants without hypertension, participants having ≥4 ideal CVHMs were no longer associated with an increased CVD risk in stage 1 hypertension (HR=1·04; 95% CI=0·83-1·31), but less so in stage 2 hypertension (HR=1·90, 95% CI=1·70-2·13). Such pattern of association was more evident in participants aged

BackgroundThe atherosclerotic cardiovascular disease (ASCVD) risk predicted by traditional risk factors is used to guide preventive treatment. We aimed to investigate whether preferable levels of non-traditional emerging risk factors (i.e., negative risk markers) could downgrade the predicted ASCVD risk beyond traditional risk factors.MethodsA total of 7,568 Chinese adults aged ≥ 40 years were followed up during 2010–2015. Negative risk markers including non-traditional lipids, urinary albumin-to-creatinine ratio, electrocardiogram (ECG), and measurements of atherosclerosis were evaluated using diagnostic likelihood ratio (DLR) and continuous net reclassification index (NRI) for their ability to downshift predicted CVD risk in the overall study population and in participants with intermediate (traditional risk factor predicted ASCVD risk 7.5% to 19.9%) or high risk (≥20%).ResultsDuring a median follow-up of 4.5 years, 416 participants developed CVD events including non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death. Among negative risk markers examined, lipoprotein(a) ≤ 10th percentile (5 mg/dL), normal ECG, and carotid intima-media thickness (CIMT) ≤ 25th percentile (0.5 mm) provided moderate CVD risk reclassification and downward changes in pre- to post-test risk on top of the traditional CVD risk factors, especially in high-risk participants. The DLRs were 0.41, 0.75, and 0.41, and the NRIs were 18, 22, and 14% for lipoprotein(a), ECG, and CIMT, respectively in high-risk participants.ConclusionsLipoprotein(a) ≤ 5 mg/dL, normal ECG, and CIMT ≤ 0.5 mm might be used as negative non-traditional risk markers to correctly downgrade predicted ASCVD risk in Chinese adults.

Background Recurrence is a risk factor for the prognosis of lung squamous carcinoma (LUSC). DNA methylation levels of RNAs are also associated with LUSC prognosis. This study aimed to construct a prognostic model with high performance in predicting LUSC prognosis using the methylation levels of lncRNAs and genes. Methods The differentially expressed RNAs (DERs) and differentially methylated RNAs (DMRs) between the recurrent and non-recurrent LUSC tissues in The Cancer Genome Atlas (TCGA; training dataset) were identified. Weighted correlation network analysis was performed to identify co-methylation networks. Differentially methylated genes and lncRNAs with opposite expression-methylation levels were used for the screening of prognosis-associated RNAs. The prognostic model was constructed and its performance was validated in the GSE39279 dataset. Results A total of 664 DERs and 981 DMRs (including 972 genes) in recurrent LUSC tissues were identified. Three co-methylation modules, including 226 differentially methylated genes, were significantly associated with LUSC. Among prognosis-associated RNAs, 18 DERs/DMRs with opposite methylation-expression levels were included in the methylation prognostic risk model. LUSC patients with high risk scores had a poor prognosis compared with patients who had low risk scores (TCGA: HR = 3.856, 95% CI [2.297–6.471]; GSE39279: HR = 3.040, 95% CI [1.435–6.437]). This model had a high accuracy in predicting the prognosis (AUC = 0.903 and 0.800, respectively), equivalent to the nomogram model inclusive of clinical variables. Conclusions Referring to the methylation levels of the 16-RNAs might help to predict the survival outcomes in LUSC.

Studies have shown that the cholesterol-lowering medicine statins alter the gut microbiome, induce chronic metabolic inflammation, and disrupt glycemic homeostasis. In this study, we aimed to investigate whether effects of atorvastatin (Ator) on gut microbiome and metabolic inflammation could be causally correlated. Mice at 8-week age were fed with high-fat diet (HFD) or HFD with Ator (HFD+Ator) for 16 weeks. 16S rRNA sequencing of stool and RNA sequencing of colon tissue were employed to analyze the intestinal alterations that could be induced by Ator. A human colon carcinoma cell line (Caco2) was used for in vitro experiments on barrier function. Compared to HFD, HFD+Ator induced more weight gain, impaired glucose tolerance, and led to gut microbiota dysbiosis, such as suppressing Akkermansia muciniphila in mice. The expressions of tight junction (TJ) proteins were attenuated in the colon, and the serum LPS-binding-protein (LBP) level was elevated in HFD+Ator mice, so as to transcriptionally activate the intestinal nuclear factor-k-gene binding (NF-κB) signaling pathway. Consistently, Ator impaired the barrier function of Caco2, and treatment of supernatant of A. Muciniphila culture could decrease the intestinal permeability and recover the attenuated expression of TJ proteins induced by Ator. In conclusion, long-term use of Ator with HFD may alter gut microbiota, induce intestinal barrier dysfunction, and hence promote chronic inflammation that contributes to disrupted glycemic homeostasis.

BackgroundThe role of immune checkpoint inhibitors (ICIs) in NSCLC patients with EGFR mutations are controversial. In this study, we aim to investigate the therapeutic efficacy of ICIs alone or in combination in patients with EGFR mutated NSCLC in late-line settings, and explore the factors that may predict the efficacy of ICIs.Patients and MethodsWe retrospectively collected the clinical and pathological information of 75 patients with confirmed EGFR mutations. All patients have developed acquired resistance to EGFR-TKIs, and were treated with ICIs in late line settings from January 2019 to January 2021, at Shandong Caner Hospital and Institute. Therapeutic efficacy was evaluated by tumor response and survival.ResultsThe median follow-up period was 7.3months (range 1.8-31.8 months). The overall response rate (ORR) was 8.0%, and the disease control rate (DCR) was 78.7%. The median PFS for all patients was 3.9 months (95% CI, 2.7-5.0), while the median OS was 9.9 months (95% CI, 5.3-14.6). We found that patients with longer response duration to EGFR-TKIs (≥10 months) showed a longer PFS when treated with immunotherapy compared with patients with shorter PFS-TKI (

Background: The pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) and mechanisms underlying different responses to systemic glucocorticoids (GC) remain unclear. The major aim of this study was to explore the transcriptomic and oxidative lipidomic signatures and the effects of GC in patients with different clinical responses.Methods: Nasal polyp biopsies were obtained before and after 14-day oral GC treatment from 16 patients with CRSwNP, and normal nasal mucosa specimens were collected from 12 control subjects. RNA sequencing and oxidative lipidomics were performed, and differential gene expression analysis was conducted in the Responder and Non-responder groups at baseline and after treatment.Results: In the Responder group, GC significantly improved clinical symptoms and reduced tissue eosinophil infiltration. Meanwhile, GC led to a pronounced transcriptomic reversion with robust suppression of inflammatory responses and abnormal metabolism of extracellular matrix, as well as restoration of cilia function. However, non-responders were mainly characterized by epithelial hyperplasia and keratinization, with much less transcriptomic improvement after GC treatment. Higher expression of type 2 inflammatory molecules (CCL13, IGHE, CCL18, CCL23, CCR3, and CLC) with lower levels of LACRT, PPDPFL, DES, C6, MUC5B, and SCGB3A1 were related to a stronger clinical response to GC. Besides decreased prostaglandins and increased leukotrienes, increased dysregulation in other oxylipid mediators derived from polyunsaturated fatty acids was determined in nasal polyps, which was ameliorated by GC treatment.Conclusion: Systemic GC exert anti-inflammatory effects, improve tissue remodeling, restore cilia function, and ameliorate dysregulation of oxylipid mediator pathway in CRSwNP. GC-responders exhibited different transcriptomic signatures from non-responders.

Rockburst is one of the major problems in rock underground engineering and mechanics. To make a risk assessment of rockburst and improve the mine safety index, some evaluation systems for rockburst propensity have been proposed and applied, and progress has been made in the study of high-value mines and single evaluation systems, but these evaluation systems are still immature for deep low and medium grade phosphate mines with more complex influencing factors. Therefore, to solve this problem, this study takes the phosphate mining area of the Sujiapo phosphate mine as the main research object, and combines the characteristics of the deep rockburst of the phosphate mine and its physical and mechanical properties; the evaluation system combines fuzzy mathematical method and multiple evaluation methods to determine the propensity of rockburst of deep mining of Sujiapo phosphate mine. The JSM-500LV SEM and acoustic emission results are used to analyze the microscopic mechanism of rockburst from the morphology and composition of the rocks, and the rationality of the evaluation system is further demonstrated. The study shows that dolomite and phosphorite in the study area are moderate rockburst, and shale has a weak rockburst tendency; because the roof dolomite and phosphorite crystallization degree are higher, the elastic modulus is large. Under the action of external load, the roof dolomite stored more elastic strain energy. Deformation damage consumes less energy. The energy released to the outside world after the damage is large, more likely to occur brittle damage, and the rockburst tendency is high. Therefore, the evaluation system combining multiple evaluation methods can comprehensively determine rockburst in phosphate mines.

AimWe aimed to detect the individual and combined effect of glucose metabolic components on cognitive function in particular domains among older adults.MethodsData of 2,925 adults aged over 60 years from the 2011 to 2014 National Health and Nutrition Examination Survey were analyzed. Individuals’ cognitive function was evaluated using the Digit Symbol Substitution Test (DSST), the Animal Fluency Test (AF), the Consortium to Establish a Registry for Alzheimer’s Disease Immediate Recall (CERAD-IR), and CERAD Delayed Recall (CERAD-DR). Participants’ glucose metabolic health status was determined based on fasting plasma glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), glycated hemoglobin (HbA1c), and 2-h postload glucose. Linear regression models were used to delineate the associations of cognitive function with individual glucose metabolic component and with metformin use. Logistic regression models were performed to evaluate the associations of cognition with the number of glucose metabolic risk components.ResultsCERAD-IR was significantly associated with HOMA-IR and insulin. HbA1c was related to all the cognitive tests except AF. Among participants without obesity, HOMA-IR and insulin were both negatively associated with CERAD-IR and CERAD-DR. Odds of scoring low in DSST increased with the number of glucose metabolic risk components (odds ratio 1.94, 95% confidence interval [CI] 1.26 to 2.98). Metformin use was associated with better performance in DSST among diabetes patients (β = 4.184, 95% CI 1.655 to 6.713).ConclusionsOur findings support the associations of insulin resistance and glycemic level with cognitive function in key domains, especially among adults without obesity. There is a positive association between metformin use and cognition.

Summary: Background: National investigations on age-specific modifiable risk factor profiles for cardiovascular disease (CVD) and mortality are scarce in China, the country that is experiencing a huge cardiometabolic burden exacerbated by population ageing. Methods: This is a nationwide prospective cohort study of 193,846 adults in the China Cardiometabolic Disease and Cancer Cohort Study, 2011-2016. Among 139,925 participants free from CVD at baseline, we examined hazard ratios and population-attributable risk percentages (PAR%s) for CVD and all-cause mortality attributable to 12 modifiable socioeconomic, psychosocial, lifestyle, and metabolic risk factors by four age groups (40-

With the rapid expansion of new energy in China, the large-scale grid connection of new energy is increasing, and the operating safety of the new energy power system is being put to the test. The static security and stability region (SSSR) with hyper-plane expression is an effective instrument for situational awareness and the stability-constrained operation of power systems. This paper proposes a hybrid improved particle swarm optimization (IPSO) and recursive least square (RLS) approach for rapidly approximating the SSSR boundary. Initially, the operating point data in the high-dimensional nodal injection space is examined using the IPSO algorithm to find the key generators, equivalent search space, and crucial points, which have a relatively large impact on static stability. The RLS method is ultimately utilized to fit the SSSR border that best suits the crucial spots. Consequently, the adopted algorithm technique was used to rapidly approximate the SSSR border in power injection spaces. Finally, the suggested algorithm is confirmed by simulating three kinds of generators of the new energy 118 bus system using the DIgSILENT/Power Factory. As a result, this method accurately characterized the stability border of the new energy power system and created the visualization space of the SSSR. Using the SSSR, a rapid state analysis could be undertaken on a variety of parameters, such as security evaluation with diverse energy supply capacities. This study’s findings confirmed the accuracy and efficacy of the suggested modeling for the considered system and may thus give technical support for the new energy power system’s stability.

ObjectivesNationwide studies focusing on the impact of early-onset type 2 diabetes and obesity on the development of cardiovascular diseases (CVD) are limited in China. We aimed to investigate the association between age at diagnosis of type 2 diabetes and the risk of CVD, and to further examine the modifying effect of obesity on this association among Chinese adults.MethodsThis study included 23,961 participants with previously diagnosed diabetes from a large nationwide population-based cohort study across mainland China. With an interviewer-assisted questionnaire, we collected detailed information on CVDs. Logistic regression analysis was used to evaluate the risk of CVDs associated with age at diagnosis of diabetes.ResultsCompared with patients with late-onset diabetes (≥60 years), those with earlier-onset diabetes had increased risks for CVD, with adjusted ORs (95% CIs) of 1.72 (1.36-2.17), 1.52 (1.31-1.75) and 1.33 (1.19-1.48) for patients diagnosed aged

Summary: Background: National investigations of age-specific modifiable risk profiles for diabetes are crucial to promote personalised strategies for the prevention and control of diabetes, particularly in countries such as China, which is experiencing both a diabetes epidemic and a rapidly ageing population. We aimed to examine the associations of 12 potentially modifiable socioeconomic, lifestyle, and metabolic risk factors with diabetes in a nationwide prospective cohort of Chinese adults across four age groups. Methods: We analysed data from the China Cardiometabolic Disease and Cancer Cohort Study, a nationwide, population-based, cohort study done between Jan 1, 2011, and Dec 31, 2016. Among 93 781 participants without diabetes at baseline and with complete information available about risk factors and diabetes incidence, we examined the hazard ratios (HRs) and population-attributable risk percentages (PAR%s) of incident diabetes associated with 12 potentially modifiable risk factors: two socioeconomic risk factors (less education and intermediate or low grade occupation), five lifestyle risk factors (unhealthy diet, physical inactivity, current alcohol consumption, current smoking, and unhealthy sleep), and five metabolic risk factors (general or central obesity, insulin resistance, prediabetes, hypertension, and dyslipidaemia) across four age groups (40 to

ObjectiveThe aim of the study was to investigate the association between the visit-to-visit variability (VVV) of fasting plasma glucose (FPG) and arterial stiffness in Chinese adults.MethodsWe performed a cohort study involving 2002 Chinese adults with no history of myocardial infarction or stroke. All the participants attended three visits (the baseline visit in 2008, the 2nd visit in 2009 and the 3rd visit in 2013). We used four measures to define the VVV of FPG across the three visits: the standard deviation (SD), the coefficient of variation (CV), the average successive variability (ASV) and the variability independent of the mean (VIM). We used brachial-ankle pulse wave velocity (ba-PWV) to measure arterial stiffness at the 2nd and the 3rd visits.ResultsCompared with the lowest tertile of all the four measurements of VVV of FPG, significantly increased levels of ba-PWV change, ratio of ba-PWV change and the occurrence of the elevated ba-PWV were found in the highest tertile. The odds ratio (OR) and 95% confidence interval (CI) comparing participants in the highest tertile vs. the lowest tertile of FPG-SD was 1.37 (1.01-1.86) for risks of having elevated ba-PWV, even after adjustment for covariates including the mean FPG. Similar results were found for FPG-CV and FPG-VIM.ConclusionGreater long-term variability of FPG was associated with an increased risk of arterial stiffness, suggesting that the VVV of FPG could be used for an early detection of subclinical atherosclerosis.

Background: Primary aldosteronism is caused by aldosterone overproduction. While conventional hematoxylin-eosin staining can demonstrate morphological abnormality, it cannot provide any functional histopathological information. We aimed to identify the diagnostic, functional and prognostic value of CYP11B2, CYP11B1, and β-catenin immunostaining in unilateral hyperaldosteronism.Method: A total of 134 patients with unilateral hyperaldosteronism were recruited in our study. The expression of CYP11B2, CYP11B1, and β-catenin was evaluated semiquantitatively on 134 patients’ sections using immunohistochemistry technology and the relationship with clinical data was assessed.Results: Patients were classified into four subtypes based on CYP11B2 staining as below: (1)118 patients with unilateral single aldosterone-producing adenoma (APA), (2)11 with unilateral multiple APA, (3)four with aldosterone-producing cell cluster (APCC), and (4)one with an undefined source. Adjusted CYP11B2 H-score was correlated with serum aldosterone, aldosterone to renin ratio (ARR), and serum potassium. In the abnormal β-catenin staining group, hypertension duration, aldosterone, ARR, cortisol, tumor diameter, tumor area, and CYP11B2 H-score were significantly higher than those of the wild-type group. Serum potassium level was significantly lower in the abnormal β-catenin staining group. Age, gender, BMI, family history of hypertension, adjusted CYP11B2 and CYP11B1 H-scores differed significantly between complete clinical success and incomplete clinical success groups. Age, gender and family history of hypertension were independently associated with complete clinical success based on multivariate logistic regression analysis.Conclusion: CYP11B2 immunostaining could improve the differential diagnosis of unilateral hyperaldosteronism. Adjusted CYP11B2 H-score could be used as a histopathological marker to reflect the severity of unilateral APA. Dysregulation of Wnt/β-catenin signaling and impaired β-catenin degradation may provoke the proliferation and enhance the steroidogenic ability of APA tumor cells, indicating that the Wnt pathway might be a potential, actionable, therapeutic target in the treatment of hyperaldosteronism. Age, sex and family history of hypertension were independent predictors of clinical outcome after adrenalectomy for unilateral hyperaldosteronism.

Background: The bioassay of thyroid-stimulating immunoglobulin was reported to have a similar performance to the commonly used thyroid-stimulating hormone binding inhibition assay, also known as thyroid receptor antibody assay. The normal reference range of thyroid receptor antibody levels indicates the withdrawal of anti-thyroid drugs in the recent clinical guidelines. Methods: A prospective, longitudinal observational study was conducted to evaluate the prognostic value of thyroid-stimulating immunoglobulin in patients with Graves’ disease. Results: A total of 77 patients with Graves’ disease treated with anti-thyroid drugs were in a continuous follow-up until 1 year after anti-thyroid drugs discontinuation. Commercial kits of thyroid-stimulating immunoglobulin and M22-thyroid-stimulating hormone binding inhibition assay were used and compared. Thyroid-stimulating immunoglobulin was all negative in healthy controls, Hashimoto thyroiditis, and subacute thyroiditis. Thyroid-stimulating immunoglobulin value was highest in untreated patients with Graves’ disease ( p

Ultra High Voltage (UHV) transmission technology is the main regional power interconnection method in China. In addition, renewable energy sources (RES) in China are characterized by centralized distribution. In view of the cross-regional flexible scheduling of large-scale grid-connected RES, we build a day-ahead optimization model which considers the generation economy and robustness of transmission for each regional grid. The model considers the spatial clustering effect of RES and loads, uses robust optimization theory to construct uncertainty sets, and introduces uncertain spatial constraint parameters to compensate for the insufficiency of traditional robust optimization. Furthermore, a co-evolutionary algorithm filter-based is proposed to solve above the mixed-integer non-convex nonlinear programming model. Taking the modified IEEE-39 nodes as an example, the results show that the system cost can be reduced by 21.9% by selecting the confidence probability of uncertain variables of both load and source under stable operation, while the prediction accuracy has a significant impact on the system cost when the confidence probability is smaller, and a better operation scheme can be obtained by increasing the space constraint parameters. Finally, the feasibility of the proposed model and algorithm are verified on the Hami power grid in Xinjiang, China.

As the distributed generation (DG) in a power supply and the user load demand constantly change in an actual distribution network, multiobjective optimal network reconfiguration considering variations in load and DG has become a major concern, which is important and required to make system operations safe and economical. The aim is to minimize the sum of the active power loss, the sum of the load balancing index and the sum of the maximum node voltage deviation index simultaneously during the reconfiguration period. Here, this article proposes a new Chaos Disturbed Beetle Antennae Search (CDBAS) algorithm to reduce the computational time and solve the multiobjective optimal problem of network reconfiguration. To adopt the Chaos Disturbed Beetle Antennae Search algorithm for solving this multiobjective problem, grey target decision-making technology is used to rank the beetles. Additionally, to the enhance the system static voltage stability and voltage quality, a grey target decision-making model is established to achieve a layer relationship between each index and the switching operation index. The plausibility and effectiveness of the presented methodology is verified on the modified IEEE 33, 69 and 118-Bus Test Radial Distribution Network. Finally, compared with other research methods in the literature, the CDBAS algorithm outperforms other algorithms and produces a quality decision solution.

With the increased distributed generation (DG) and the combination of residential, commercial, and industrial loads connected to the distribution networks, it is more difficult to ensure the safe and economic operation of the distribution networks because of the great volatility and randomness of DG and complex loads. In this paper, with the aim of minimizing network loss, load balance, and maximum voltage deviation, a multiobjective reconfiguration model of the distribution network is established under the condition of satisfying network constraints. Moreover, a new social beetle swarm optimization algorithm (SBSO) considering two social behaviors is adopted to solve the complex problem according to the characteristics of the distribution network reconfiguration (DNRC). Based on the SBSO algorithm, grey target decision-making (GTDM) strategy is used to choose the best beetle in the process of solving the multiobjective problem. Additionally, The grey relation projection (GRP) method is used to divide the time period of DNRC according to the change of DG and loads in a day, in order to reduce the number of switching operations. Finally, the effectiveness of the proposed multiobjective model and algorithm are verified on the standard IEEE-33 system and IEEE-69 system.

Aiming to improve the operation economy and power quality of distribution systems subject to the fluctuating and stochastic power outputs of distributed generation (DG) units and electric vehicles (EVs), a multiobjective optimization model for network reconfiguration and its corresponding solution method are proposed. First, a dynamic reconfiguration model is constructed based on the power loss rate (PLR) as well as the active power loss, the load balancing index and the maximum node voltage deviation, which serve as the optimization indexes. Second, the Lévy flight and chaos disturbed beetle antennae search (LDBAS) algorithm is presented based on the grey target decision-making technique, which can not only improve the computational efficiency but also find the most satisfactory solution for the proposed dynamic reconfiguration model. Considering the uncertainties of loads and DG outputs, the influence on the load curve of EV connecting to the distribution network at different penetration rates and under different charging/discharging modes is analysed. Additionally, the modified IEEE 33-bus and 118-bus test radial distribution networks are simulated to verify the effectiveness and superiority of the presented reconfiguration model and the improved LDBAS method, and the results illustrate that the proposed reconfiguration method can improve the operation economy and power quality of the distribution system and encourage the penetration of EVs.

Reversible data hiding (RDH) algorithm is developing rapidly for many years. Usually, the histogram shifting (HS) based RDH algorithm has two main steps: Firstly, a steep difference histogram is generated with some effective methods for difference. Secondly, by extending and shifting some differences in the histogram, bits of information can be embedded into the cover image which can be restored reversibly. In this paper, we proposed the second-order difference to obtain a steeper difference histogram. Firstly, we slide a window with size 2 × 2 through the image. For each block, we can get the two first-order differences by calculating the absolute values of the two differences for its two columns. Thus, the second-order difference of each block, which is the absolute values of the difference of the two first-order differences, can be obtained. By extending and shifting the second-order difference, a bit may be embedded into the block finally. Experiments reveal that the proposed algorithm outperforms the previous state-of-the-art RDH methods in terms of the computational complexity, image distortion and the embedding performance.

With the increased distributed generation (DG) and electric vehicle (EV) load penetration in distribution networks, it is more difficult to ensure the safe and economic operation of the distribution networks because of the great volatility and randomness of DG and EV loads. In this article, the uncertainties of wind power, photovoltaics, conventional loads, and EV loads are considered. Photovoltaics and conventional loads are related to solar radiation, and they are subtracted to form the net load. Then, the Wasserstein distance is used to divide the scene, and K-means clustering is used to reduce the scene, so the reconstruction analysis is carried out in the limited typical scene. In addition, to minimize network loss, load balance and maximum voltage deviation, a multiobjective game reconstruction model of the distribution network is established under the condition of satisfying network constraints. Moreover, the social beetle swarm optimization algorithm considering two social behaviors is adopted to solve the complex problem. Finally, the simulation results are verified on the standard IEEE-33 system and IEEE-118 system. The results show that the proposed strategy and algorithm can effectively reduce the network loss, improve the node voltage level and ensure that the load is not overloaded.

Background: Depression is prevalent in patients with all stages of CKD and is associated with adverse outcome. Abnormally elevated GFR, or hyperfiltration, may play a crucial role in the initiation and progression of CKD. However, the association between depression and hyperfiltration is not known. The aim of this study is to investigate the relationship between depression and hyperfiltration. Methods: This was an observational cross-sectional study. A total of 3,716 volunteers (1,303 males and 2,413 females) aged 40–75 years without CKD from a community in China were included for the study. Depressive symptoms and the presence of a minor or major depressive episode were assessed with the 9-item Patient Health Questionnaire (PHQ-9) and Diagnostic and Statistical Manual of Mental Disorders (4th edition)-based structured interview, respectively. Results: The mean age of the participants in the present study was 53.8 ± 9.0 years. 115 participants had clinically relevant depression, and 122 participants had a minor or major depressive episode. In a multivariable logistic regression analysis adjusted for potential confounders, the association between clinically relevant depression and renal hyperfiltration remained significant in men but not in women. As compared with men without depression (PHQ

The pore characteristics of shale reservoirs in the lower submember of Member 3 to upper submember of Member 4 of Shahejie Formation in Dongying sag are analyzed, influences of mineral content and organic matter content on porosity and pore size are also investigated, and through the diagenetic thermal simulation experiment, the main pore evolution is further discussed. The results show that the pore structure of shale reservoirs is complex, the micron-nanometer pores can storage liquid hydrocarbons, and the free-phase crude oil is mainly distributed in intergranular dissolution pores of calcite, recrystallized intergranular pores, intergranular shrinkage fractures of clay mineral which have large pore size. Framework minerals and organic matter content directly influence porosity and pore size of shale reservoirs, relationship between porosity and content of felsic mineral as well as content of organic matter content is linear and positive, while relationship between content of carbonated mineral is negative. At the buried depth from 2500 to 3500 m, concentration of organic acid from hydrocarbon generation and expulsion of organic matter, increasing range of pressure coefficient, are well corresponding to high-porosity intervals; pore formation in shale oil reservoirs are almost controlled by diagenetic evolution of clay minerals; framework storage spaces formed by carbonate grain crystals as well as intergranular and intergranular dissolution pores of carbonate increases porosity of shale oil reservoirs; local increase of porosity at the depth of 3500–3800 m is mainly caused by coupling of hydrocarbon-generating overpressure and dissolution, and size, distribution and connectivity of pores are enhanced obviously. Keywords: Shale oil, Pore and fracture, Diagenesis, Clay mineral transformation, Dissolution, Recrystallization, Hydrocarbon-generation and acid expulsion, Paleogene, Dongying sag

Abstract Previous observational studies supported a positive association of glycated hemoglobin A1c (HbA1c) level with serum triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). However, the causal relationship between HbA1c and either one of them was unclear in the East Asians. We performed a Mendelian Randomization (MR) analysis in a community-based study sample in Shanghai, China (n = 11,935). To clarify the cause-and-effect relationships of HbA1c with the four interested lipids, an Expanded HbA1c genetic risk score (GRS) with 17 HbA1c-related common variants and a Conservative score by excluding 11 variants were built and adopted as the Instrumental Variables (IVs), respectively. The Expanded HbA1c-GRS was associated with 0.19 unit increment in log-TG (P = 0.009), 0.42 mmol/L TC (P = 0.01), and 0.33 mmol/L LDL-C (P = 0.01); while the Conservative HbA1c-GRS was associated with 0.22 unit in log-TG (P = 0.03), 0.60 mmol/L TC (P = 0.01), and 0.51 mmol/L LDL-C (P = 0.007). No causal relationship was detected for HDL-C. Sensitivity analysis supported the above findings. In conclusions, MR analysis supports a causal role of increased HbA1c level in increment of circulating TG, TC, and LDL-C in a Chinese population.

This study presents an adaptive proportional-integral (PI) and radial basis function neural network proportional-integral-derivative (PID) current control solution for permanent magnet synchronous motor (PMSM) drives. The proposed controller includes four controls: a decoupling term, a PI term, a supervision term, and a radial basis neural network-PID (RBFNN-PID) term. The first control term makes up the nonlinear factors, the second automatically adjusts the control gains, the third guarantees the system stability, and the fourth optimizes the PID parameters to achieve optimal system performance. Unlike off-line tuned PID controllers, the adaptive controller includes an adaptive tuning method for the on-line adjustment of control gain based on the gradient descent strategy. Therefore, it can be adjusted and handle the uncertainty of any system parameters. The program is not only simple and easy to be implemented but also ensures the accuracy and rapidity of the tracking speed. The control system has proven to be asymptotically stable. To verify the theory and application of the algorithm, a comparative experiment between the adaptive PI + RBFNN-PID controller and traditional PI + PID controller was conducted, demonstrating good robustness, which can effectively improve the PMSM. The results confirm that the proposed design achieves excellent control stability (i.e., quicker transient responding and smaller steady state error) in the presence of parametric uncertainty compared to conventional PID methods.

Background: Metabolic syndrome (MetS) is highly related to the excessive accumulation of visceral adipose tissue (VAT). Quantitative measurements of VAT are commonly applied in clinical practice for measurement of metabolic risks; however, it remains largely unknown whether the texture of VAT can evaluate visceral adiposity, stratify MetS and predict surgery-induced weight loss effects. Methods: 675 Chinese adult volunteers and 63 obese patients (with bariatric surgery) were enrolled. Texture features were extracted from VATs of the computed tomography (CT) scans and machine learning was applied to identify significant imaging biomarkers associated with metabolic-related traits. Findings: Combined with sex, ten VAT texture features achieved areas under the curve (AUCs) of 0.872, 0.888, 0.961, and 0.947 for predicting the prevalence of insulin resistance, MetS, central obesity, and visceral obesity, respectively. A novel imaging biomarker, RunEntropy, was identified to be significantly associated with major metabolic outcomes and a 3.5-year follow-up in 338 volunteers demonstrated its long-term effectiveness. More importantly, the preoperative imaging biomarkers yielded high AUCs and accuracies for estimation of surgery responses, including the percentage of excess weight loss (%EWL) (0.867 and 74.6%), postoperative BMI group (0.930 and 76.1%), postoperative insulin resistance (0.947 and 88.9%), and excess visceral fat loss (the proportion of visceral fat reduced over 50%; 0.928 and 84.1%). Interpretation: This study shows that the texture features of VAT have significant clinical implications in evaluating metabolic disorders and predicting surgery-induced weight loss effects. Funding: The complete list of funders can be found in the Acknowledgement section.

Background: The presence of loss-of-heterozygosity (LOH) mutations in cancer cell genomes is commonly encountered. Moreover, the occurrences of LOHs in tumor suppressor genes play important roles in oncogenesis. However, because the causative mechanisms underlying LOH mutations in cancer cells yet remain to be elucidated, enquiry into the nature of these mechanisms based on a comprehensive examination of the characteristics of LOHs in multiple types of cancers has become a necessity. Methods: We performed next-generation sequencing on inter-Alu sequences of five different types of solid tumors and acute myeloid leukemias, employing the AluScan platform which entailed amplification of such sequences using multiple PCR primers based on the consensus sequences of Alu elements; as well as the whole genome sequences of a lung-to-liver metastatic cancer and a primary liver cancer. Paired-end sequencing reads were aligned to the reference human genome to identify major and minor alleles so that the partition of LOH products between homozygous-major vs. homozygous-minor alleles could be determined at single-base resolution. Strict filtering conditions were employed to avoid false positives. Measurements of LOH occurrences in copy number variation (CNV)-neutral regions were obtained through removal of CNV-associated LOHs. Results: We found: (a) average occurrence of copy-neutral LOHs amounting to 6.9 % of heterologous loci in the various cancers; (b) the mainly interstitial nature of the LOHs; and (c) preference for formation of homozygous-major over homozygous-minor, and transitional over transversional, LOHs. Conclusions: The characteristics of the cancer LOHs, observed in both AluScan and whole genome sequencings, point to the formation of LOHs through repair of double-strand breaks by interhomolog recombination, or gene conversion, as the consequence of a defective DNA-damage response, leading to a unified mechanism for generating the mutations required for oncogenesis as well as the progression of cancer cells. [ABSTRACT FROM AUTHOR]

Background: The presence of loss-of-heterozygosity (LOH) mutations in cancer cell genomes is commonly encountered. Moreover, the occurrences of LOHs in tumor suppressor genes play important roles in oncogenesis. However, because the causative mechanisms underlying LOH mutations in cancer cells yet remain to be elucidated, enquiry into the nature of these mechanisms based on a comprehensive examination of the characteristics of LOHs in multiple types of cancers has become a necessity. Methods: We performed next-generation sequencing on inter-Alu sequences of five different types of solid tumors and acute myeloid leukemias, employing the AluScan platform which entailed amplification of such sequences using multiple PCR primers based on the consensus sequences of Alu elements; as well as the whole genome sequences of a lung-to-liver metastatic cancer and a primary liver cancer. Paired-end sequencing reads were aligned to the reference human genome to identify major and minor alleles so that the partition of LOH products between homozygous-major vs. homozygous-minor alleles could be determined at single-base resolution. Strict filtering conditions were employed to avoid false positives. Measurements of LOH occurrences in copy number variation (CNV)-neutral regions were obtained through removal of CNV-associated LOHs. Results: We found: (a) average occurrence of copy-neutral LOHs amounting to 6.9 % of heterologous loci in the various cancers; (b) the mainly interstitial nature of the LOHs; and (c) preference for formation of homozygous-major over homozygous-minor, and transitional over transversional, LOHs. Conclusions: The characteristics of the cancer LOHs, observed in both AluScan and whole genome sequencings, point to the formation of LOHs through repair of double-strand breaks by interhomolog recombination, or gene conversion, as the consequence of a defective DNA-damage response, leading to a unified mechanism for generating the mutations required for oncogenesis as well as the progression of cancer cells. [ABSTRACT FROM AUTHOR]

Obesity is an important risk factor for metabolic syndrome and obstructive sleep apnea (OSA). Bariatric surgery has been shown to effectively reduce weight and obesity-related comorbidities. However, the prevalence and severity of OSA in obese patients with different baseline metabolic states and the improvements of OSA after bariatric surgery remain unknown. The main aims of this study were to ascertain the prevalence of OSA in young Chinese obese patients with different metabolic states and to evaluate their respective OSA remission after laparoscopic sleeve gastrectomy. We first performed a cross-sectional study involving 123 metabolically healthy obese patients and 200 metabolically unhealthy obese patients (who had the same age and BMI ranges) to estimate the prevalence of OSA at baseline. Then we performed a retrospective study, which was registered at ClinicalTrials.gov (ref. NCT02653430) of 67 patients who underwent laparoscopic sleeve gastrectomy to evaluate the remission of OSA. Metabolically healthy and unhealthy obese patients had similar apnea-hypopnea index levels (16.6 ± 22.0 vs. 16.7 ± 18.7 events/h, P = 0.512) and prevalence of OSA (66.7% vs. 69.0%, P = 0.662). Male sex, age, waist circumference and lower liver-to-spleen ratio were independent risk factors for OSA. After laparoscopic sleeve gastrectomy, no difference was found in the decrease in body mass index (BMI) change (10.8 ± 4.8 vs. 10.8 ± 3.0 kg/m2, P = 0.996) or the decrease in the apnea-hypopnea index (18.9 ± 24.6 vs. 17.0 ± 24.0 events/h, P = 0.800). The remission of moderate-to-severe OSA was observed in the MHO (36.3%; 54.5–18.2%, P = 0.125) and MUO (32.2%; 66.1–33.9%, P = 0.001) patients. These results suggest that, in patients with obesity, metabolic syndrome does not add extra risk for the prevalence or severity of OSA. Both metabolically healthy and unhealthy obese patients could benefit equally from laparoscopic sleeve gastrectomy in terms of weight loss and obstructive sleep apnea remission.

Objective We aimed to examine the associations of urinary albumin-to-creatinine ratio (ACR) levels with risks of subclinical atherosclerosis, cardiovascular events and all-cause deaths.Methods Data from a large population-based cohort were used, which included 9580 participants aged ≥40 years free from cardiovascular diseases. Carotid intima–media thickness, brachial-ankle pulse wave velocity and ankle-brachial index were measured at baseline to assess subclinical atherosclerosis. After a median of 4.53 years’ follow-up, 486 cardiovascular events and 230 all-cause deaths were recorded.Results The urinary ACR levels were categorised into three groups. Compared with the normal group (0≤ACR

In quantum-electrodynamics scatterings the transfer of angular momentum between initial and final states can be resolved using the vortex scattering theory, where involved particles are described by quantum vortex states with featured orbital angular momentum (OAM). Here we employ the vortex scattering scenario in bremsstrahlung of a plane-wave electron by describing the final electron and photon in vortex states. We find that, while the total cross-section and angular distribution of the vortex scattering scenario are consistent with those from the ordinary plane-wave scattering, the final states in the former can gain non-negligible OAM values even though the incident electron does not contain any OAM. Moreover, introducing the OAM degree of freedom conserves the total angular momentum in polarized scattering. The dependence of the OAM on the opening angle of the vortex state and the energy ratio of photon to electron are obtained. It is shown that the emitted photon gains higher OAM at larger angles and energy ratios.

Objective The relationship between obesity and albuminuria has not been clarified. This study aimed to investigate the correlation between obesity and the urinary albumin-creatinine ratio (UACR) in Southern and Northern China.Design A descriptive, cross-sectional study.Setting Eight regional centres in REACTION (China’s Risk Evaluation of cAncers in Chinese diabeTic Individuals, a lONgitudinal study), including Dalian, Lanzhou, Zhengzhou, Guangzhou, Guangxi, Luzhou, Shanghai and Wuhan.Participants A total of 41 085 patients who were not diagnosed with chronic kidney disease (CKD) and had good compliance were selected according to the inclusion criteria. Patients who were diagnosed with CKD, who had other kidney diseases that could lead to increased urinary protein excretion, who were using angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers and whose important data were missing were excluded.Results Participants with both, central and peripheral obesity, had a higher risk of elevated UACR, even after adjusting for multiple factors (OR: 1.14, 95% CI: 1.07 to 1.12, p

Background Malignant gliomas are the most common form of primary malignant brain tumor. It has recently been suggested that genetic changes are involved in the progression of malignant gliomas. In previous studies, a novel gene, p42.3, was characterized as a tumor-specific gene that encodes a mitosis phase-dependent expression protein which is expressed in gastric cancer, but not in matched normal tissues. Methods In a series of 200 human brain gliomas and 13 normal tissues, we performed RT-PCR and mRNA in situ hybridization for analysis of p42.3 gene expression in gliomas, including astrocytoma (grade 2), oligoastrocytomas (grade 2), anaplastic oligoastrocytomas (grade 3), glioblastomas (grade 4) and normal tissues. Also, the mRNA expression was detected in gliomas by in situ hybridization. After producing polyclonal antibody to p42.3, we further tested p42.3 protein expression in astrocytomas and glioblastomas by immunohistochemistry and Western blot analysis. Results Our results demonstrated that overexpression of the p42.3 gene is detected in gliomas, but not in normal brain tissues. Importantly, p42.3 mRNA expression is correlated with the pathological features of gliomas. In addition, p42.3 protein is expressed in both the cytoplasm and the nucleus in astrocytomas, whereas this protein appeared in the cytoplasm in glioblastomas. Conclusions These results indicate that p42.3 might be involved in carcinogenesis as a potential molecular marker for malignant gliomas. [ABSTRACT FROM AUTHOR]

Aims: To examine whether electrocardiography (ECG) could provide additional values to the traditional risk factors for cardiovascular disease (CVD) risk prediction among different cardiovascular risk subgroups. Methods: A total of 7,872 community residents aged ≥40 years were followed up for a median of 4.5 years. A 12-lead resting ECG was examined for participants at baseline. CVD events including myocardial infarction, stroke and cardiovascular mortality were collected. Cox proportional hazards models were used and models of traditional risk factors with and without ECG were compared. Results: At baseline, 2,470 participants (31.3%) had ECG abnormalities. During follow-up, 464 participants developed CVD events. ECG abnormalities were associated with an increased risk of CVD after adjustment for the traditional risk factors in participants with a 10-year atherosclerotic CVD (ASCVD) risk ≥10% (hazard ratio, HR: 1.45; 95% confidence interval, CI: 1.11, 1.91). Adding ECG abnormalities to the traditional CVD risk factors improved reclassification for those who did not experience events [net reclassification index: 8.0% (95% CI: 2%, 19.5%)], discrimination (integrated discrimination improvement: 0.7% (95% CI: 0.1%, 1.9%), and calibration (goodness of fit P value from 0.600 to 0.873) in participants with a 10-year ASCVD risk ≥10%. However, no significant association and improvement were found in participants with a 10-year ASCVD risk