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Background Diabetes mellitus is a global public health issue. Cross sectional studies have found that visceral fat is closely related to the prevalence of diabetes mellites, while prospective cohort studies on the trend of onset time of diabetes mellitus and its correlation with Chinese visceral adiposity index (CVAI) are scant. Objective To analyze the trend of onset time of diabetes mellitus and its correlation with CVAI in Pudong New Area, Shanghai, residents by the prospective cohort study, thus providing evidence for the scientific prevention and treatment of diabetes mellitus. Methods This was a prospective cohort study involving 5 236 residents from 12 townships and 35 village committees who participated in the chronic disease risk factor monitoring project in Pudong New Area, from January to July, 2013. Baseline data were collected, including CVAI, visceral adiposity index (VAI), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), a body shape index (ABSI), and body adiposity index (BAI). Follow-up was conducted in 2016 and 2019. By the end of follow-up in October 2019, the incidence of new onset of diabetes mellitus in this cohort was calculated through questionnaire survey, laboratory testing, medical system visit information and vital statistics information system. According to the baseline quartile, the CVAI, VAI, BMI, WC, WHR, WHtR, ABSI, and BAI of the included population were divided into Q1 to Q4 quartiles. The number of cases in CVAI Q1-Q4 groups was 1 306, 1 307, 1 307, and 1 307, respectively. The number of cases in VAI Q1-Q4 groups was 1 300, 1 316, 1 306, and 1 306, respectively. The number of cases in BMI Q1-Q4 groups was 1 305, 1 302, 1 312, and 1 311, respectively. The number of cases in WC Q1-Q4 groups was 1 302, 1 273, 1 287, and 1 367, respectively. The number of cases in WHR Q1-Q4 groups was 1 180, 1 203, 1 332, and 1 514, respectively. The number of cases in WHtR Q1-Q4 groups was 1 199, 1 393, 1 400, and 1 237, respectively. The number of cases in ABSI Q1-Q4 groups was 1 316, 1 302, 1 302, and 1 308 respectively. The number of cases in BAI Q1-Q4 groups was 1 310, 1 304, 1 308, and 1 307, respectively. The multivariable Cox regression analysis was used to analyze the correlation of CVAI and other obesity indicators with the onset of diabetes mellitus. The predictive potential of CVAI and other obesity indicators in diabetes mellitus was assessed using receiver operator characteristic (ROC) curves. Results The incidence density of diabetes mellitus in Pudong New Area was 33.55/1 000 person-years from 2013 to 2016, and 23.25/ 1 000 person-years from 2017 to 2019. With aging, the total incidence density of diabetes mellitus showed an increasing trend (2013-2016: χ2=28.503, Ptrend

Ti(C,N)-HfN/Ti(C,N)-WC laminated ceramics were prepared by alternately making layer method and vacuum hot pressing sintering technology, using Ti(C,N) as the matrix phase, HfN and WC as the reinforced phases for the different layers, and metal Ni and Mo as the binder phases. The effects of sintering temperature on the microstructure and mechanical properties of the laminated ceramics were investigated. The results show that with the increase of sintering temperature, the grains grow up gradually. When the sintering temperature is 1350 ℃ and 1400 ℃, the grains are small but unevenly distributed with many micro-defects. At the sintering temperature of 1450 ℃ and 1500 ℃, the grains are uniform (~1 μm) and there are fewer micro-defects. However, when the sintering temperature reaches 1550 ℃, a large number of coarse grains (~2 μm) appear. Moreover, with the increase of the sintering temperature, the flexural strength, Vickers hardness, and fracture toughness of the laminated ceramics increase first and then decrease. The laminated ceramic sintered at 1450 ℃ shows the better comprehensive mechanical properties, the flexural strength, Vickers hardness, and fracture toughness are (1263.6±17.1) MPa, (18.5±0.3) GPa, and (8.2±0.1) MPa·m1/2, respectively. In addition, the Ti(C,N)-HfN/Ti(C,N)-WC laminated ceramics exhibit the co-existence model of intergranular fracture and transgranular fracture.

TiCN–WC–HfN ceramics were prepared by vacuum hot pressing sintering technology, and the effects of Re contents (molar fraction) on the microstructure and mechanical properties of the ceramics were investigated. The results show that, the TiCN–WC–HfN–Ni–Re ceramics are composed of TiC0.41N0.5, WC, HfN, TiC, Ni and Re, and TiC0.4N0.50 is the solid solution formed between TiC and TiN in the sintering process. Micro-pits and cleavage planes are discovered in the fracture surface of TiCN–WC–HfN ceramics with the different molar fraction of Re. When the molar fraction of Re is 2.5%, there are more micro-pits on the ceramic fractures. When the mole fraction of Re increases from 0 to 3.0%, the Vickers hardness, flexural strength, and fracture toughness of the TiCN–WC–HfN ceramics first increase and then decrease. When the mole fraction of Re is 2.5%, the mechanical properties of the ceramics show the best as the Vickers hardness is (19.25±0.21) GPa, bending strength is (1304±23) MPa, and fracture toughness is (7.73±0.22) MPa∙m1/2. Transgranular fracture and intergranular fracture of the TiCN–WC–HfN–Ni–Re ceramics occur during the fracture process, and the toughening mechanisms are the crack deflection and crack bridging.

ObjectiveTo evaluate the intervention effect of meteorological risk forecasting service on acute onset and medical expenses of chronic obstructive pulmonary disease（COPD） patients， and to provide scientific basis for the establishment of health management model for chronic obstructive pulmonary disease（COPD） patients.MethodsStudy subjects were recruited from chronic obstructive pulmonary patients aged ≥40 in Pudong New Area. Propensity score matching method was used to determine the intervention group and the control group. The control group received regular health education and follow-up management， and the intervention group was provided with meteorological and environmental risk forecasting services through WeChat， mobile phone short message service（SMS）and telephone. Finally， a total of 2 589 subjects were included in the analysis， including 1 300 in the intervention group and 1 289 in the control group. General demographic data， past medical history and family history of COPD， COPD related knowledge and practice survey， COPD related symptom assessment， acute onset， health service utilization and medical expenses before and after intervention were collected through questionnaire survey. The differences of acute attack， health service utilization and related medical expenses between the two groups before and after intervention were compared to evaluate the intervention effect.ResultsIn terms of acute attacks， after intervention， the incidence of acute attacks in the intervention group was lower than that before intervention（χ2=52.901， P0.05）. After intervention， the difference between the control group and the intervention group with different intervention methods was statistically significant （H=11.864， P

Background There is no effective cure for Alzheimer's disease. Early identification of mild cognitive impairment (MCI) and determination of its sensitive warning indicators are current research hotspots. Objective To explore the relationship between taste recognition decline and cognitive function, and to clarify the value of taste recognition decline in early recognition of MCI. Methods From July to August 2022, 30 older adults with MCI were recruited from a Nanjing community by convenience sampling method, and were compared to age-, sex-, and years of education-matched 32 healthy controls. The General Information Questionnaire, the Montreal Cognitive Assessment-Beijing Version (MoCA-Beijing), the Mini-Mental State Examination (MMSE), the Activities of Daily Living (ADL), and the Clinical Dementia Rating (CDR) were used to assess demographics, cognitive function, status of activities of daily living, and severity of dementia, respectively. The taste function was examined by the whole mouth test. Correlation analysis and the receiver operating characteristic (ROC) curve were used to determine the value of taste recognition decline in early warning of MCI. Results Two groups had no significant differences in average age, gender ratio and average years of education (P>0.05), but significantly differed in the average MoCA-Beijing score and MMSE score (P

TiB2-TiC/TiB2-TiN (TC/TN) laminated ceramics were fabricated, and effects of layer thickness ratio (LTR) on their residual stress, microstructure and mechanical properties were investigated. Residual compressive stress (RCS) and residual tensile stress distributed alternately with the alternation of TC and TN; with an increase in the LTR, the RCS decreased. The fracture mode of the ceramic consisted of transgranular fracture and intergranular fracture. Compared with the TN, the TC had less micro-void defects. With the LTR increasing, the fracture mode of the TC or TN was almost unchanged, and the variation of the number of microdefects was small; Vickers hardness (VH) and fracture toughness (FT) declined, while flexural strength (FS) first improved and then declined; at the same LTR, the TC had better VH and FT than the TN. When the LTR was 0.75, this ceramic had better comprehensive mechanical properties: VH of the TC and TN was 20.9 ± 0.2 GPa and 16.3 ± 0.3 GPa, respectively; FT of the TC and TN was 6.5 ± 0.1 MPa·m1/2 and 6.1 ± 0.2 MPa·m1/2, respectively; and FS was 748 ± 12 MPa. For TiB2-based ceramics, this research to a certain extent played a great role on the road of exploration for improving their properties. [ABSTRACT FROM AUTHOR]

In the context of the carbon trading mechanism, this study investigated a multi-visit vehicle routing problem with a truck-drone collaborative delivery model. This issue involves the route of a truck fleet and drones, each truck equipped with a drone, allowing drones to provide services to multiple customers. Considering the carbon emissions during both the truck's travel and the drone's flight, this study established a mixed integer programming model to minimize the sum of fixed costs, transportation costs, and carbon trading costs. A two-stage heuristic algorithm was proposed to solve the problem. The first stage employed a "Scanning and Heuristic Insertion" algorithm to generate an initial feasible solution. In the second stage, an enhanced variable neighborhood search algorithm was designed with problem-specific neighborhood structures and customized search strategies. The effectiveness of the proposed algorithm was validated with numerical experiments. Additionally, this study analyzed the impact of various factors on carbon trading costs, revealing that there exists an optimal combination of drones and trucks. It was also observed that changes in carbon quotas do not affect carbon emissions but do alter the total delivery costs. These results provide insights for logistics enterprise operations management and government policy-making. [ABSTRACT FROM AUTHOR]

Purpose: Social isolation and depression have an impact on cognitive frailty. However, the underlying mechanisms between these variables have not been well defined. This study aims to investigate the mediating role of depressive symptoms in the association between social isolation and cognitive frailty among older adults in China. Methods: From Mar 2023 to Aug 2023, a cross-sectional study was conducted with 496 community-dwelling older adults aged ≥ 60 years in Nanjing, Jiangsu Province, China. Demographic information was collected using the General Information Questionnaire. The Lubben Social Network Scale-6 (LSNS-6), Geriatric Depression Scale 15-item (GDS-15), Montreal Cognitive Assessment (MoCA), Clinical Dementia Rating (CDR), and FRAIL scale were used for the questionnaire survey. Multiple linear regression and binary logistic regression were utilized to explore the associations among social isolation, depressive symptoms, and cognitive frailty, and Bootstrap analysis was used to explore the mediating role of depressive symptoms in social isolation and cognitive frailty. Results: Linear regression results revealed that social isolation was positively associated with depressive symptoms (β = 0.873, p < 0.001). Logistic regression analysis showed that social isolation (OR = 1.769, 95% CI = 1.018~3.075) and depressive symptoms (OR = 1.227, 95% CI = 1.108~1.357) were significantly associated with cognitive frailty. Mediation analysis demonstrated that depressive symptoms significantly mediated the relationship between social isolation and cognitive frailty, with an indirect effect of 0.027 (95% CI = 0.003~0.051), and the mediating effect accounted for 23.6% of the total effect. Conclusion: Social isolation is associated with cognitive frailty in community-dwelling older adults, and depressive symptoms partially mediate the effect between social isolation and cognitive frailty. Active promotion of social integration among older individuals is recommended to enhance their mental health, reduce the incidence of cognitive frailty, and foster active aging. [ABSTRACT FROM AUTHOR]