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Key clinical message Unicentric Castleman disease, particularly the hypervascular variant subtype, commonly presents as a localized lymphadenopathy without systemic symptoms. Surgical excision is often curative for this subtype, leading to a good prognosis. However, some patients with autoimmune complications may require additional systemic therapy along with surgery. Accurate diagnosis through a combination of clinical, radiological, and pathological findings is crucial for optimal management.

The water retention service of the forest ecosystem has ecological functions such as adjusting the climate and maintaining the ecological water balance. The Qinghai-Tibet Plateau is an alpine region. Due to its high altitude and harsh environment, it is difficult to manually observe the water retention in the field, and it is impossible to better evaluate the water retention function. In order to better obtain the water retention in the alpine region, hyperspectral technology is introduced and applied to the acquisition of surface vegetation information, and the water retention in a specific area is obtained by constructing a model. In this study, the Bayi District of Nyingchi Prefecture was used as the research area. The main tree species in the study area are Picea likiangensis var. linzhiensis(PLVL), Quercus aquifolioides(QA), Pinus densata(PD) and Rhododendron nivale(RN). In actual situations, it is not easy to directly obtain water retention information, so a model can be found to quantitatively express the relationship between leaf spectrum and water retention. Then based on the leaf spectrum to invert the water retention. In order to study the quantitative relationship between different vegetation and water retention, each type of vegetation collects leaf samples and water retention data at 30 sampling points. Use ASD Fildsoec Handheld spectrometer to obtain hyperspectral data. Seven band indexes of red edge, green peak, NDVI, NDWI, EVI, WBI and NDPI were selected, and the relationship between vegetation band index and water conservation was fitted through many kinds of regression models. Comparing the fitting results, construct water retention prediction model. The interception of vegetation canopy, litter water holding capacity and soil water content are obtained through experiments. The sum of the three represents the water retention capacity of vegetation. The reflectance spectra of the four types of vegetation leaves all show similar regularities, and the difference in the visible light band is not obvious. The near-infrared to mid-infrared bands show four distinct water absorption bands, with the highest reflectivity in the red to near-infrared bands (700 nm-1400 nm). The reflectance of the four types of vegetation varies across different spectral bands, with the reflectance levels exhibiting the characteristic order of QA > PD > PLVL ≈ RN. Comparing the fitting results of different regression models with seven waveband parameters, the R2 of the four types of vegetation are higher in the regression models of EVI and NDPI, and reach a significant level. According to the regression model corresponding to each kind of vegetation, the water retention prediction model is composed, and the simulation accuracy is tested by R2 and RMSE. The overall simulation accuracy R2 is greater than 0.7 and the RMSE is basically less than 10 t·hm−2, indicating that the forecasting model has a good forecasting effect and the model can effectively estimate the water retention of the forest ecosystem.

Carbon neutrality, achieved by increasing carbon sinks, is an effective strategy for solving the increasingly serious global climate change problem. The continuous exploitation of resources has damaged, the original ecosystem of mining cities leading to poor vegetation growth environment and decreased regional carbon sink capacity. Therefore, it is crucial to restore and enhance the ecological environment of the region and strengthen the carbon sink capacity of vegetation. However, studies on ecological spatial network optimization for mining cities are few. Here, we constructed the ecological spatial network of Xuzhou City, a mining city in China, using a modified minimal cumulative resistance model (MCR). Subsequently, we calculated the topological properties of ecological nodes and ecological spatial network in Xuzhou City by combining complex network theory with ecological network theory and proposed a scheme to optimize the landscape space based on ecological conditions. The functionality of ecological sources was determined by coupling the results of the Functional description of ecological sources by Remote Sensing Index (RSEI) and integral index of connectivity (dIIC). Carbon sinks were estimated by land use and the topological indicators were correlated with carbon sinks. Carbon sinks showed a significant positive correlation with betweenness centricity. We proposed an optimization strategy in accordance with the functionality and carbon sink capacity of ecological sources. Finally, we determined the effect of optimization by the change in robustness and carbon sink. The stability of the optimized ecological spatial network and ecological restoration capacity of Xuzhou City significantly improved, while the carbon sink was simultaneously enhanced. Through national ecological construction projects, restoration and renewal of ecological space can effectively enhance the carbon sink of mining cities, and thus achieve the goal of carbon neutrality. This study provides a theoretical and measure reference for future ecological engineering of mining cities. Additionally, it can also be applied in remote sensing to promote urban development and sustainability.

Enhancing and protecting biodiversity is a prerequisite for achieving “harmony between human beings and nature”. With the disturbance of human activities, the landscape pattern is constantly changing, changing the flow of species, information, and energy within the landscape, which in turn has a significant impact on biodiversity. Therefore, based on the InVEST model, this paper obtained the spatial distribution of biodiversity maintenance function and established a Chinese biodiversity conservation empowerment network through GIS spatial analysis. Based on the complex network theory, the dynamic evolution characteristics of the ecological spatial network structure were analyzed, and the relationship between its topological structure and the conservation of terrestrial biodiversity was revealed. The results show that: biodiversity maintenance function is high in south, southwest, and northeast China and low in the west, and ecological corridors also show a dense distribution in the east and sparse in the west. Over the past 20 years, the average biodiversity maintenance function has grown slowly, and the ecological community of the network has increased, the structure is more stable, and the connectivity is stronger. The weight degree, betweenness centrality, PageRank, and eigenvector centrality were significantly correlated with biodiversity maintenance function, indicating that ecological network structure plays a huge role in maintaining biodiversity. By focusing on building significant correlation sources, and constructing corridors to adjust network connections, the integrity and connectivity of important habitats will be gradually restored, so that ecological land biodiversity function can exert greater ecological benefits.

We study the effects of managerial overconfidence and agency costs on cash holdings of blockchain firms, where the overconfidence is defined as a cognitive bias that a manager will underestimate volatility in an uncertain environment. We develop a real-options game model that incorporates both overconfidence and agency costs. The theoretical results show that future investment opportunities are necessary for holding cash when agency costs are within the firm. Expected returns from blockchain projects decrease with managerial overconfidence. The level of corporate cash holdings increases with overconfidence and decreases with agency costs. Using the data of Chinese listed firms from 2010 to 2019, we find that the regression results are consistent with our theoretical findings. Moreover, we find that the blockchain firms’ cash holdings are higher than their peers. Our results shed some light on the impacts of behavioral characteristics on cash holdings.

In order to clearly show the influence on the rotating stall of the impeller of a double-suction centrifugal pump, this paper, using the numerical simulation method of Shear Stress Transform (SST), analyzes the effects of different inlet angles of the blade on hydraulic performance, internal flow field and pressure pulsation in the impeller. The results show that the small angle of attack of the blade inlet scheme can effectively suppress the impeller rotation stall and that the design point head and efficiency are increased by 6.4% and 5.7% respectively. This paper, using turbulence intensity to determine the generation of rotating stall, proposed that the average of turbulence intensity exceeding 2% is a necessary condition for the generation of rotating stall and discovered that the standard deviation of the big angle of attack of the scheme is always greater than that of the small angle being analyzed by the impeller pressure pulsation. The basic critical frequencies of blade inlet pressure pulsation with components of a low frequency is dominated by the impeller rotating frequency F0 and its harmonic frequencies 2F0, and 3F0, but the basic critical frequencies of blade outlet pressure pulsation is governed by Blade Passing Frequency (BPF). The research results can provide some theoretical support for stall research and hydraulic performance optimization of a double-suction pump.

(1) Background: Eco−spatial networks play an important role in enhancing ecosystem services and landscape connectivity. It is necessary to study landscape structure optimization to achieve synergistic gains in network connectivity and ecosystem functionality. (2) Method: Based on remote sensing data, RS and GIS were used to evaluate the spatiotemporal changes in ecosystem services in China. Combined with complex network theory, the spatiotemporal evolution of China’s ecological spatial network and its topological structure from 2005 to 2020 is discussed. Network function–structure co−optimization was carried out using the edge augmentation strategy. (3) Result: The “three River resource” has high water conservation and high soil and water conservation in southeastern hilly areas. There is strong windbreak and sand fixation in southeastern Inner Mongolia. In the past 15 years, there have been about 8200 sources and about 14,000 corridors. The network has the characteristics of small−world and heterogeneity. After optimization, 18 sources and 3180 corridors are added, and the network connectivity and robustness are stronger. Finally, five regions are divided according to the network heterogeneity and corresponding protection and management countermeasures are proposed to provide scientific guidance for the country’s territorial space planning.

Forest and grass ecological space is the key component of the ecosystem and plays a vital role in regulating the carbon, water, and energy cycle. The long-term exploitation of forest and grass ecological space and huge population pressure have gradually degraded the function of China’s ecosystem. Therefore, forest and grass ecological space plays an important role in maintaining the stability of the ecosystem. The relationship between forest and grass ecospatial network structure and ecosystem service has been the focus of research. In this study, the forest and grass ecospatial network is constructed based on the minimum cumulative resistance (MCR) model. Then, the topological indicators (degree, weight clustering coefficient, node weight, unit weight, weight distribution difference, betweenness, PageRank) of the forest and grass ecospatial network were calculated by combining the complex network theory to analyze the relationship between these topological indicators and the three ecosystems (water retention, soil conservation, carbon storage). Based on the ecological significance of topological indicators, we identified ecologically fragile areas and proposed areas and directions for optimizing the ecospatial structure. Results show that the spatial distribution of the three ecosystem services in the southeast region of China is higher than that in the northwest region of China and shows a gradual decrease from the east to the west. The degree, node weight, unit weight, PageRank, and betweenness were highly significant and positively correlated with the three ecosystem services, among which PageRank had the highest correlation with water retention (p < 0.01, R2 = 0.835). Based on the spatial distribution characteristics of the different topological indicators, the quantitative relationship between the structural characteristics of the forest and grass ecospatial network and ecosystem services is clarified, revealing the intrinsic connection between ecological processes and ecosystem services. Through rational optimization of the forest and grass ecospatial network, ecosystem services can be effectively improved and ecosystem stability can be enhanced.

The continuous extraction of mining resources has led to the destruction of landscape space, which has had a great impact on the human living environment and pristine ecosystems. Optimizing the ecological spatial networks of mining areas can restore and enhance the damaged ecological environment. However, there are few cases of ecological spatial network optimization in mining areas, and there are still some shortcomings. Therefore, in this study, we propose an ecological spatial network theory and a synergistic enhancement of ecological functions and carbon sink optimization model (SEEC) for urban restoration in mining areas, emphasizing the functional and carbon sink nature of ecological sources. We selected a typical mining area in Xuzhou City as the study area, explored the changes in the nature and function of the ecological spatial network from 2000 to 2020, and selected the ecological spatial network in the mining area of Xuzhou City in 2020 as the optimization study case, adding 27 ecological stepping stones and 72 ecological corridors. Through the comparison of robustness before and after optimization, we found that the optimized ecological spatial network has a stronger stability and ecological restoration ability. This study provides strategies and methods for ecological restoration projects in national mining cities and also provides references and lessons for ecological restoration in other mining areas in the future.

In the context of strengthening the construction of ecological civilization and accelerating the “carbon peak” in China, the regional ecological pattern and its connection with carbon sink capacity have become an urgent topic. Given that Inner Mongolia is a large carbon emission province and the conflict between economic development and ecological protection is particularly prominent, we took Inner Mongolia as an example to extract its ecospatial network, then calculated the integrity index, topological indices, and recovery robustness of the network and evaluated integrity and other properties of the ecospatial network structure by combining them with the ecological background. In addition, we analyzed the relationship between the topological indices and net primary productivity (NPP). The results showed that the network was scale-free and heterogeneous, with low integrity, connectivity and stability, which were the focus of future optimization. The nodes with important functions were mainly distributed in the farm-forest ecotone, grasslands, and the agro-pastoral ecotone; under the simulation attack, the node recovery robustness was stronger than the corridor recovery robustness, and NPP was negatively and significantly correlated with the woodland nodes and grassland nodes. In terms of ecological restoration, the unused land in the west is a key area, and it is necessary to add new ecological nodes and corridors. In terms of enhancing carbon sequestration capacity, under the premise of ensuring network connectivity, the appropriate and rational merging of ecological nodes and corridors within woodlands and grasslands is a particularly effective means. This study provides a reference for evaluating and optimizing the ecological pattern of areas with prominent ecological problems and improving the carbon sink of ecosystems in terms of their ecospatial network structure.

In arid and semi-arid regions, vegetation restoration will have a significant impact on ecosystem services (ESs). Accurate assessment of the relationship and driving mechanism between ESs will play an important role in the implementation of subsequent vegetation restoration projects and ecosystem management. The purpose of this study is to evaluate and identify the relationship between ESs, and explore the impact and driving mechanism of ecological restoration on the relationship between ESs. Taking the middle reaches of the Yellow River as the study area, this study analyzed three ESs including: Net Primary Productivity (NPP), soil conservation (SC), and water yield (WY), in the vegetation restoration area (VRA) in the middle reaches of the Yellow River for 20 years (2000–2010 and 2010–2020 years(a)). Taking the ecological restoration unit (ERU) as the evaluation unit, we evaluated the impact of three vegetation restoration models on ESs. Using geo-detectors to identify the economic, social and natural drivers that affect the relationship between ESS. The results showed the following: (1) Different vegetation restoration models will lead to significant differences in the restoration rate for ESs. They will lead to an increase in the recovery rate of NPP and SC. The first vegetation restoration mode and the third planting restoration mode will reduce the restoration rate for the WY. (2) The three vegetation restoration models will enhance the synergistic relationship between NPP and SC. They will weaken the trade-off relationship between NPP and WY, SC and WY. (3) Temperature, precipitation, and NDVI will affect the changes in ESs in VRAs. The ESs trade-off-synergy relationship will be affected by precipitation, NDVI, and GDP. This study showed that, with the implementation of vegetation restoration projects, ESs in time and space and the complex heterogeneity of ESs will affect ecosystem management. The results of this study will be helpful for the implementation of subsequent vegetation restoration projects and provide scientific advice for ecosystem management.

Nur Adilah Shuhada Abd Aziz, Nur Islami Mohd Fahmi Teng, Mohd Ramadan Abdul Hamid, Nazrul Hadi Ismail Department of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia Purpose: The increasing number of elderly people worldwide throughout the years is concerning due to the health problems often faced by this population. This review aims to summarize the nutritional status among hospitalized elderly and the role of the nutritional assessment tools in this issue.Methods: A literature search was performed on six databases using the terms “malnutrition”, “hospitalised elderly”, “nutritional assessment”, “Mini Nutritional Assessment (MNA)”, “Geriatric Nutrition Risk Index (GNRI)”, and “Subjective Global Assessment (SGA)”.Results: According to the previous studies, the prevalence of malnutrition among hospitalized elderly shows an increasing trend not only locally but also across the world. Under-recognition of malnutrition causes the number of malnourished hospitalized elderly to remain high throughout the years. Thus, the development of nutritional screening and assessment tools has been widely studied, and these tools are readily available nowadays. SGA, MNA, and GNRI are the nutritional assessment tools developed specifically for the elderly and are well validated in most countries. However, to date, there is no single tool that can be considered as the universal gold standard for the diagnosis of nutritional status in hospitalized patients.Conclusion: It is important to identify which nutritional assessment tool is suitable to be used in this group to ensure that a structured assessment and documentation of nutritional status can be established. An early and accurate identification of the appropriate treatment of malnutrition can be done as soon as possible, and thus, the malnutrition rate among this group can be minimized in the future. Keywords: malnutrition in elderly, nutritional assessment, MNA, GNRI, SGA

The water cycle in the key agricultural and pastoral zones (KAPZs) is an important factor for maintaining the stability of the ecosystem. Groundwater collection and lateral seepage are indispensable parts of the water cycle, and it is difficult to monitor the groundwater situation in each area. The strength of the alternate circulation of groundwater is directly related to the utilization value and development prospects of groundwater; therefore, creating an effective method for the detection of groundwater burial depth has become an issue of increasing concern. In this paper, we attempt to create a method for the detection of groundwater burial depth that combines cokriging interpolation, spatial autocorrelation, geographically weighted regression, and other methods to construct a quantitative relationship between different land cover types and groundwater depth. By calculating the band index of the land cover type, the groundwater depthinformation of the unknown area can be obtained more accurately. Through collaborative kriging interpolation, normalized difference vegetation index (NDVI), precipitation, and hydrogeological conditions were used as covariates. The groundwater burial depth of Wengniute Banner in 2005, 2009, 2013, and 2017 was the response variable, and the groundwater burial depth in the study area was calculated. The groundwater burial depth data after the cokriging interpolation was used to transform the raster data into vector data in space using the improved hydrological response unit (HRU) model to make it more suitable for the actual groundwater confluence. Subsequently, 551 minimum response units (MHRUs) were obtained by division, and the spatial autocorrelation analysis was performed accordingly. The groundwater burial depth in the study area is spatially distinct from east to west, and the groundwater level shows a trend of being high in the west and low in the east, gradually increasing due to precipitation and rivers. The average change of groundwater depth in the time series is not significant, but it does gradually show a trend of accumulation. According to the aggregation characteristics of spatial autocorrelation analysis, a geographically weighted regression model of groundwater depth and NDVI, normalized difference drought index (NDDI), and net relatedness index (NRI) was established. The NDVI representing the forest land and the Adjusted R2 of the groundwater depth is 0.67. The NRI representing the cultivated land and the Adjusted R2 of the groundwater depth is 0.8675. The NDDI representing the bare land and the Adjusted R2 of the groundwater depth is 0.7875. It shows that the band index representing the ground type has a good fitting effect with the groundwater burial depth.

The Beijing government initiated the Clean Air Action Plan (CAAP) in 2013. Through a series of actions to control air pollution, the emissions of major atmospheric pollutants are reduced to improve urban air quality. In order to evaluate the effectiveness of control measures taken to mitigate atmospheric pollution, we investigated and analyzed the implementation of the CAAP in Beijing from 2013 to 2017, estimating the corresponding reduction in emissions of major air pollutants. The contribution of different control measures to the improvement of air quality was quantified and the experiences of managing air pollution were summarized, which provided references for the continuous improvement of air quality in Beijing and the surrounding areas. The results showed that the emission of SO2, NOX, PM10, PM2.5, and VOCs from air pollution source have been decreased by 119,924, 116,091, 116,810, 46,652, and 97,267 tons after the implementation of the CAAP. The sum of these five air pollutants emissions have been reduced by 39% in 2017 compared with 2013, the largest decrease in SO2 emissions was 87%, which was related to the vigorous control on coal-fired combustion. The control measure with the greatest contribution to decreasing the ambient PM2.5 concentration was the clean energy transformation of coal-fired power plants, which contributed 27% of the total reduced concentration and 6.1 μg/m3 of the average PM2.5 concentration reduction in Beijing. Clean Residential coal use also significantly decreased the PM2.5 concentration by 5.4 μg/m3, which was 23% of the total reduction. In addition, the industrial restructuring and the management of automotive vehicle use and dust could also contribute to efficiently reducing the PM2.5 concentration by 4.0, 3.2, and 2.3 μg/m3, or 17%, 14%, and 10% of the total reduction, respectively. Due to the implementation of control measures of Clean Air Action Plan, the energy and industrial structure of Beijing have been adjusted and optimized, leading to the reduction of pollutant emissions, which is the secret of urban long-term air quality improvement.

Mohamad Hasnan Ahmad,1 Suzana Shahar,2 Nur Islami Mohd Fahmi Teng,2 Zahara Abdul Manaf,2 Noor Ibrahim Mohd Sakian,3 Baharudin Omar41Centre of Nutrition Epidemiology Research, Institute of Public Health, Ministry of Health, Kuala Lumpur, Malaysia; 2Dietetics Program, 3Occupational Therapy Program, 4Department of Biomedical Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Abstract: This study aimed to determine the factors associated with exercise behavior based on the theory of planned behavior (TPB) among the sarcopenic elderly people in Cheras, Kuala ­Lumpur. A total of 65 subjects with mean ages of 67.5±5.2 (men) and 66.1±5.1 (women) years participated in this study. Subjects were divided into two groups: 1) exercise group (n=34; 25 men, nine women); and 2) the control group (n=31; 22 men, nine women). Structural equation modeling, based on TPB components, was applied to determine specific factors that most contribute to and predict actual behavior toward exercise. Based on the TPB’s model, attitude (ß=0.60) and perceived behavioral control (ß=0.24) were the major predictors of intention to exercise among men at the baseline. Among women, the subjective norm (ß=0.82) was the major predictor of intention to perform the exercise at the baseline. After 12 weeks, attitude (men’s, ß=0.68; women’s, ß=0.24) and subjective norm (men’s, ß=0.12; women’s, ß=0.87) were the predictors of the intention to perform the exercise. “Feels healthier with exercise” was the specific factor to improve the intention to perform and to maintain exercise behavior in men (ß=0.36) and women (ß=0.49). “Not motivated to perform exercise” was the main barrier among men’s intention to exercise. The intention to perform the exercise was able to predict actual behavior regarding exercise at the baseline and at 12 weeks of an intervention program. As a conclusion, TPB is a useful model to determine and to predict maintenance of exercise in the sarcopenic elderly.Keywords: theory planned behavior, aging, elderly, sarcopenic, exercise

In the title compound, C25H25NO2, the phenyl ring on the 1,3-oxazole ring is disordered over two positions with occupancies of 0.600 (4) and 0.400 (4). The interplanar angle between these two disordered rings is 77.8 (2)°. There is an intramolecular O—H...N hydrogen bond of moderate strength. In the crystal, C—H...π interactions interconnect neighbouring molecules. The absolute structure has been derived from the known absolute structure of the reagents.

Abstract Background Breeding programs for the water lotus (Nelumbo nucifera) are hampered by an inability to account for variation in seed set associated with crosses between different cultivars. We studied seed set in two reciprocal crosses between lotus cultivars (‘Guili’ × ‘Aijiangnan’ and ‘Molingqiuse’ × ‘Qinhuaiyanzhi') to obtain insights into factors that govern fecundity in these experimental hybrids. Pollen viability, stigma receptivity and embryo development were compared for each hybrid and reciprocal cross. Results Pollen viability of the individual cultivars ranged from 4.1% to 20.2%, with the highest level (>11.9%) for all cultivars observed from the earliest collected grains (05:00–06:00 a.m.). Stigmatic pollen germination peaked at 4 h after pollination and varied from 4.8 to 60.6 grains per stigma among the crosses. Production of normal embryos ranged from 7.6% to 58.8% at 1 d after pollination and from 0 to 25% by 11 d after pollination. Seed set in crosses (0.2–23.3%) was generally lower than in open-pollinated plants (8.4–26.5%). Similar to the germination results, seed set was substantially reduced in both reciprocal crosses. Conclusions These results suggested that poor pollen fertility, low stigma receptivity, and embryo abortion were responsible for the failure of the crosses ‘Molingqiuse’ × ‘Qinhuaiyanzhi’, ‘Qinhuaiyanzhi’ × ‘Molingqiuse’, and ‘Aijiangnan’ × ‘Guili’.

Abstract Background The leaf is an important plant organ, and how it will respond to future global warming is a question that remains unanswered. The effects of experimental warming on leaf photosynthesis and respiration acclimation has been well studied so far, but relatively little information exists on the structural and biochemical responses to warming. However, such information is very important to better understand the plant responses to global warming. Therefore, we grew Arabidopsis thaliana at the three day/night temperatures of 23/18°C (ambient temperature), 25.5/20.5°C (elevated by 2.5°C) and 28/23°C (elevated by 5°C) to simulate the middle and the upper projected warming expected within the 21st century for this purpose. Results The 28/23°C treatment significantly reduced the life span, total biomass and total weight of seeds compared with the other two temperatures. Among the three temperature regimes, the concentrations of starch, chlorophyll, and proline were the lowest at 28/23°C, whereas the total weight of seeds, concentrations of chlorophyll and proline, stomatal density (SD), stomatal conductance (gs), net CO2 assimilation rate (A) and transpiration rate (E) were the highest at 25.5/20.5°C. Furthermore, the number of chloroplasts per cell and mitochondrial size were highest at 25.5/20.5°C and lowest at 28/23°C. Conclusions The conditions whereby the temperature was increased by 2.5°C were advantageous for Arabidopsis. However, a rise of 5°C produced negative effects, suggesting that lower levels of warming may benefit plants, especially those which belong to the same functional group as Arabidopsis, whereas higher levels of warming may produce negative affects. In addition, the increase in A under moderately warm conditions may be attributed to the increase in SD, chlorophyll content, and number of chloroplasts. Furthermore, starch accumulation in chloroplasts may be the main factor influencing chloroplast ultrastructure, and elevated temperature regulates plant respiration by probably affecting mitochondrial size. Finally, high SOD and CAT activities may enable plants grown at elevated temperatures to exhibit relatively high tolerance to temperature stress, thus alleviating the harmful effects of superoxide anion radicals and hydrogen peroxide.

Background/Objectives: Nutritional status significantly influences cardiac surgery outcomes, with malnutrition contributing to poorer results and increased complications. This study addresses the critical gap in understanding by exploring the relationship between pre-operative nutritional status and post-operative cognitive dysfunction (POCD) in adult cardiac patients. Methods : A comprehensive search across key databases investigates the prevalence of malnutrition in pre-operative cardiac surgery patients, its effects, and its association with POCD. Factors exacerbating malnutrition, such as chronic illnesses and reduced functionality, are considered. The study also examines the incidence of POCD, its primary association with CABG procedures, and the impact of malnutrition on complications like inflammation, pulmonary and cardiac failure, and renal injury. Discussions : Findings reveal that 46.4% of pre-operative cardiac surgery patients experience malnutrition, linked to chronic illnesses and reduced functionality. Malnutrition significantly contributes to inflammation and complications, including POCD, with an incidence ranging from 15 to 50%. CABG procedures are particularly associated with POCD, and malnutrition prolongs intensive care stays while increasing vulnerability to surgical stress. Conclusions : The review underscores the crucial role of nutrition in recovery and advocates for a universally recognized nutrition assessment tool tailored to diverse cardiac surgery patients. Emphasizing pre-operative enhanced nutrition as a potential strategy to mitigate inflammation and improve cognitive function, the review highlights the need for integrating nutrition screening into clinical practice to optimize outcomes for high-risk cardiac surgery patients. However, to date, most data came from observational studies; hence, there is a need for future interventional studies to test the hypothesis that pre-operative enhanced nutrition can mitigate inflammation and improve cognitive function in this patient population.

The present study aimed to determine the association between chrononutrition behaviors, sugar-sweetened beverage intake, and sleep quality among Malaysian women. A cross-sectional study using a validated, self-administered Chrononutrition Profile Questionnaire, Beverage Questionnaire and Sleep Quality Index were conducted among 934 Malaysian women. Multinomial logistic regression was performed to obtain odds ratios of being overweight/underweight and to test the association with poor sleep quality. 40% of Malaysian women were either overweight or obese and 65.4% had poor sleep quality. We found that breakfast skipping (OR: 4.101; CI: 2.378-7.070), poor evening eating (OR: 4.073; CI: 1.631-10.186), and eating the largest meal at night (OR: 6.970; CI: 1.944-24.994) increased the odds of being underweight. On the other hand, the daily consumption of 100% fruit juices (OR: 1.668; CI: 1.058-1.731), daily consumption of sweetened coffee or tea (OR: 1.707; CI: 1.162-2.508) and consumption of diet soft drinks by 6 times or fewer (OR: 1.484; CI: 1.066-2.064) are associated with increased odds of being overweight. However, when adjusted, only poor evening latency (AOR: 16.638; CI: 1.986-139.383) revealed an increased odd of being underweight. The highest odds predicting poor sleep quality were found for eating the largest meal during dinner (OR: 3.696; CI: 1.967-6.945) and (AOR: 2.194; CI: 1.119-4.304) when adjusted. Hence, the result indicates that multifactorial impacts on women's body weight and recommendations to adjust chrononutrition and sugar-sweetened beverages intake in lifestyle must be done carefully considering other parameters together.

The circadian system in the human body responds to daily environmental changes to optimise behaviour according to the biological clock and also influences various physiological processes. The suprachiasmatic nuclei are located in the anterior hypothalamus of the brain, and they synchronise to the 24 h light/dark cycle. Human physiological functions are highly dependent on the regulation of the internal circadian clock. Skeletal muscles comprise the largest collection of peripheral clocks in the human body. Both central and peripheral clocks regulate the interaction between the musculoskeletal system and energy metabolism. The skeletal muscle circadian clock plays a vital role in lipid and glucose metabolism. The pathogenesis of osteoporosis is related to an alteration in the circadian rhythm. In the present review, we discuss the disturbance of the circadian rhythm and its resultant effect on the musculoskeletal system. We also discuss the nutritional strategies that are potentially effective in maintaining the system's homeostasis. Active collaborations between nutritionists and physiologists in the field of chronobiological and chrononutrition will further clarify these interactions. This review may be necessary for successful interventions in reducing morbidity and mortality resulting from musculoskeletal disturbances.

Postoperative cognitive dysfunction (POCD) is cognitive decline after surgery. The authors hypothesized that gene-level changes could be involved in the pathogenesis of POCD. The present study evaluated the incidence of POCD and its associated differentially expressed genes. This was a prospective cohort study conducted on high-risk coronary artery bypass graft patients aged 40 to 75 years. POCD classification was based on a one standard deviation decline in the postoperative scores compared to the preoperative scores. The differentially expressed genes were identified using microarray analysis and validated using quantitative RT-PCR. Forty-six patients were recruited and completed the study. The incidence of POCD was identified using a set of neurocognitive assessments and found to be at 17% in these high-risk CABG patients. Six samples were selected for the gene expression analyses (3 non-POCD and 3 POCD samples). The findings showed five differentially expressed genes in the POCD group compared to the non-POCD group. The upregulated gene was ERFE, whereas the downregulated genes were KIR2DS2, KIR2DS3, KIR3DL2, and LIM2. According to the results, the gene expression profiles of POCD can be used to find potential proteins for POCD diagnostic and predictive biomarkers. Understanding the molecular mechanism of POCD development will further lead to early detection and intervention to reduce the severity of POCD, and hence, reduce the mortality and morbidity rate due to the condition.

Background: Maternal depression may affect child feeding practices and growth., Objective: The objective of this study is to determine the relationship between child feeding practices and current maternal depression with malnutrition among young children in a rural community., Methods: This is a case-control study consisting of 52 Malay mothers of malnourished children (case) and 50 Malay mothers of well-nourished children (control) in Kuala Langat, Selangor, Malaysia. Structured questionnaires on child feeding practices and Beck Depression Inventory: Second Edition questionnaire were distributed to mothers., Results: Depressed mothers stopped exclusive breastfeeding (2.8 ± 2.1 months) earlier than non-depressed mothers (3.7 ± 2.0 months; p = 0.045). Binary logistic regression analysis showed current maternal depression was a primary contributor associated with risk of malnutrition in children (adjusted odds ratio: 2.5, 95% confidence interval: 1.08-6.09), and followed by the number of children (adjusted odds ratio: 1.3, 95% confidence interval: 1.02-1.77)., Conclusion: Mothers who experienced depression were twice as likely to have malnourished children. Each additional child in the family will increase the risk of malnutrition by 1.3 times. Maternal depression is associated with child feeding practices and malnutrition among young children in the studied population. Preliminary screening to identify depression symptoms should be conducted to all mothers as early as the first trimester to prevent the incidence of malnutrition in children.

Background: Chrononutrition studies how biological rhythms and nutrition are associated with human health. However, a validated assessment in Malaysia is still absent., Objectives: To create a translation of the Chrononutrition Profile Questionnaire (CPQ), test its validity and reliability, and determine the general chrononutrition behaviors among Malaysian young adults., Methods: The Malay-CPQ was distributed to respondents through online platforms ( n = 110), and data analyses were performed. The data were analyzed for their validity using content validity index (CVI) and face validity index (FVI), whereas intraclass correlation coefficient (ICC) was used to determine test-retest reliability., Results: Our results showed both CVI and FVI of Malay-CPQ were 1, indicating excellent content translation, while the ICC values ranged from moderate to good (0.50-0.90). The Cronbach α values for all items ranged from moderate to good (0.50-0.90), and the Bland-Altman analysis showed a P value >0.05, indicating agreement of the item between repeated measurements. The chrononutrition behaviors among Malaysian young adults presented fair to good scores for all behavior patterns: eating window, breakfast skipping, evening eating, night eating, and largest meal, except evening latency, being mostly at the poor score (>80% responses)., Conclusions: The Malay-CPQ is a valid and reliable tool to assess the Malaysian chrononutrition profile. However, further testing on Malay-CPQ should be conducted in a different setting in Malaysia for cross-validation studies., (© 2023 Published by Elsevier Inc. on behalf of American Society for Nutrition.)

Background: The recent pandemic of COVID-19 has had a tremendous impact on healthcare frontliners. This study sought to assess healthcare shift workers' depression, anxiety, and stress and its associated factors., Methods: The sampling frame includes healthcare shift workers directly managing COVID-19 cases around Klang Valley, Malaysia. The participants' mental health status was assessed using the Depression, Anxiety, Stress Scale-21 (DASS-21). The associated factors specified in this study include sleep quality, physical activities, and eating habits. Pearson's χ 2 and simple and multivariable binary logistic regression models were constructed following the Hosmer-Lemeshow approach to determine the potential associated factors., Results: A total of 413 participants were recruited. Overall, 40.7% of participants had one or more symptoms of depression, anxiety, or stress. Poor sleep quality was significantly associated with all mental health outcomes of depression, anxiety, and stress. Inactivity was found to be strongly associated with symptoms of depression and anxiety. At the same time, eating habits were strongly associated with anxiety and stress., Conclusions: Sleep quality, inactivity, and eating habits that were found to be associated with the mental health status of healthcare shift workers are modifiable factors that must be addressed to curb mental health issues among this group of workers.

In several regions of the world, the recent Coronavirus Disease-2019 (COVID-19) pandemic outbreak increased morbidity and mortality. The pandemic situation disrupted many workers' previously established lifestyles. The main aim of the present review was to describe the circadian disruption and occupational toxicant exposure affecting the immunity of shift workers during the SARS CoV-2 pandemic. We retrieved pertinent published literature from the Google Scholar, PubMed, and Scopus databases. In the present review, we discuss the circadian rhythm involving the hypothalamic-pituitary-adrenal (HPA) axis at the molecular level, its disruption, occupational toxicant exposure causing immunomodulatory effects, and the role of immunity during the SARS CoV-2 pandemic. The severity of the progression of the viral infection depends on multiple factors affecting immunity. Hence, shift workers may need to be aware of those factors such as circadian rhythm disruption as well as occupational toxicant exposure. The timing of shift workers' energy intake is also important concerning the shift of the workers. The information in the present review may be important for all workers who are at risk during the pandemic. In the absence of any published literature related to association of circadian rhythm disruption with occupational toxicant exposure, the present review may have greater importance., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Mohd Fuad, Juliana, Mohd Azmi, Mohd Fahmi Teng, Azmani, Abu and Das.)

Cardiothoracic surgeries are life-saving procedures but often it results in various complications. Intraoperative cerebral oximetry monitoring used to detect regional cerebral oxygen saturation (rScO2) is a non-invasive method that provides prognostic importance in cardiac surgery. The main aim of the present study was to evaluate the association of intraoperative cerebral oxygen monitoring during cardiac surgery on postoperative complications. This was a case-controlled retrospective study conducted on adult patients, who underwent open-heart surgery in National Heart Institute, Malaysia. The case group comprised patients on protocolized cerebral oximetry monitoring. They were treated using a standardized algorithm to maintain rScO2 not lower than 20% of baseline rScO2. The control group comprised patients with matched demographic background, preoperative risk factors, and type of surgical procedures. Propensity score stratification was utilized to contend with selection bias. Retrospective analysis was performed on 240 patients (case group) while comparing it to 407 patients (control group). The non-availability of cerebral oximetry monitoring during surgery was the prominent predictor for all outcome of complications; stroke (OR: 7.66), renal failure needing dialysis (OR: 5.12) and mortality (OR: 20.51). Postoperative complications revealed that there were significant differences for risk of mortality (p<0.001, OR = 20.51), renal failure that required dialysis (p<0.001, OR = 5.12) and stroke (p <0.05, OR = 7.66). Protocolized cerebral oximetry monitoring during cardiothoracic surgeries was found to be associated with lower incidence of stroke, renal failure requiring dialysis and mortality rate., Competing Interests: The authors have declared that no competing interests exist.

The synthesis and secretion of cortisol are controlled by the hypothalamic-pituitary-adrenal axis. Cortisol exhibits a proper 24-h circadian rhythm that affects the brain, the autonomic nervous system, the heart, and the vasculature that prepares the cardiovascular system for optimal function during these anticipated behavioral cycles. A literature search was conducted using databases such as Google Scholar, PubMed, and Scopus. Relevant search terms included "circadian rhythm and cardiovascular", "cortisol", "cortisol and acute coronary syndrome", "cortisol and arrhythmias", "cortisol and sudden cardiac death", "cortisol and stroke", and "cardioprotective agents". A total of 120 articles were obtained on the basis of the above search. Lower levels of cortisol were seen at the beginning of sleep, while there was a rise towards the end of sleep, with the highest level reached at the moment the individual wakes up. In the present review, we discuss the role of 11β-hydroxysteroid dehydrogenase (11β-HSD1), which is a novel molecular target of interest for treating metabolic syndrome and type-2 diabetes mellitus. 11β-HSD1 is the major determinant of cortisol excess, and its inhibition alleviates metabolic abnormalities. The present review highlights the role of cortisol, which controls the circadian rhythm, and describes its effect on the cardiovascular system. The review provides a platform for future potential cardioprotective therapeutic agents.

The workers and employees in various institutions are subjected to different shifts and work schedules. The employees work not only at daytime but also during odd hours at night. The biological clock of an individual is often altered during night shifts. This affects the psychosocial well-being and circadian nutritional intake of the worker. Disturbance in circadian rhythm results in the development of metabolic disorders such as hypertension, dyslipidemia, dysglycemia, and abdominal obesity. In the present review, we discuss the nature of shift work, sleep/wake cycle of an individual, chrononutrition, dietary habits, and meal changes with regard to timing and frequency, related to shift work. We also discuss the relationship between nutritional intake and psychosocial well-being among shift workers. The review may be beneficial for prevention of metabolic disorders and maintaining sound psychological condition in shift workers.

Background & Aims: Malnutrition is common among hospitalized elderly patients, and the prevalence is increasing not only in Malaysia but also in the rest of the world. The Geriatric Nutrition Risk Index (GNRI) and the Mini Nutritional Assessment (MNA) were developed to identify malnourished individuals among this group. The MNA was validated as a nutritional assessment tool for the elderly. The GNRI is simpler and more efficient than the MNA, but studies on the use of the GNRI and its validity among the Malaysian population are absent. This study aimed to determine the prevalence of malnourished hospitalized elderly patients and assess the criterion validity of the GNRI and MNA among the geriatric Malaysian population against the reference standard for malnutrition, the Subjective Global Assessment (SGA), and determine whether the optimal cutoff value of the GNRI is suitable for the Malaysian population and determine the optimal tool for use in this population., Methods: A cross-sectional study was conducted among 134 geriatric patients with a mean age of 68.9 ± 8.4 who stayed at acute care wards in Hospital Tuanku Ampuan Rahimah, Klang from July 2017 to August 2017. The SGA, MNA, and GNRI were administered through face-to-face interviews with all the participants who gave their consent. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the GNRI and MNA were analyzed against the SGA. Receiver-operating characteristic (ROC) curve analysis was used to obtain the area under the curve (AUC) and suitable optimal cutoff values for both the GNRI and MNA., Results: According to the SGA, MNA, and GNRI, 26.9%, 42.5%, and 44.0% of the participants were malnourished, respectively. The sensitivity, specificity, PPV, and NPV for the GNRI were 0.622, 0.977, 0.982, and 0.558, respectively, while those for the MNA were 0.611, 0.909, 0.932, and 0.533, respectively. The AUC of the GNRI was comparable to that of the MNA (0.831 and 0.898, respectively). Moreover, the optimal malnutrition cutoff value for the GNRI was 94.95., Conclusions: The prevalence of malnutrition remains high among hospitalized elderly patients. Validity of the GNRI is comparable to that of the MNA, and use of the GNRI to assess the nutritional status of this group is proposed with the new suggested cutoff value (GNRI ≤ 94.95), as it is simpler and more efficient. Underdiagnosis of malnutrition can be prevented, possibly reducing the prevalence of malnourished hospitalized elderly patients and improving the quality of the nutritional care process practiced in Malaysia., (Copyright © 2018 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Objective: Calorie restriction and intermittent fasting are two dietary interventions that can improve aging. Religious fasting also suggested having similar benefit; however, such studies are still scarce. Thus, this study aimed to determine the effect of fasting calorie restriction (FCR) on metabolic parameters and DNA damage among healthy older adult men., Methods: A randomized controlled study was done on men, aged 50-70 years in Klang Valley, Malaysia. Subjects were divided into two groups; FCR (reduction of 300-500 kcal/d combined with 2 days/week of Muslim Sunnah Fasting) and control. Assessment was ascertained at three time point; baseline, weeks 6 and 12. Blood samples were analyzed for lipid profile, DNA damage and malondialdehyde (MDA)., Results: The FCR group reduced their energy intake for approximately 18% upon completion of the study. A significant interaction effect was found in body weight, body mass index, fat percentage, fat mass, blood pressure, total cholesterol, low-density lipoprotein cholesterol and the ratio of total cholesterol/high-density lipoprotein cholesterol (p < 0.05). A significant improvement (p < 0.001) in total DNA rejoining cells and MDA (p < 0.05) was also observed in the FCR group., Conclusion: FCR improved metabolic parameters and DNA damage in healthy older adult men. Therefore, there is a need to further examine the mechanism of FCR.

Objective: An intervention study on the FCR (Fasting and Calorie Restriction) dietary regime was carried out to determine its efficacy in improving mood states and depression status among ageing men., Subjects: A total of 32 healthy males (Mean±SD), aged 59.7±6.3 years, with a BMI of 26.7±2.2 kg/m2 were recruited to the study., Method: Participants were randomized to either the FCR group (and were instructed to follow a calorie restricted dietary regime with intermittent fasting) or to the control group (in which individuals were asked to maintain their current lifestyle), for a 3 month period. Mood was assessed using the Profile of Mood States and depression was assessed using Beck Depression Inventory-II and Geriatric Depression Scale-15 at baseline, week 6 and week 12 of the intervention., Results: A total of 31 subjects completed the study (n=16, FCR and n=15, control). Significant decreases in tension, anger, confusion and total mood disturbance and improvements in vigor were observed in participants in the FCR group compared to the control group (p<0.05). No significant changes in mean depression scores were observed. Weight, BMI and percent body fat were reduced by 3.8%, 3.7% and 5.7% respectively in the FCR group., Conclusions: Our findings show that a FCR dietary regime is effective in improving mood states and nutritional status among ageing men.

Objective: Variations in testosterone levels are associated with several outcomes of aging. The present study aimed to examine the relationship between age-related decline of testosterone levels and changes in bone health status, handgrip strength, body fat percentage and fat-free mass., Materials and Methods: A total of 335 Malaysian Chinese and Malay men aged 40 years and above were recruited for this study. Their body compositions, calcaneal speed of sound and handgrip strength were measured and their blood was collected. Linear regression analysis was done to examine the relationship among age, testosterone levels and outcomes of aging., Results: The results indicated significant changes in all testosterone measurements, sex hormone binding globulin level, calcaneal speed of sound, handgrip strength, body fat percentage and fat-free mass with age (p < 0.05). Age-dependent decline in bioavailable and free testosterone levels were significantly associated with reduction in calcaneal speed of sound, fat-free mass and handgrip strength (p < 0.05). Age-dependent decline in the total testosterone level was significantly associated with an increase in body fat percentage among the elderly men (p < 0.05)., Conclusion: Testosterone levels are associated with changes in outcome of aging such as bone health status, muscle strength and body composition, and the relationships are age-dependent.

Calorie restriction (CR) has been promoted to increase longevity. Previous studies have indicated that CR can negatively affect mood and therefore the effect of CR on mood and quality of life (QOL) becomes crucial when considering the feasibility of CR in humans. We conducted a three month clinical trial on CR (reduction of 300 to 500 kcal/day) combined with two days/week of Muslim sunnah fasting (FCR) to determine the effectiveness of FCR on QOL among aging men in Klang Valley, Malaysia. A total of 25 healthy Malay men (age 58.8±5.1 years), with no chronic diseases and a BMI of 23.0 to 29.9 kg/m2 were randomized to FCR (n=12) and control (n=13) groups. Body composition measurements and QOL questionnaires were ascertained at baseline, week 6 and week 12. QOL was measured using the Short-Form 36, sleep quality was determined using the Pittsburgh Sleep Quality Index, the Beck Depression Inventory II was used to measure mood and the Perceived Stress Scale was used to measure depression. The FCR group had a significant reduction in body weight, BMI, body fat percentage and depression (P<0.05). The energy component of QOL was significantly increased in FCR group (p<0.05). There were no significant changes in sleep quality and stress level between the groups as a result of the intervention. In conclusion, FCR resulted in body weight and fat loss and alleviated depression with some improvement in the QOL in our study and has the potential to be implemented on a wider scale., (Copyright © 2011 Elsevier Inc. All rights reserved.)