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Abstract The unconfined compressive strength (UCS) of stabilized soil with lime and cement is a crucial mechanical factor in developing accurate geomechanical models. In the past, determining UCS required laborious laboratory testing of core samples or complex well-log analysis, both of which consumed many resources. This study introduces a novel method for real-time UCS prediction while acknowledging the need for efficiency. This method makes use of Specific Naive Bayes (NB) predictive models that are strengthened by the smell agent optimization (SAO) and the Dynamic Arithmetic Optimization Algorithm (DAOA), two reliable meta-heuristic algorithms. Combining these algorithms improves prediction precision while streamlining the process. By examining UCS samples from various soil types obtained from earlier stabilization tests, these models are validated. This study identifies three different models: NBDA, NBSA, and a single NB. The individual insights each model provides work in concert to increase the overall UCS prediction accuracy. This approach represents a significant advancement in UCS prediction methodologies, revealing a quick and effective method with wide-ranging implications for various geomechanical applications. Meta-heuristic algorithms combined with particular NB models produce promising results, opening up new possibilities for real-time UCS estimation across various geological scenarios. Especially noteworthy are the NBDA model’s impressive performance metrics. The entire dataset achieves an R 2 value of 0.992 during testing. The RMSE of 108.69 for the NBDA model during the training phase also shows that it has the best performance overall. It consistently exhibits commendable generalization and predictive abilities that outperform those of the developed NB and NBSA models, highlighting its usefulness and effectiveness in practical applications.

Abstract Background To prevent thyroid storm and ensure surgical safety, it is imperative to regulate excessive thyroid hormone levels in patients with thyrotropin-secreting pituitary adenomas (TSHoma) prior to surgery. Somatostatin analogues (SSAs), such as octreotide, have showed efficacy in shrinking tumors, which may facilitate surgical resection. This retrospective study aimed to investigate the effect of shortterm preoperative octreotide treatment on the surgical outcome of TSHoma. Methods A total of 65 TSHoma patients from January 2010 to July 2019 were included in the study. Of these,41 patients received short-term preoperative octreotide (Sandostatin, intermittent subcutaneous injection) treatment and all patients subsequently underwent surgery. The following data were recorded: clinical manifestations, laboratory examinations, sellar region MRI, postoperative pathological and electron microscopy data, intraoperative situation, and follow-up (> 3 months) regarding hormone levels and tumor recurrence. Results There was no significant difference in the consistency and blood supply of the tumor between patients who received short-term preoperative octreotide treatment and those who did not. Additionally, preoperative short-term octreotide treatment (median of 10 days with a range of 6–18 days) did not significantly improve the rates of gross total resection (GTR) or biochemical remission. Moreover, electron microscopy revealed subcellular level impairments and cell apoptotic in the octreotide treated TSHoma specimens. Conclusion Preoperative octreotide treatment for the purpose of reducing excessive thyroid hormones may not enhance surgical outcomes, and the duration of octreotide treatment needs to be extended to fully benefit from the tumor-shrinking effects of SSAs.

Summary: The overall survival rate of gliomas has not significantly improved despite new effective treatments, mainly due to tumor heterogeneity and drug delivery. Here, we perform an integrated clinic-genomic analysis of 1, 477 glioma patients from a Chinese cohort and a TCGA cohort and propose a potential prognostic model for gliomas. We identify that SBS11 and SBS23 mutational signatures are associated with glioma recurrence and indicate worse prognosis only in low-grade type of gliomas and IDH-Mut subtype. We also identify 42 genomic features associated with distinct clinical outcome and successfully used ten of these to develop a prognostic risk model of gliomas. The high-risk glioma patients with shortened survival were characterized by high level of frequent copy number alterations including PTEN, CDKN2A/B deletion, EGFR amplification, less IDH1 or CIC gene mutations, high infiltration levels of immunosuppressive cells and activation of G2M checkpoint and Oxidative phosphorylation oncogenic pathway.

The logistics sector plays an imperative role in the economic development of a country. However, it can also affect environmental quality as it the viewed as a major energy-consuming sector. The current literature on the relationship between logistics performance and environmental quality is scant and most studies neglect its environmental impact in the context of emerging countries. In this context, this study investigates the impact of logistics performance index (LPI), green innovation, renewable energy, and economic globalization on the environmental quality in the 22 emerging countries. Using the panel data from 2007 to 2018, we employed the Method of Moments Quantile Regression (MM-QR) for empirical analysis. The empirical results show that LPI deteriorates the environmental quality by increasing CO2 emissions across all quantiles (10th–90th). Moreover, green innovation is significantly and negatively related to CO2 emission in all the quantiles except at the 10th quantiles, while renewable energy use significantly improves the environmental quality across all quantiles (10th–90th). Economic globalization shows a significant and negative impact on CO2 emission across quantiles (10th–90th) in emerging countries. Based on these findings, this study proposes that emerging countries need to align their logistics sector policies with sustainable development goals. At the same time, more resources should be allocated for green innovation and the renewable energy sector and promote economic globalization to foster sustainable development.

ZFPM2, encoding a zinc finger protein and abundantly expressed in the brain, uterus and smooth muscles, plays important roles in cardiac and gonadal development. Abnormal expression of ZFPM2 in ovarian tumors and neuroblastoma has been reported but hitherto its genetic association with cancer and effects on gliomas have not been studied. In the present study, the hexamer insertion-deletion polymorphism rs71305152, located within a large haplotype block spanning intron 1 to intron 3 of ZFPM2, was genotyped in Chinese cohorts of glioma (n = 350), non-glioma cancer (n = 354) and healthy control (n = 463) by direct sequencing and length polymorphism in gel electrophoresis, and ZFPM2 expression in glioma tissues (n = 69) of different grades was quantified by real-time RT-PCR. Moreover, potential natural selection pressure acting on the gene was investigated. Disease-association analysis showed that the overall genotype of rs71305152 was significantly associated with gliomas (P = 0.016), and the heterozygous genotype compared to the combined homozygous genotypes was less frequent in gliomas than in controls (P = 0.005) or non-glioma cancers (P = 0.020). ZFPM2 mRNA expression was negatively correlated with the grades of gliomas (P = 0.002), with higher expression levels in the low-grade gliomas. In the astrocytoma subtype, higher ZFPM2 expression was also correlated with the rs71305152 heterozygous genotype (P = 0.028). In addition, summary statistics tests gave highly positive values, demonstrating that the gene is under the influence of balancing selection. These findings suggest that ZFPM2 is a glioma susceptibility gene, its genotype and expression showing associations with incidence and severity, respectively. Moreover, the balancing selection acting on ZFPM2 may be related to the important roles it has to play in multiple organ development or associated disease etiology.

Abstract To accommodate China’s electricity market reforms integrating medium and long-term (MLT) transactions and spot transactions, and to boost renewable energy consumption through the spot market, this paper proposes an optimized cross-provincial electricity trading strategy model based on a two-layer game framework. The proposed model incorporates an MLT green certificate contract decomposition method, enabling nested optimization of green certificate contracts and scheduling plans for cross-provincial power transactions. To encourage broader participation, a bilateral green certificate trading framework is established, which globally optimizes green certificate allocation to increase benefits for market participants. A Nash-Stackelberg game model is introduced to address complex game interactions among multiple participants under the green certificate mechanism and the limitation of assuming complete rationality. The game model combines supply and demand sides with an embedded demand-side evolutionary game. Additionally, an improved Aquila optimization algorithm (IAOA) is developed to accurately calculate electricity supply and demand. The algorithm integrates a Circle chaotic map, Sobol sequence, random walk strategy, and filtering technology to enhance optimization capabilities and manage complex constraints. The algorithm is then embedded with a distributed iterative approach to achieve equilibrium strategies. A real-world case study was conducted to validate the feasibility and effectiveness of the proposed model. The results demonstrate that the proposed approach effectively achieves equilibrium, optimizes trading strategies, and fosters win-win, coordinated development among participants in the cross-provincial electricity market.

The emergence of electric vehicles has contributed to mitigating air pollution and greenhouse effects caused by traditional fuel vehicles. The power battery industry chain, which is a primary component of electric vehicles, requires more attention to monitor its development status. This study proposes a novel method for forecasting the development status of the power battery industry chain by monitoring the market value index of all listed companies in the power battery industry. It proposes a new forecasting model, RRMIDAS-SVR, which outlines reverse-restricted mixed data sampling (RRMIDAS) into support vector regression (SVR) to end the data-driven challenges of mixed-frequency data and nonlinear relationships. We estimate the RRMIDAS-SVR model using a quadratic programming problem and mixed-frequency West Texas Intermediate crude oil futures prices, electric vehicle sales, and the consumer price index as predictors of the market value of all listed companies in the power battery industry chain. The experimental findings reveal that the RRMIDAS-SVR model outperforms the other models, as evidenced by its lower mean absolute error and root-mean-square error. This study contributes to understanding the development status of the power battery industry value chain by proposing and developing a new approach, RRMIDAS-SVR, to monitor the industry's development status that considers a multi-source information set. Moreover, this study provides strategic insights for stakeholders in the power battery industry.

This study evaluates the effectiveness of generative artificial intelligence (GAI) in identifying and reconstructing legal arguments from judges’ reasons in court cases, focusing on the practical implications for law students and legal educators. By examining the performance of two versions of popular Large Language Models – ChatGPT and Claude – across five recent High Court of Australia decisions, the study makes a preliminary assessment of the accuracy of LLM systems in replicating a skill essential for lawyers: identification of arguments and argument chains in judges’ reasons. The methodology involves marking LLM-generated outputs with reference to both a sample answer and a detailed rubric. Key findings reveal a significant variance in the accuracy of different LLMs, with Claude 3.5 markedly outperforming all others, achieving average grades up to 90 per cent. In contrast, ChatGPT versions demonstrated lower accuracy, with average marks not exceeding 50 per cent. These results highlight the critical importance of selecting the right GAI system for legal applications, as well as the necessity for users to critically engage with AI outputs rather than relying solely on automated tools. The study concludes that while LLMs hold potential benefits for the legal profession, including increased efficiency and enhanced access to justice, for GAI use that may be carried out by a law student, the technology cannot yet replace the nuanced human skill of legal argument analysis.

Abstract To ensure the effective implementation of the compulsory green certificate transaction in China, a multi-participant cross-regional green certificate bilateral transaction model considering the relevant technical characteristics of the unit is proposed to solve the problems such as the mismatch between the supply and demand of green certificates and the reduction of the transaction plan by the grid operation constraints in the current green certificate transaction. To mobilize the initiative of participants, the model adopts the bilateral transaction of free negotiation. To balance the interests of transaction participants, the paper analyzes the complex interaction of multi participants in cross-regional bilateral transactions by using cooperative game theory. Simultaneously, the model considers multiple uncertainties among participants and takes into account the correlation of photovoltaic power in multiple periods. Based on the distributed robust theory, the multivariate nonlinear model and mixed-effect model of Bayesian are proposed to construct the fuzzy sets of the probability distribution for wind and photovoltaic power. On this basis, the paper analyzes the strategic behaviors of multi participants affected by uncertainty factors in the cross-regional green certificate bilateral trade through a numerical example, and quantitatively analyzes the sensitivity of each participant’s transaction plan affected by uncertainty factors. The results show that the degree of competition will affect the strategic behavior and income of the participants, and the full cooperation mode can not only avoid the risk of fluctuations in the transaction price and transaction power within the alliance but also stabilize the supply and demand of green certificate transactions.

Abstract Immunity has shown potentials in informing drug development for cardiometabolic diseases, such as type 2 diabetes (T2D) and coronary artery disease (CAD). Here, we performed a transcriptome-wide Mendelian randomization (MR) study to estimate the putative causal effects of 11,021 gene expression profiles during CD4+ T cells activation on the development of T2D and CAD. Robust MR and colocalization evidence was observed for 162 genes altering T2D risk and 80 genes altering CAD risk, with 12% and 16% respectively demonstrating CD4+ T cell specificity. We observed temporal causal patterns during T cell activation in 69 gene-T2D pairs and 34 gene-CAD pairs. These genes were eight times more likely to show robust genetic evidence. We further identified 25 genes that were targets for drugs under clinical investigation, including LIPA and GCK. This study provides evidence to support immune-to-metabolic disease connections, and prioritises immune-mediated drug targets for cardiometabolic diseases.

Abstract BackgroundSex differences in blood pressure (BP) levels and hypertension are important and the role of socioeconomic status (SES) in sex differences in hypertension remains unclear. ObjectiveThis study aimed to evaluate the impact of SES on sex differences of hypertension in a nationally representative survey study. MethodsA total of 98,658 participants aged ≥18 years who have lived in their current residence for ≥6 months were recruited from 162 study sites across mainland China. Sex was self-reported. Individual-level SES included the highest level of education and annual household income. Area-level SES included economic development status, urban/rural residency, and north/south location. Outcomes included levels of systolic and diastolic BP, and hypertension. Linear and Cox regression models were used to examine the associations between sex (women vs men) and BP characteristics stratified by individual or combined SES indicators. ResultsSystolic and diastolic BP levels and the prevalence of hypertension were higher in men than in women. This sex difference was found across categories of SES with widened sex disparities in participants having more favorable SES. Significant multiplicative interaction effects of SES on the association of sex with BP characteristics were found. Women with improving SES were associated with lower BP and hypertension prevalence compared to men. For combined SES, a 9% (prevalence ratio 0.91, 95% CI 0.83-0.98) and a 30% lower probability (prevalence ratio 0.70, 95% CI 0.63-0.78) of having hypertension were found in women with an overall intermediate SES and high SES, respectively, compared to those with low SES, while no significant reduction was found in men. ConclusionsThere are significant sex differences in BP characteristics and SES has a potent impact on the disparities. Sex-specific public health policies to alleviate socioeconomic inequalities, especially in women are important for the prevention of hypertension.

Background: Ambient air pollution has become a challenging global health issue since industrialization, especially affecting respiratory diseases. However, the causal link between air pollution and allergic respiratory diseases (ARDs) remains unclear due to confounding factors in conventional epidemiological studies across different populations. Thus, we aimed to clarify the causal associations between air pollution and ARDs in European and East Asian populations using Mendelian randomization (MR). Methods: MR utilizes genetic variants and provides a satisfactory level of causal evidence. Genetic data for exposures (PM2.5, PM2.5 absorbance, PM10, PMcoarse, NO2 and NOx) and outcomes (allergic rhinitis, chronic rhinosinusitis, asthma, and obesity related asthma) were obtained from genome-wide association studies. Instrumental variables were strictly filtered based on core assumptions. Two-sample MR and sensitivity analyses were conducted separately for European and East Asian populations. Results: PMcoarse was causally associated with an increased risk of chronic rhinosinusitis (OR = 1.588 [1.002–2.518]; p = 0.049) and obesity related asthma (OR = 1.956 [1.012–3.780]; p = 0.046) in European population, and PM10 was associated with a decreased risk of allergic rhinitis in East Asian population (OR = 0.882 [0.798–0.974]; p = 0.013). No heterogeneity or pleiotropy was detected in any significant causal association. Conclusion: Our findings indicate that ambient air pollution has opposite impacts on the etiology of ARDs in European and East Asian populations, which provides evidence for decisions on public policies and suggests that different responses to environmental factors such as air pollution may contribute to racial heterogeneity of ARDs.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusion : s: In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

Low-maturity shale oil has great resource potential in Jiyang Depression and has become an important field after the successful breakthrough of medium- to high-maturity shale oil. Objective The purpose of this paper is to clarify the pore and fracture characteristics of low-maturity continental shale and their significance to shale oil occurrence. Methods By studying the Es3x and Es4scs members in Qingnan Depression, Jiyang Depression, this study combines thin section observation, TOC content, XRD analysis, solvent extraction, low-temperature N2 adsorption, high-pressure mercury injection, scanning electron microscope observation and EDS analysis to classify the shale lithofacies, characterize the pore and fracture development, and illustrate the importance of shale pores and fractures for shale oil occurrence. Results The TOC content is mostly in the range of 1.0%-4.0%, and the mineral composition mainly includes felsic minerals, followed by clay and carbonate minerals. The major pore types are ink-bottle-shaped pores and plate-parallel-shaped pores, including quartz intergranular pores, clay mineral interlamellar pores, and dolomite intercrystalline pores. The major pore sizes are mostly less than 200 nm and exhibit a multipeak distribution, which is concentrated in the ranges of 2-50 nm, 50-80 nm and 100-200 nm. Horizontal bedding fractures, vertical fractures and network fractures developed in the studied shales and were mostly filled or contacted by bitumen.Felsic-rich shale lithofacies usually have a greater pore volume and specific surface area than clay-rich lithofacies, and felsic minerals positively contribute to pore development. The pore volume and specific surface area first decreased and then increased with increasing thermal maturity. When Ro>0.6%, the shale oil content increases significantly, which is mainly related to the large amount of hydrocarbon generation in organic matters. Conclusion Horizontal bedding fractures, quartz intergranular pores, and dolomite and calcite intercrystalline pores are favourable storage and occurrence spaces for shale oil.

The identification, classification, and integration of microfacies characteristics of carbonate-rich shale in the Dongying Sag of the Bohai Bay Basin are fundamental for understanding the sedimentary origin and spatial structure of related sediments. Leveraging core and rock thin section data, along with analytical techniques such as X-ray diffraction and scanning electron microscopy, high-resolution core sampling and testing were conducted to analyze the rock mineralogy and paleontology of the carbonate-rich shale in the slope zone of the Dongying Sag. The research findings identified the presence of 10 types of microfacies within the carbonate-rich shale, including algal mat microfacies and shell shale microfacies. These microfacies combined in various ways to form a spectrum of microfacies combinations, exhibiting shale phase transition characteristics on a meter scale. Corresponding to the different stages of saline lake evolution in the Dongying Sag, three types of rock microfacies combinations emerged: shallow water evaporite microfacies combination, oscillatory semi-deep water shale microfacies combination, and oscillatory deep water shale microfacies combination. These combinations were typically controlled by the cyclical rise and fall of lake levels against a backdrop of high-frequency oscillations. In the upper submember of the fourth member of the Shahejie Formation, from bottom to top, as the climate became more humid and hot, weathering intensified, lake levels rose and lake salinity decreased, the proportion of oscillatory deep water shale microfacies combinations gradually increased, while that of shallow water evaporite microfacies combinations decreased. This series of upward-deepening depositional cycles recorded the continuous subsidence and co-evolution of biology and environment during the middle Eocene in the Dongying Sag.

Summary: Background: Little is known about the complex associations of socioeconomic status (SES) and healthy lifestyle with cognitive dysfunction. Methods: Using data from the Health and Retirement Study (HRS) [2008–2020] and the English Longitudinal Study of Ageing (ELSA) [2004–2018], SES was constructed by latent class analysis using education level, total household income and wealth. Overall healthy lifestyle was derived using information on never smoking, low to moderate alcohol consumption (drinks/day: (0, 1] for women and (0, 2] for men), top tertile of physical activity, and active social contact. Findings: A total of 12,437 and 6565 participants from the HRS and ELSA were included (40.8% and 46.0% men and mean age 69.3 years and 65.1 years, respectively). Compared with participants of high SES, those of low SES had higher risk of incident dementia (hazard ratio 3.17, 95% confidence interval 2.72–3.69 in the HRS; 1.43, 1.09–1.86 in the ELSA), and the proportions mediated by overall lifestyle were 10.4% (7.3%–14.6%) and 2.7% (0.5%–14.0%), respectively. Compared with participants of high SES and favorable lifestyle, those with low SES and unfavorable lifestyle had a higher risk of incident dementia (4.27, 3.40–5.38 in the HRS; 2.02, 1.25–3.27 in the ELSA) and accelerated rate of global cognitive decline (β = −0.058 SD/year; 95% CI: −0.073, −0.043 in the HRS; β = −0.049 SD/year; 95% CI: −0.063, −0.035 in the ELSA). Interpretation: Unhealthy lifestyle only mediated a small proportion of the socioeconomic inequality in dementia risk in both US and UK older adults. Funding: This work was supported by grants from the National Natural Science Foundation of China (82088102 and 82370819), the National Key R&D Program of China (2023YFC2506700), the Shanghai Municipal Government (22Y31900300), the Shanghai Clinical Research Center for Metabolic Diseases (19MC1910100), the Innovative Research Team of High-Level Local Universities in Shanghai, the Special Project for Clinical Research in Health Industry of Shanghai Municipal Health Commission (202340084), and Ruijin Hospital Youth Incubation Project (KY20240805). Y.X. is supported by the National Top Young Talents program.

Abstract Background An updated definition was developed to better evaluate cardiovascular health (CVH). We aimed to investigate whether optimal or improvement of six CVH metrics defined by new Life's Essential 8 (LE8) may counteract the risk of subclinical atherosclerosis among patients with hyperglycemia. Methods We conducted a prospective analysis of 5225 participants without prior cardiovascular diseases, of whom 4768 had complete data on CVH change. Subjects with CVH scores of 0–49, 50–79, and 80–100 points were categorized as having low, moderate, or high CVH, respectively. Subclinical atherosclerosis was evaluated by brachial‐ankle pulse wave velocity, pulse pressure and albuminuria, both separately and in combination. Results Of the 5225 participants, 1937 (37.1%) had normal glucose regulation, while 3288 (62.9%) had hyperglycemia. The multivariable‐adjusted odds ratio (OR) for composite subclinical atherosclerosis was 2.34 (95% confidence interval [CI], 1.88–2.91), 1.43 (95% CI, 1.21–1.70), and 0.74 (95% CI, 0.46–1.18), for participants with hyperglycemia who had low, moderate, or high overall CVH scores, respectively, compared with participants with normal glucose regulation. In addition, compared with those with stable CVH and normal glucose regulation, participants who exhibited greater improvements in overall CVH from 2010 to 2014 had a reduced risk of composite subclinical atherosclerosis with an OR of 0.72 (95% CI, 0.53–0.98) for those with normal glucose regulation, and 1.13 (95% CI, 0.87–1.48) for those with hyperglycemia. Conclusions The novel defined CVH using six metrics was inversely associated with subsequent risk of subclinical atherosclerosis. Both the status of CVH and its changes modified the relationship between hyperglycemia and subclinical atherosclerosis.

BackgroundThe WFS1 gene encodes the protein wolframin, which is crucial for maintaining endoplasmic reticulum homeostasis. Variants in this gene are predominantly associated with Wolfram syndrome and have been implicated in other disorders such as diabetes mellitus and psychiatric diseases, which increases the rate of clinical misdiagnosis.MethodsPatients were diagnosed with early-onset unclassified diabetes according to their clinical and laboratory data. We performed whole-exome sequencing (WES) in 165 patients, interpreting variants according to the American College of Medical Genetics/Association for Molecular Pathology (ACMG/AMP) 2015 guidelines. Variant verification was done by Sanger sequencing. In vitro experiments were conducted to evaluate the effects of WFS1 compound heterozygous variants.ResultsWe identified WFS1 compound heterozygous variants (p.A214fs*74/p.F329I and p.I427S/p.I304T) in two patients with Wolfram Syndrome-Like disorders (WSLD). Both WFS1 compound heterozygous variants were associated with increased ER stress, reduced cell viability, and decreased SERCA2b mRNA levels. Additionally, pathogenic or likely pathogenic WFS1 heterozygous variants were identified in the other three patients.ConclusionOur results underscore the importance of early genetic testing for diagnosing young-onset diabetes and highlight the clinical relevance of WFS1 variants in increasing ER stress and reducing cell viability. Incorporating these genetic insights into clinical practice can reduce misdiagnoses and improve treatment strategies for related disorders.

Abstract Background Novel diabetes phenotypes were proposed by the Europeans through cluster analysis, but Chinese community diabetes populations might exhibit different characteristics. This study aims to explore the clinical characteristics of novel diabetes subgroups under data‐driven analysis in Chinese community diabetes populations. Methods We used K‐means cluster analysis in 6369 newly diagnosed diabetic patients from eight centers of the REACTION (Risk Evaluation of cAncers in Chinese diabeTic Individuals) study. The cluster analysis was performed based on age, body mass index, glycosylated hemoglobin, homeostatic modeled insulin resistance index, and homeostatic modeled pancreatic β‐cell functionality index. The clinical features were evaluated with the analysis of variance (ANOVA) and chi‐square test. Logistic regression analysis was done to compare chronic kidney disease and cardiovascular disease risks between subgroups. Results Overall, 2063 (32.39%), 658 (10.33%), 1769 (27.78%), and 1879 (29.50%) populations were assigned to severe obesity‐related and insulin‐resistant diabetes (SOIRD), severe insulin‐deficient diabetes (SIDD), mild age‐associated diabetes mellitus (MARD), and mild insulin‐deficient diabetes (MIDD) subgroups, respectively. Individuals in the MIDD subgroup had a low risk burden equivalent to prediabetes, but with reduced insulin secretion. Individuals in the SOIRD subgroup were obese, had insulin resistance, and a high prevalence of fatty liver, tumors, family history of diabetes, and tumors. Individuals in the SIDD subgroup had severe insulin deficiency, the poorest glycemic control, and the highest prevalence of dyslipidemia and diabetic nephropathy. Individuals in MARD subgroup were the oldest, had moderate metabolic dysregulation and the highest risk of cardiovascular disease. Conclusion The data‐driven approach to differentiating the status of new‐onset diabetes in the Chinese community was feasible. Patients in different clusters presented different characteristics and risks of complications.

Abstract BackgroundCardiovascular-kidney-metabolic (CKM) health is affected by social determinants of health, especially education. CKM syndrome has not been evaluated in Chinese population, and the association of education with CKM syndrome in different sexes and its intertwined relation with lifestyles have not been explored. ObjectiveWe aimed to explore the association between educational attainment and the prevalence of CKM syndrome stages in middle-aged and older Chinese men and women as well as the potential role of health behavior based on Life’s Essential 8 construct. MethodsThis study used data from the nationwide, community-based REACTION (Risk Evaluation of Cancers in Chinese diabetic individuals: a longitudinal study). A total of 132,085 participants with complete information to determine CKM syndrome stage and education level were included. Educational attainment was assessed by the self-reported highest educational level achieved by the participants and recategorized as low (elementary school or no formal education) or high (middle school, high school, technical school/college, or above). CKM syndrome was ascertained and classified into 5 stages according to the American Heart Association presidential advisory released in 2023. ResultsAmong 132,085 participants (mean age 56.95, SD 9.19 years; n=86,675, 65.62% women) included, most had moderate-risk CKM syndrome (stages 1 and 2), and a lower proportion were at higher risk of CKM (stages 3 and 4). Along the CKM continuum, low education was associated with 34% increased odds of moderate-risk CKM syndrome for women (odds ratio 1.36, 95% CI 1.23-1.49) with a significant sex disparity, but was positively correlated with high-risk CKM for both sexes. The association between low education and high-risk CKM was more evident in women with poor health behavior but not in men, which was also interactive with and partly mediated by behavior. ConclusionsLow education was associated with adverse CKM health for both sexes but was especially detrimental to women. Such sex-specific educational disparity was closely correlated with health behavior but could not be completely attenuated by behavior modification. These findings highlight the disadvantage faced by women in CKM health ascribed to low education, underscoring the need for public health support to address this inequality.

Abstract Background Sinonasal mucosal melanoma (SNMM) is a relatively rare malignant tumour with a poor prognosis. This study was designed to identify prognostic factors and establish a nomogram model to predict the overall survival (OS) of patients with SNMM. Methods A total of 459 patients with SNMM were selected from the Surveillance, Epidemiology, and End Results (SEER) database as the training cohort. Univariate and multivariate Cox regression analyses were used to screen for independent factors associated with patient prognosis and develop the nomogram model. In addition, external validation was performed to evaluate the effectiveness of the nomogram with a cohort of 34 patients with SNMM from Peking Union Medical College Hospital. Results The median OS in the cohort from the SEER database was 28 months. The 1-year, 3-year and 5-year OS rates were 69.8%, 40.4%, and 30.0%, respectively. Multivariate Cox regression analysis indicated that age, T stage, N stage, surgery and radiotherapy were independent variables associated with OS. The areas under the receiver operating characteristic curves (AUCs) of the nomograms for predicting 1-, 3- and 5-year OS were 0.78, 0.71 and 0.71, respectively, in the training cohort. In the validation cohort, the area under the curve (AUC) of the nomogram for predicting 1-, 3- and 5-year OS were 0.90, 0.75 and 0.78, respectively. Patients were classified into low- and high-risk groups based on the total score of the nomogram. Patients in the low-risk group had a significantly better survival prognosis than patients in the high-risk group in both the training cohort (P

Traffic regulations provide a solid foundation for the safety of all road users; however, the ambiguous provisions and unclear safety thresholds within these regulations pose significant challenges to compliance, particularly concerning the safe operation of autonomous vehicles. To address this issue, this paper conducts an in-depth analysis of vehicle emergency braking behavior based on the Aerial Dataset for China Congested Highway and Expressway (AD4CHE). The extraction method for the emergency braking risk scenario of natural driving data is proposed, and the correlation between safe distance, safe speed, and driving safety under the scenario of a slightly congested expressway is elaborated in detail. The safety threshold of ambiguous traffic rules obtained can be used for the digitalization of traffic rules that can support the functional development and traffic safety testing of automated driving systems.

Background/Aims: Necrotizing pancreatitis (NP) presents a more severe clinical trajectory and increased mortality compared to edematous pancreatitis. Prompt identification of NP is vital for patient prognosis. A risk prediction model for NP among Chinese patients has been developed and validated to aid in early detection. Methods: A retrospective analysis was performed on 218 patients with acute pancreatitis (AP) to examine the association of various clinical variables with NP. The least absolute shrinkage and selection operator (LASSO) regression was utilized to refine variables and select predictors. Subsequently, a multivariate logistic regression was employed to construct a predictive nomogram. The model's accuracy was validated using bootstrap resampling (n=500) and its calibration assessed via a calibration curve. The model's clinical utility was evaluated through decision curve analysis. Results: Of the 28 potential predictors analyzed in 218 AP patients, the incidence of NP was 25.2%. LASSO regression identified 14 variables, with procalcitonin, triglyceride, white blood cell count at 48 hours post-admission, calcium at 48 hours post-admission, and hematocrit at 48 hours post-admission emerging as independent risk factors for NP. The resulting nomogram accurately predicted NP risk with an area under the curve of 0.822, sensitivity of 82.8%, and specificity of 76.4%. The bootstrap-validated area under the curve remained at 0.822 (95% confidence interval, 0.737 to 0.892). This model exhibited excellent calibration and demonstrated greater predictive efficacy and clinical utility for NP than APACHE II, Ranson, and BISAP. Conclusions: We have developed a prediction nomogram of NP that is of great value in guiding clinical decision.

BackgroundThe triglyceride glucose (TyG) index has been associated with an increased risk in breast cancer. However, this association remains unclear among the Chinese population. This study aimed to investigate whether the TyG index is associated with the risk of prevalent breast cancer in Chinese women.MethodsThis cross-sectional study included 142,184 women from the REACTION (Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal) Study, which recruited adults aged 40 years or older from 25 centers across mainland China between 2011 and 2012. The TyG index was calculated according to the formula: Ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2). Multivariable-adjusted logistic regression models were used to evaluate odds ratios (ORs) and 95% confidence intervals (CIs) regarding the associations between the TyG index and breast cancer.ResultsMultivariable-adjusted logistic regression analysis showed that compared with the lowest quartile of the TyG index, the highest quartile of the TyG index was significantly associated with an increased risk of prevalent breast cancer, with an OR (95% CI) of 1.61 (1.19–2.17). In the stratified analysis, the association of each 1 SD increase in the TyG index with risk of prevalent breast cancer was more dominant in individuals with menarche at age 13–17, those who were postmenopausal, those with a history of breastfeeding, and those who had two to four children, with the ORs (95% CIs) of 1.35 (1.09–1.68), 1.27 (1.05–1.54), 1.26 (1.05–1.52), and 1.32 (1.08–1.62), respectively. Moreover, among those without discernible insulin resistance (homeostatic model assessment-insulin resistance [HOMA-IR] ≥2.5), hyperglycemia and dyslipidemia, each 1 SD increase in the TyG index was associated with a 1.36-fold increase in breast cancer risk, with an OR (95% CI) of 2.36 (1.44–3.87).ConclusionThe TyG index is significantly associated with the prevalent breast cancer risk among middle-aged and elderly Chinese women.

BackgroundAdrenocortical carcinoma (ACC) is an aggressive endocrine malignancy with limited therapeutic options. Treating advanced ACC with mitotane, the cornerstone therapy, remains challenging, thus underscoring the significance to predict mitotane response prior to treatment and seek other effective therapeutic strategies.ObjectiveWe aimed to determine the efficacy of mitotane via an in vitro assay using patient-derived ACC cells (PDCs), identify molecular biomarkers associated with mitotane response and preliminarily explore potential agents for ACC.MethodsIn vitro mitotane sensitivity testing was performed in 17 PDCs and high-throughput screening against 40 compounds was conducted in 8 PDCs. Genetic features were evaluated in 9 samples using exomic and transcriptomic sequencing.ResultsPDCs exhibited variable sensitivity to mitotane treatment. The median cell viability inhibition rate was 48.4% (IQR: 39.3-59.3%) and -1.2% (IQR: -26.4-22.1%) in responders (n=8) and non-responders (n=9), respectively. Median IC50 and AUC were remarkably lower in responders (IC50: 53.4 µM vs 74.7 µM, P

Abstract Aims The adverse effects of sedentary behavior on obesity and chronic diseases are well established. However, the prevalence of sedentary behavior has increased, with only a minority of individuals meeting the recommended physical activity guidelines. This study aimed to investigate whether habitual leg shaking, a behavior traditionally considered unfavorable, could serve as an effective strategy to improve energy metabolism. Materials and Methods A randomized crossover study was conducted, involving 15 participants (mean [SD] age, 25.4 [3.6]; mean [SD] body mass index, 22 [3]; 7 women [46.7%]). The study design involved a randomized sequence of sitting and leg shaking conditions, with each condition lasting for 20 min. Energy expenditure, respiratory rate, oxygen saturation, and other relevant variables were measured during each condition. Results Compared to sitting, leg shaking significantly increased total energy expenditure [1.088 kj/min, 95% confidence interval, 0.69–1.487 kj/min], primarily through elevated carbohydrate oxidation. The average metabolic equivalent during leg shaking exhibited a significant increase from 1.5 to 1.8. Leg shaking also raised respiratory rate, minute ventilation, and blood oxygen saturation levels, while having no obvious impact on heart rate or blood pressure. Electromyography data confirmed predominant activation of lower leg muscles and without increased muscle fatigue. Intriguingly, a significant correlation was observed between the increased energy expenditure and both the frequency of leg shaking and the muscle mass of the legs. Conclusions Our study provides evidence that habitual leg shaking can boost overall energy expenditure by approximately 16.3%. This simple and feasible approach offers a convenient way to enhance physical activity levels.

The physical properties of shale oil reservoirs under overburden pressure are of great significance for reservoir prediction and evaluation during exploration and development. Based on core, thin section, and SEM observations, as well as test data such as XRD, TOC, and porosity and permeability under pressure conditions, this study systematically analyzes the variation of physical properties of different lithofacies shales in the Jiyang depression and the influence of rock fabric on the physical variation under pressure. The porosity and permeability of shale samples significantly decrease under pressure. According to the phased reduction in porosity and permeability, the pressurization process is divided into three pressure stages: low pressure (15 MPa). The reduction of porosity is fastest in the low-pressure stage and slowest in the medium-pressure stage. The reduction of permeability is fastest in the low-pressure stage and the slowest in the high-pressure stage. The rock fabric has a significant impact on porosity and permeability under pressure conditions. The permeability of laminated shale and bedded shale is higher than that of massive shale under pressure, and the permeability loss rate is lower than that of massive shales. Especially under lower pressure, the difference can be 10–20 times. In addition, the reduction rate of porosity and permeability under pressure is negatively correlated with felsic minerals content, which is positively correlated with carbonate minerals content and clay minerals content. The contribution of clay minerals to the porosity reduction rate is dominant, followed by carbonate minerals. The contribution of carbonate minerals to the permeability reduction rate is dominant, followed by clay minerals. The TOC content has no significant impact on the porosity and permeability of shales under pressure in the study due to the low maturity.

Abstract Background Some studies have assessed the predictive role of the atherogenic index of plasma (AIP) for macrovascular diseases. This prospective investigation aimed to elucidate whether AIP is associated with diabetic kidney disease (DKD) and diabetic retinopathy (DR) incidence. Methods The data were extracted from 4831 participants, of whom 2943 and 3360 participants with type 2 diabetes (T2D) were included in the DKD and DR follow-up analyses, respectively. Cox regression models were performed to test the relationships of AIP value at baseline with the risk of incident DKD and DR. Group-based trajectory modelling was utilized to discern AIP trajectories during the follow-up period. Subsequently, logistic regressions were applied to ascertain the influence of AIP trajectories on the incidence of DKD and DR. Results During the follow-up period, 709 (24.1%) and 193 (5.7%) participants developed DKD and DR, respectively. The median (interquartile range) follow-up time was 24.2 (26.3) months for DKD and 25.7 (27.0) months for DR. According to the multivariate Cox regression models, baseline AIP was positively and linearly related to the occurrence of DKD, with a hazard ratio of 1.75 (95% confidence interval [CI] 1.36–2.26). Three distinct trajectories of AIP were identified throughout the follow-up time: Low (31.4%), Median (50.2%), and High (18.3%). Compared to participants with the Low AIP trajectory, those with High and Median AIP trajectories presented 117% (95% CI: 1.62–2.91) and 84% (95% CI 1.46–2.32) greater odds of developing DKD, respectively. However, neither baseline levels nor trajectories of AIP were shown to be related to DR after adjusting for confounding factors. Conclusions Baseline levels and trajectories of AIP were independently related to elevated DKD risk, indicating that AIP could be used as a predictor for identifying T2D participants at higher risk of DKD. No association between AIP and DR was detected.

Abstract Background Previous observational studies have documented an inverse association of birthweight with myocardial infarction (MI) but a positive association with atrial fibrillation (AF). However, the causality of these associations and the underlying mediating pathways remain unclear. We aimed to investigate the causal effects of birthweight, incorporating both fetal and maternal genetic effects, on MI and AF, and identify potential mediators in their respective pathways. Methods We performed Mendelian randomization (MR) analyses using genome-wide association study summary statistics for birthweight (N = 297,356 for own birthweight and 210,248 for offspring birthweight), MI (Ncase=61,000, Ncontrol=577,000), AF (Ncase=60,620, Ncontrol=970,216), and 52 candidate mediators (N = 13,848-1,295,946). Two-step MR was employed to identify and assess the mediation proportion of potential mediators in the associations of birthweight with MI and AF, respectively. As a complement, we replicated analyses for fetal-specific birthweight and maternal-specific birthweight. Results Genetically determined each 1-SD lower birthweight was associated with a 40% (95% CI: 1.22–1.60) higher risk of MI, whereas each 1-SD higher birthweight was causally associated with a 29% (95% CI: 1.16–1.44) higher risk of AF. Cardiometabolic factors, including lipids and lipoproteins, glucose and insulin, blood pressure, and fatty acids, each mediated 4.09-23.71% of the total effect of birthweight on MI, followed by body composition and strength traits (i.e., appendicular lean mass, height, and grip strength) and socioeconomic indicators (i.e., education and household income), with the mediation proportion for each factor ranging from 8.08 to 16.80%. By contrast, appendicular lean mass, height, waist circumference, childhood obesity, and body mass index each mediated 15.03-45.12% of the total effect of birthweight on AF. Both fetal-specific birthweight and maternal-specific birthweight were inversely associated with MI, while only fetal-specific birthweight was positively associated with AF. Psychological well-being and lifestyle factors conferred no mediating effect in either association. Conclusions Cardiometabolic factors mainly mediated the association between lower birthweight and MI, while body composition and strength traits mediated the association between higher birthweight and AF. These findings provide novel evidence for the distinct pathogenesis of MI and AF and advocate adopting a life-course approach to improving fetal development and subsequent causal mediators to mitigate the prevalence and burden of cardiovascular diseases.

Based on rock mineral and geochemical analysis, microscopic observation, physical property measurement, and thin laminae separation test, etc., the characteristics of typical laminae of the Paleogene Shahejie Formation carbonate-rich shale in the Jiyang Depression were analyzed, and the organic matter abundance, reservoir properties, and oil-bearing properties of different laminae were compared. Typical shale reservoir-flow structures were classified, and the mobility of oil in different types of shale reservoir-flow structure was compared. The results show that the repeated superposition of mud laminae and calcite laminae are the main layer structure of carbonate-rich shales. The calcite laminae are divided into micritic calcite laminae, sparry calcite laminae and fibrous calcite vein. The mud-rich laminae are the main contributor to the organic matter abundance and porosity of shale, with the best hydrocarbon generation potential, reservoir capacity, and oil-bearing property. The micritic calcite laminae also have relatively good hydrocarbon generation potential, reservoir capacity and oil-bearing property. The sparry calcite laminae and fibrous calcite vein have good permeability and conductivity. Four types of shale reservoir-flow structure are developed in the carbonate-rich shale, and the mobility of oil in each type of reservoir-flow structure is in descending order: sparry calcite laminae enriched shale reservoir-flow structure, mixed calcite laminae enriched shale reservoir-flow structure, fibrous calcite vein enriched shale reservoir-flow structure, and micritic calcite laminae enriched shale reservoir-flow structure. The exploration targets of carbonate-rich shale in the Jiyang Depression Shahejie Formation are different in terms of reservoir-flow structure at different thermal evolution stages.

Abstract Background The association between weight change during early adulthood and cardiometabolic diseases remains uncertain in Chinese population. Whether the association varies with comprehensive cardiovascular health (CVH) in midlife assessed by “Life’s Essential 8” has not been characterized. We aim to examine the associations of early adulthood weight change and midlife “Life’s Essential 8” CVH status with cardiometabolic outcomes in a Chinese cohort. Methods The study participants were from the China Cardiometabolic Disease and Cancer Cohort (4 C) Study. This analysis included 72,610 middle-aged and older participants followed for a median of 3.6 years. At baseline, the participants recalled body weight at age 20 and 40 years, and we calculated change in weight and BMI between 20 and 40 years of age. Health behaviors information in “Life’s Essential 8” was collected by questionnaire, and health factors were measured in the study center. During follow-up, we ascertained incident cardiovascular events based on medical records, and diagnosed incident diabetes according to the American Diabetes Association 2010 criteria. Results 72,610 study participants were included with a mean age of 56.0 ± 8.8 years and 29% of them were males. Weight gain of more than 10 kg between 20 and 40 years of age was associated with 22% increased risk of incident cardiovascular events (HR: 1.22; 95%CI: 1.04–1.43) and 38% increased risk of diabetes (HR: 1.38; 95%CI: 1.25–1.53) compared to stable weight. Besides, the association of weight gain more than 10 kg in early adulthood with cardiometabolic risk was even stronger in those with low CVH score in midlife (HR: 2.44; 95%CI: 2.01–2.97 for incident cardiovascular events; HR: 2.20; 95%CI: 1.90–2.55 for incident diabetes) or with few ideal cardiovascular health metrics in midlife. Conclusions Our study indicated that weight gain in early adulthood was associated with significantly increased risk of cardiometabolic diseases. And the association could be stronger in those with poor CVH profiles in midlife. These findings confirmed the significance of weight management during early adulthood and suggested that individuals who experienced substantial weight gain in early life should be encouraged to maintain good CVH status in Chinese population.

Abstract Background Gut microbiota imbalances have been suggested as a contributing factor to atrial fibrillation (AF), but the causal relationship is not fully understood. Objectives To explore the causal relationships between the gut microbiota and AF using Mendelian randomization (MR) analysis. Methods Summary statistics were from genome-wide association studies (GWAS) of 207 gut microbial taxa (5 phyla, 10 classes, 13 orders, 26 families, 48 genera, and 105 species) (the Dutch Microbiome Project) and two large meta-GWASs of AF. The significant results were validated in FinnGen cohort and over 430,000 UK Biobank participants. Mediation MR analyses were conducted for AF risk factors, including type 2 diabetes, coronary artery disease (CAD), body mass index (BMI), blood lipids, blood pressure, and obstructive sleep apnea, to explore the potential mediation effect of these risk factors in between the gut microbiota and AF. Results Two microbial taxa causally associated with AF: species Eubacterium ramulus (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.04–1.12, P = 0.0001, false discovery rate (FDR) adjusted p-value = 0.023) and genus Holdemania (OR 1.15, 95% CI 1.07–1.25, P = 0.0004, FDR adjusted p-value = 0.042). Genus Holdemania was associated with incident AF risk in the UK Biobank. The proportion of mediation effect of species Eubacterium ramulus via CAD was 8.05% (95% CI 1.73% − 14.95%, P = 0.008), while the proportion of genus Holdemania on AF via BMI was 12.01% (95% CI 5.17% − 19.39%, P = 0.0005). Conclusions This study provided genetic evidence to support a potential causal mechanism between gut microbiota and AF and suggested the mediation role of AF risk factors.

Abstract. Background:. The hemoglobin glycation index (HGI) was developed to quantify glucose metabolism and individual differences and proved to be a robust measure of individual glycosylated hemoglobin (HbA1c) bias. Here, we aimed to explore the relationship between different HGIs and the risk of 5-year major adverse cardiovascular events (MACEs) by performing a large multicenter cohort study in China. Methods:. A total of 9791 subjects from the Risk Evaluation of Cancers in Chinese Diabetic Individuals: a Longitudinal Study (the REACTION study) were divided into five subgroups (Q1-Q5) with the HGI quantiles (≤5th, >5th and ≤33.3th, >33.3th and ≤66.7th, >66.7th and ≤95th, and >95th percentile). A multivariate logistic regression model constructed by the restricted cubic spline method was used to evaluate the relationship between the HGI and the 5-year MACE risk. Subgroup analysis between the HGI and covariates were explored to detect differences among the five subgroups. Results:. The total 5-year MACE rate in the nationwide cohort was 6.87% (673/9791). Restricted cubic spline analysis suggested a U-shaped correlation between the HGI values and MACE risk after adjustment for cardiovascular risk factors (χ2 = 29.5, P 0.82 showed odds ratios (ORs) for MACE of 1.471 (95% confidence interval [CI], 1.027-2.069) and 2.222 (95% CI, 1.641-3.026) compared to subjects with HGIs of >-0.75 and ≤-0.20. In the subgroup with non-coronary heart disease, the risk of MACE was significantly higher in subjects with HGIs ≤-0.75 (OR, 1.540 [1.039-2.234]; P = 0.027) and >0.82 (OR, 2.022 [1.392-2.890]; P 0.82 after adjustment for potential confounders. Conclusions:. We found a U-shaped correlation between the HGI values and the risk of 5-year MACE. Both low and high HGIs were associated with an increased risk of MACE. Therefore, the HGI may predict the 5-year MACE risk.

Abstract Background Low‐density lipoprotein cholesterol (LDL‐C) and diabetes mellitus are both modifiable risk factors for cardiovascular disease; however, whether elevated LDL‐C levels confer a risk for diabetes remains unclear. Objective We aimed to examine the association between serum LDL‐C concentrations at baseline and the risk of developing diabetes at follow‐up in the general population of Chinese adults. Methods This study included 5274 adults aged ≥ 40 years from a community cohort who were without diabetes and followed for a median of 4.4 years. A standard 75‐g oral glucose tolerance test was conducted at baseline and follow‐up visits to diagnose diabetes. Logistic regression models and a restricted cubic spline were used to examine the association between baseline serum LDL‐C levels and the risk of diabetes development. Subgroup analyses were conducted stratifying on age, sex, body mass index, hypertension, family history of diabetes, and LDL‐C levels. Results A total of 652 participants (12%) developed diabetes during the follow‐up period. Compared to quartile 1 of serum LDL‐C, quartiles 2, 3, and 4 were associated with a 30%, 33%, and 30% significantly higher risk of diabetes, respectively after adjustment for confounders including homeostatic model assessment for insulin resistance. The linear relationship between baseline LDL‐C down to 30.1 mg/dL and incident diabetes was demonstrated by restricted cubic spline analysis, and each 1‐SD increase in LDL‐C concentration (28.5 mg/dL) was associated with a 12% increase in the risk of diabetes (odds ratio 1.12, 95% confidence interval 1.03–1.22). Conclusion In this community‐based general population, higher serum LDL‐C levels were linearly associated with an elevated risk of incident diabetes.

Background and Purpose We investigated the causal relationships between the gut microbiota (GM), stroke, and potential metabolite mediators using Mendelian randomization (MR). Methods We leveraged the summary statistics of GM (n=18,340 in the MiBioGen consortium), blood metabolites (n=115,078 in the UK Biobank), and stroke (cases n=60,176 and controls n=1,310,725 in the Global Biobank Meta-Analysis Initiative) from the largest genome-wide association studies to date. We performed bidirectional MR analyses to explore the causal relationships between the GM and stroke, and two mediation analyses, two-step MR and multivariable MR, to discover potential mediating metabolites. Results Ten taxa were causally associated with stroke, and stroke led to changes in 27 taxa. In the two-step MR, Bifidobacteriales order, Bifidobacteriaceae family, Desulfovibrio genus, apolipoprotein A1 (ApoA1), phospholipids in high-density lipoprotein (HDL_PL), and the ratio of apolipoprotein B to ApoA1 (ApoB/ApoA1) were causally associated with stroke (all P

Abstract As a complex non‐linear system, the chaotic oscillation of power system seriously threatens the safe and stable operation of power grids. In this paper, a finite time adaptive synchronization control method is proposed to mitigate the problem of chaotic oscillation in the power system. The proposed method can realize chaos control and parameter identification by completely synchronizing the fractional‐order chaotic power system with the stable fractional‐order power system to identify parameters within a finite time. The fractional Lyapunov stability theory is used for numerical simulation. Theoretical and simulation results show that this method can effectively stabilize the system in a finite time. It is proved that compared with the adaptive synchronous control method, the control method is simpler in design, shorter in action time, and more meaningful in engineering practice.

ContextThe prevalence of unilateral primary aldosteronism (UPA) with cortisol co-secretion varies geographically.ObjectiveTo investigate the prevalence and clinical characteristics of UPA with cortisol co-secretion in a Chinese population.DesignRetrospective cohort study.MethodsWe recruited 580 patients with UPA who underwent cosyntropin stimulation test (CST) after the 1-mg dexamethasone suppression test (DST) and retrospectively analyzed the clinical characteristics and postoperative outcomes of UPA with and without cortisol co-secretion.ResultsUPA with cortisol co-secretion (1 mg DST>1.8 ug/dL) was identified in 65 of 580 (11.2%) patients. These patients were characterized by older age, longer duration of hypertension, higher concentration of plasma aldosterone and midnight cortisol, lower adrenocorticotropic hormone (ACTH) and dehydroepiandrosterone sulfate (DHEAS), larger tumor diameter, and more history of diabetes mellitus. Cortisol and aldosterone levels were higher and DHEAS level was lower in UPA with cortisol co-secretion at 0–120 min after CST. Among 342 UPA patients with KCNJ5 gene sequencing and follow-up results, the complete clinical success rate was lower in UPA with cortisol co-secretion (33.3% vs. 56.4%, P