Serum S-adenosylhomocysteine levels are associated with first stroke in Chinese adults with hypertension.

BACKGROUND: The association between S-adenosylhomocysteine (SAH) and stroke has not been confirmed due to the specialized equipment and time requirements necessary for S-adenosylhomocysteine testing. We aimed to explore the association between SAH and stroke. METHODS: A nested, case-control study drawn from the China Stroke Primary Prevention Trial of rural adults with hypertension, including 557 first stroke cases and 557 matched controls was conducted. Serum SAH was measured by stable-isotope dilution liquid chromatography-tandem mass spectrometry using 4500MD. Multiple conditional logistic regression models were used to evaluate the association between SAH and first stroke. RESULTS: In females, SAH levels were significantly higher in the stroke population than in the control group (16.0 ng/mL vs. 14.6 ng/mL). When SAH was assessed as quartiles, the odds of stroke were 1.78 (95 % CI: 1.02-3.09) in Quartile 2, 1.31 (95 % CI: 0.73-2.33) in Quartile 3, and 1.93 (95 % CI: 1.03-3.62) in Quartile 4, compared to Quartile 1. When Quartiles 2-4 were combined, the adjusted odds ratio of first stroke was 1.64 (95 % CI: 1.03-2.62) compared with Quartile 1. In subgroup analysis, a significant SAH-stroke association was observed in the lower vitamin D3 group (OR = 3.35, 95 % CI:1.72-6.53; P interaction, 0.035). In males, higher levels of SAH were associated with an increased risk of stroke in those under age 60. Compared with the reference group, the adjusted odds ratio of total stroke was 2.40 (95 % CI: 1.02-5.91) in the combined group (Quartile 2-4). In contrast, no significant association between SAH and stroke was found in males aged 60 or older. CONCLUSIONS: This study reveals that SAH is associated with a higher risk of stroke independently of homocysteine, especially in females. SAH may be a second predictor of stroke in the metabolic pathway of methionine, after homocysteine.

Molecular characterization and structure basis of a malonyltransferase with both substrate promiscuity and catalytic regiospecificity from Cistanche tubulosa.

Enzymatic malonylation of natural glycosides provides a promising alternative method for drug-like malonylated glycosides supply. However, the catalytic potential and structural basis of plant malonyltransferase are far from being fully elucidated. This work identified a new malonyltransferase CtMaT1 from Cistanche tubulosa. It displayed unprecedented mono- and/or di-malonylation activity toward diverse glucosides with different aglycons. A "one-pot" system by CtMaT1 and a malonyl-CoA synthetase was established to biosynthesize nine new malonylated glucosides. Structural investigations revealed that CtMaT1 possesses an adequately spacious acyl-acceptor pocket capable of accommodating diverse glucosides. Additionally, it recognizes malonyl-CoA through strong electrotactic and hydrogen interactions. QM/MM calculation revealed the H167-mediated SN2 reaction mechanism of CtMaT1, while dynamic simulations detected the formation of stable hydrogen bonds between the glucose-6-OH group and H167, resulting in its high malonylation regiospecificity. Calculated energy profiles of two isomeric glycosides highlighted lower reaction energy barriers towards glucoside substrates, emphasizing CtMaT1's preference for glucosides. Furthermore, a mutant CtMaT1H36A with notably increased di-malonylation activity was obtained. The underlying molecular mechanism was illuminated through MM/GBSA binding free energy calculation. This study significantly advances the understanding of plant acyltransferases from both functional and protein structural perspectives, while also providing a versatile tool for enzymatic malonylation applications in pharmacology.

The combined effect of MTHFR C677T and A1298C polymorphisms on the risk of digestive system cancer among a hypertensive population.

BACKGROUND AND PURPOSE: The enzyme methylenetetrahydrofolate reductase (MTHFR) plays a crucial role in directing folate species towards nucleotide synthesis or DNA methylation. The MTHFR polymorphisms C677T and A1298C have been linked to cancer susceptibility, but the evidence supporting this association has been equivocal. To investigate the individual and joint associations between MTHFR C677T, A1298C, and digestive system cancer in a Chinese hypertensive population, we conducted a population-based case-control study involving 751 digestive system cancer cases and one-to-one matched controls from the China H-type Hypertension Registry Study (CHHRS). METHODS: We utilized the conditional logistic regression model to evaluate multivariate odds ratios (ORs) and 95% confidence intervals (CIs) of digestive system cancer. RESULTS: The analysis revealed a significantly lower risk of digestive system cancer in individuals with the CT genotype (adjusted OR: 0.71; 95% CI 0.52, 0.97; P = 0.034) and TT genotype (adjusted OR: 0.57; 95% CI 0.40, 0.82; P = 0.003; P for trend = 0.003) compared to those with the 677CC genotype. Although A1298C did not show a measurable association with digestive system cancer risk, further stratification of 677CT genotype carriers by A1298C homozygotes (AA) and heterozygotes (AC) revealed a distinct trend within these subgroups. CONCLUSION: These findings indicate a potential protective effect against digestive system cancer associated with the T allele of MTHFR C677T. Moreover, we observed that the presence of different combinations of MTHFR polymorphisms may contribute to varying susceptibilities to digestive system cancer.

Associations between brachial-ankle pulse wave velocity and hypertensive retinopathy in treated hypertensive adults: Results from the China Stroke Primary Prevention Trial (CSPPT).

Although the association between persistent hypertension and the compromise of both micro- and macro-circulatory functions is well recognized, a significant gap in quantitative investigations exploring the interplay between microvascular and macrovascular injuries still exists. In this study, the authors looked into the relationship between brachial-ankle pulse wave velocity (baPWV) and hypertensive retinopathy in treated hypertensive adults. The authors conducted a cross-sectional study of treated hypertensive patients with the last follow-up data from the China Stoke Primary Prevention Trial (CSPPT) in 2013. With the use of PWV/ABI instruments, baPWV was automatically measured. The Keith-Wagener-Barker classification was used to determine the diagnosis of hypertensive retinopathy. The odds ratio (OR) and 95% confidence interval (CI) for the connection between baPWV and hypertensive retinopathy were determined using multivariable logistic regression models. The OR curves were created using a multivariable-adjusted restricted cubic spline model to investigate any potential non-linear dose-response relationships between baPWV and hypertensive retinopathy. A total of 8514 (75.5%) of 11,279 participants were diagnosed with hypertensive retinopathy. The prevalence of hypertensive retinopathy increased from the bottom quartile of baPWV to the top quartile: quartile 1: 70.7%, quartile 2: 76.1%, quartile 3: 76.7%, quartile 4: 78.4%. After adjusting for potential confounders, baPWV was positively associated with hypertensive retinopathy (OR = 1.05, 95% CI, 1.03-1.07, p < .001). Compared to those in the lowest baPWV quartile, those in the highest baPWV quartile had an odds ratio for hypertensive retinopathy of 1.61 (OR = 1.61, 95% CI: 1.37-1.89, p < .001). Two-piece-wise logistic regression model demonstrated a nonlinear relationship between baPWV and hypertensive retinopathy with an inflection point of 17.1 m/s above which the effect was saturated .

An Investigation of a Biomimetic Optical System and an Evaluation Model for the Qualitative Analysis of Laser Interference Visual Levels.

To objectively quantify the level of visual interference induced by lasers, we developed a biomimetic optical system designed to emulate human vision. This system is based on an optical model of the eye and synthetic imaging principles, allowing it to generate biomimetic optical images that closely mimic human visual perception. Upon exposure to a 532 nm laser, biomimetic optical images were captured under various ambient lighting conditions. By employing a contrast threshold model for human visual target detection and grayscale hierarchy analysis, we devised an evaluation model to quantify the levels of laser-induced visual interference. The bionic images obtained from our experiments, in conjunction with the constructed model, enabled us to assess the degree of laser-induced visual interference. Our results indicate that this system can effectively substitute the human eye when testing laser imaging effects, with the generated bionic images achieving up to 90% concordance with human vision. The proposed evaluation model facilitates the quantitative analysis of laser-induced visual impairment. This apparatus and evaluation model hold significant promise for the precise quantification of laser-induced visual interference levels.

Evaluation of plasma vitamin E and development of proteinuria in hypertensive patients.

Background: The prospective relationship between plasma vitamin E levels and proteinuria remains uncertain. We aimed to evaluate the association between baseline plasma vitamin E levels and the development of proteinuria and examine any possible effect modifiers in patients with hypertension. Methods: This was a post hoc analysis of the renal sub-study of the China Stroke Primary Prevention Trial (CSPPT). In total, 780 participants with vitamin E measurements and without proteinuria at baseline were included in the current study. The study outcome was the development of proteinuria, defined as a urine dipstick reading of a trace or ≥ 1+ at the exit visit. Results: During a median follow-up duration of 4.4 years, the development of proteinuria occurred in 93 (11.9%) participants. Overall, there was an inverse relationship between plasma vitamin E and the development of proteinuria (per standard deviation [SD] increment; odds ratio [OR]: 0.73, 95% confidence interval [CI]: 0.55-0.96). Consistently, when plasma vitamin E was assessed as quartiles, lower risk of proteinuria development was found in participants in quartiles 2-4 (≥ 7.3 µg/mL; OR: 0.57, 95% CI: 0.34-0.96) compared to those in quartile 1. None of the variables, including sex, age, and body mass index, significantly modified the association between vitamin E and proteinuria development. Conclusion: There was a significant inverse association between plasma vitamin E levels and the development of proteinuria in patients with hypertension. The results were consistent among participants with different baseline characteristics.

Rapid and Non-Destructive Prediction of Moisture Content in Maize Seeds Using Hyperspectral Imaging.

The moisture content of corn seeds is a crucial indicator for evaluating seed quality and is also a fundamental aspect of grain testing. In this experiment, 80 corn samples of various varieties were selected and their moisture content was determined using the direct drying method. The hyperspectral imaging system was employed to capture the spectral images of corn seeds within the wavelength range of 1100-2498 nm. By utilizing seven preprocessing techniques, including moving average, S-G smoothing, baseline, normalization, SNV, MSC, and detrending, we preprocessed the spectral data and then established a PLSR model for comparison. The results show that the model established using the normalization preprocessing method has the best prediction performance. To remove spectral redundancy and simplify the prediction model, we utilized SPA, CASR, and UVE algorithms to extract feature wavelengths. Based on three algorithms (PLSR, PCR, and SVM), we constructed 12 predictive models. Upon evaluating these models, it was determined that the normalization-SPA-PLSR algorithm produced the most accurate prediction. This model boasts high RC2 and RP2 values of 0.9917 and 0.9914, respectively, along with low RMSEP and RMSECV values of 0.0343 and 0.0257, respectively, indicating its exceptional stability and predictive capabilities. This suggests that the model can precisely estimate the moisture content of maize seeds. The results showed that hyperspectral imaging technology provides technical support for rapid and non-destructive prediction of corn seed moisture content and new methods in seed quality evaluation.

A Method for Measuring Shaft Diameter Based on Light Stripe Image Enhancement.

When the workpiece surface exhibits strong reflectivity, it becomes challenging to obtain accurate key measurements using non-contact, visual measurement techniques due to poor image quality. In this paper, we propose a high-precision measurement method shaft diameter based on an enhanced quality stripe image. By capturing two stripe images with different exposure times, we leverage their different characteristics. The results extracted from the low-exposure image are used to perform grayscale correction on the high-exposure image, improving the distribution of stripe grayscale and resulting in more accurate extraction results for the center points. The incorporation of different measurement positions and angles further enhanced measurement precision and robustness. Additionally, ellipse fitting is employed to derive shaft diameter. This method was applied to the profiles of different cross-sections and angles within the same shaft segment. To reduce the shape error of the shaft measurement, the average of these measurements was taken as the estimate of the average diameter for the shaft segment. In the experiments, the average shaft diameters determined by averaging elliptical estimations were compared with shaft diameters obtained using a coordinate measuring machine (CMM) the maximum error and the minimum error were respectively 18 µm and 7 µm; the average error was 11 µm; and the root mean squared error of the multiple measurement results was 10.98 µm. The measurement accuracy achieved is six times higher than that obtained from the unprocessed stripe images.

Opto-thermal deformation fitting method based on a neural network and a transfer learning.

The thermal deformation fitting result of an optical surface is an important factor that affects the reliability of optical-mechanical-thermal integrated analysis. The traditional numerical methods are challenging to balance fitting accuracy and efficiency, especially the insufficient ability to deal with high-order Zernike polynomials. In this Letter, we innovatively proposed an opto-thermal deformation fitting method based on a neural network and a transfer learning to overcome shortcomings of numerical methods. The one-dimensional convolutional neural network (1D-CNN) model, which can represent deformation of the optical surface, is trained with Zernike polynomials as the input and the optical surface sag change as the output, and the corresponding Zernike coefficients are predicted by the identity matrix. Meanwhile, the trained 1D-CNN is further combined with the transfer learning to efficiently fit all thermal deformations of the same optical surface at different temperature conditions and avoids repeated training of the network. We performed thermal analysis on the main mirror of an aerial camera to verify the proposed method. The regression analysis of 1D-CNN training results showed that the determination coefficient is greater than 99.9%. The distributions of Zernike coefficients predicted by 1D-CNN and transfer learning are consistent. We conducted an error analysis on the fitting results, and the average values of the peak-valley, root mean square, and mean relative errors of the proposed method are 51.56%, 60.51, and 45.14% of the least square method, respectively. The results indicate that the proposed method significantly improves the fitting accuracy and efficiency of thermal deformations, making the optical-mechanical-thermal integrated analysis more reliable.

Association of plasma iron with the risk of incident cancer in Chinese adults with hypertension: a nested case-control study.

Background: Iron is an essential element for organismal health but excessive iron is potentially toxic. However, few observational studies link plasma iron (PI) concentrations and cancer risk, and the results are inconsistent. Objective: This study aimed to explore the associations of PI concentrations with cancer risk in Chinese adults with hypertension. Methods: We conducted a nested, case-control study, including 223 pairs of incident cancer cases and matched controls from the China Stroke Primary Prevention Trial. The median time between blood sample collection and subsequent cancer event occurrence was 2.13 years. The odds ratio (OR) and 95% confidence interval (CI) for the risk of cancer by PI were estimated from multivariable conditional logistic regression models. Results: There was a nonlinear association between PI concentrations and total cancer risk. When compared with participants in tertile 2 of PI, the ORs of total cancer were 2.17 (95%CI: 1.25-3.85) and 1.29 (95%CI: 0.77-2.19) in participants in PI tertiles 3 and 1, respectively. Furthermore, higher PI was associated with increased digestive system cancer risk (OR=3.25, 95%CI:1.29-8.90), while lower PI was associated with increased risk of non-digestive system cancer (OR=3.32, 95%CI: 1.39-8.71). In a sensitivity analysis, the increases in total cancer risk or digestive system cancer risk were still observed with higher PI after excluding cancer cases occurring within the first year. Conclusion: Our results showed an increased risk of cancer related to higher PI or lower PI in Chinese adults with hypertension. Higher iron levels were linked to an increased risk of digestive system cancers, whereas lower iron levels were linked to an increased risk of non-digestive system cancers.

Association of folic acid dosage with circulating unmetabolized folic acid in Chinese adults with H-type hypertension: a multicenter, double-blind, randomized controlled trial.

Background: There is growing concern regarding elevated levels of circulating unmetabolized folic acid (UMFA) due to excessive intake of folic acid (FA). However, no randomized clinical trial has been conducted to examine the FA-UMFA dose-response relationship. Objective: This study aimed to investigate the FA-UMFA dose-response relationship in Chinese adults with hypertension and elevated homocysteine (H-type hypertension), a population with clear clinical indication for FA treatment. Methods: The data for this study were derived from a randomized, double-blind, multicenter clinical trial of 8 FA dosages on efficacy of homocysteine (Hcy) lowering. The parent trial had three 3 stages: screening period (2-10 days), run-in period (0-2 weeks, baseline visit), and double-blind treatment period (8 weeks) with follow-up visits at the end of the 2nd, 4th, 6th, and 8th weeks of treatment. Participants were randomly assigned to 8 treatment groups corresponding to FA dosages of 0, 0.4, 0.6, 0.8, 1.2, 1.6, 2.0 mg to 2.4 mg. Results: This study included 1,567 Chinese adults aged ≥45 years with H-type hypertension. There was a positive but non-linear association between FA supplementation and UMFA levels in the dosage range of 0 mg to 2.4 mg. In the regression analysis, the coefficients for the linear and quadratic terms of FA dosage were both statistically significant (P < 0.001). Notably, the slope for UMFA was greater for FA dosages >0.8 mg (ß = 11.21, 95% CI: 8.97, 13.45) compared to FA dosages ≤0.8 mg (ß = 2.94, 95% CI: 2.59, 3.29). Furthermore, FA dosages higher than 0.8 mg did not confer additional benefits in terms of increasing 5-methyl tetrahydrofolic acid (5-MTHF, active form of folate) or reducing homocysteine (Hcy). Conclusion: In Chinese adults with H-type hypertension, this study showed a positive, non-linear, dosage-response relationship between FA supplementation ranging from 0 to 2.4 mg and circulating UMFA levels. It revealed that 0.8 mg FA is an optimal dosage in terms of balancing efficacy (increasing 5-MTHF and lowering Hcy) while minimizing undesirable elevation of UMFA. Clinical trial registration: https://clinicaltrials.gov/ct2/show/NCT03472508?term=NCT03472508&draw=2&rank=1, identifier NCT03472508.

Multi-Scale Attention Feature Enhancement Network for Single Image Dehazing.

Aiming to solve the problem of color distortion and loss of detail information in most dehazing algorithms, an end-to-end image dehazing network based on multi-scale feature enhancement is proposed. Firstly, the feature extraction enhancement module is used to capture the detailed information of hazy images and expand the receptive field. Secondly, the channel attention mechanism and pixel attention mechanism of the feature fusion enhancement module are used to dynamically adjust the weights of different channels and pixels. Thirdly, the context enhancement module is used to enhance the context semantic information, suppress redundant information, and obtain the haze density image with higher detail. Finally, our method removes haze, preserves image color, and ensures image details. The proposed method achieved a PSNR score of 33.74, SSIM scores of 0.9843 and LPIPS distance of 0.0040 on the SOTS-outdoor dataset. Compared with representative dehazing methods, it demonstrates better dehazing performance and proves the advantages of the proposed method on synthetic hazy images. Combined with dehazing experiments on real hazy images, the results show that our method can effectively improve dehazing performance while preserving more image details and achieving color fidelity.

Efficacy and safety of single-pill amlodipine/losartan versus losartan in patients with inadequately controlled hypertension after losartan treatment: a multicenter, double-blind, randomized phase III clinical trial.

Objective: Single-pill amlodipine besylate (AML) plus losartan (LOS) has been used to treat inadequately controlled hypertension after antihypertensive monotherapy; however, relevant data in China are limited. This study aimed to compare the efficacy and safety of single-pill AML/LOS and LOS alone in Chinese patients with inadequately controlled hypertension after LOS treatment. Methods: In this multicenter, double-blind, randomized, controlled phase III clinical trial, patients with inadequately controlled hypertension after 4 weeks of LOS treatment were randomized to receive daily single-pill AML/LOS (5/100 mg, AML/LOS group, N = 154) or LOS (100 mg, LOS group, N = 153) tablets for 8 weeks. At weeks 4 and 8 of treatment, sitting diastolic and systolic blood pressure (sitDBP and sitSBP, respectively) and the BP target achievement rate were assessed. Results: At week 8, the sitDBP change from baseline was greater in the AML/LOS group than in the LOS group (-8.84 ± 6.86 vs. -2.65 ± 7.62 mmHg, P < 0.001). In addition, the AML/LOS group also showed greater sitDBP change from baseline to week 4 (-8.77 ± 6.60 vs. -2.99 ± 7.05 mmHg) and sitSBP change from baseline to week 4 (-12.54 ± 11.65 vs. -2.36 ± 10.33 mmHg) and 8 (-13.93 ± 10.90 vs. -2.38 ± 12.71 mmHg) (all P < 0.001). Moreover, the BP target achievement rates at weeks 4 (57.1% vs. 25.3%, P < 0.001) and 8 (58.4% vs. 28.1%, P < 0.001) were higher in the AML/LOS group than those in the LOS group. Both treatments were safe and tolerable. Conclusion: Single-pill AML/LOS is superior to LOS monotherapy for controlling BP and is safe and well tolerated in Chinese patients with inadequately controlled hypertension after LOS treatment.

Homocysteine levels, H-Hypertension, and the MTHFR C677T genotypes: A complex interaction.

Background and objectives: High homocysteine levels are associated with increased risk of hypertension and stroke. Homocysteine is metabolized by the methylenetetrahydrofolate reductase (MTHFR). We aimed to investigate the levels of homocysteine and their association with hypertension, stroke, and antihypertensive medication usage in patients with different MTHFR C677T genotypes. Methods and results: Genotype frequency of MTHFR polymorphism was performed, and plasma homocysteine levels were measured in 2,640 adult Lebanese patients. Hypertension, history of stroke, and list of medications were documented, among other clinical and demographic parameters. The TT mutant genotype and the T mutant allele of MTHFR were more prevalent in hyperhomocysteinemia (HHcy) and H-hypertensive (H-HTN, defined as hypertension with hyperhomocysteinemia) patients when compared to non-HHcy subjects and non H-HTN patients respectively. Homocysteine levels were significantly higher in hypertensive patients specifically among those on diuretics. A higher level of homocysteine was found in hypertensive patients with the MTHFR T allele compared to patients carrying the C allele. Among the T allele carriers, the average plasma homocysteine level was 13.3 ± 0.193 µmol/L for hypertensive subjects compared to 11.9 ± 0.173 µmol/L (non-hypertensives). Furthermore, homocysteine levels significantly correlated with stroke risk in patients with the T alleles. Conclusions: We found an association of homocysteine with hypertension, hypertensive medication, and stroke risk among patients with the MTHFR T allele and the TT genotype. The association of diuretics therapy with higher homocysteine levels calls for routine measurements and therapeutic control of homocysteine in patients on diuretic, to improve health-related outcomes.

AIWW: a new nutrition-screening tool for the oncologic population.

Malnutrition is a common comorbidity among patients with cancer. However, no nutrition-screening tool has been recognized in this population. A quick and easy screening tool for nutrition with high sensitivity and easy-to-use is needed. Based on the previous 25 nutrition-screening tools, the Delphi method was made by the members of the Chinese Society of Nutritional Oncology to choose the most useful item from each category. According to these results, we built a nutrition-screening tool named age, intake, weight, and walking (AIWW). Malnutrition was defined based on the scored patient-generated subjective global assessment (PG-SGA). Concurrent validity was evaluated using the Kendall tau coefficient and kappa consistency between the malnutrition risks of AIWW, nutritional risk screening 2002 (NRS-2002), and malnutrition screening tool (MST). Clinical benefit was calculated by the decision curve analysis (DCA), integrated discrimination improvement (IDI), and continuous net reclassification improvement (cNRI). A total of 11,360 patients (male, n=6,024 (53.0%) were included in the final study cohort, and 6,363 patients had malnutrition based on PG-SGA. Based on AIWW, NRS-2002, and MST, 7,545, 3,469, and 1,840 patients were at risk of malnutrition, respectively. The sensitivities of AIWW, NRS-2002, and MST risks were 0.910, 0.531, and 0.285, and the specificities were 0.768, 0.946, and 0.975. The Kendall tau coefficients of AIWW, NRS-2002, and MST risks were 0.588, 0.501, and 0.326, respectively. The area under the curve of AIWW, NRS-2002, and MST risks were 0.785, 0.739, and 0.630, respectively. The IDI, cNRI, and DCA showed that AIWW is non-inferior to NRS-2002 (IDI: 0.002 (-0.009, 0.013), cNRI: -0.015 (-0.049, 0.020)). AIWW scores can also predict the survival of patients with cancer. The missed diagnosis rates of AIWW, NRS-2002, and MST were 0.09%, 49.0%, and 73.2%, respectively. AIWW showed a better nutrition-screening effect than NRS-2002 and MST for patients with cancer and could be recommended as an alternative nutrition-screening tool for this population.

Positive correlation between hypertensive retinopathy and albuminuria in hypertensive adults.

PURPOSE: We investigated the association between albuminuria and hypertensive retinopathy (HR) in hypertensive adults. METHODS: This was a cross-sectional subgroup analysis of data from the China Stroke Primary Prevention Trial. We enrolled 2,964 hypertensive adults in this study. Keith-Wagener-Barker stages was used to assess HR. The urinary albumin to creatinine ratio (UACR) was calculated to evaluate albuminuria. RESULTS: HR was found in 76.6% (n = 2, 271) of the participants, albuminuria was found in 11.1% (n = 330). The UACR levels were significantly higher in subjects with HR than in those without HR (grade 1, ß = 1.42, 95% confidence intervals [CI]: -0.12, 2.95, p = 0.070; grade 2, ß = 2.62, 95% CI: 0.56, 4.67, p = 0.013; grade 3, ß = 5.17, 95% CI: 1.13, 9.20, p = 0.012). In the subgroup analyses, the association between HR and UACR was stronger in current smokers (p for interaction = 0.014). The correlation between HR grades 1 and 2 and UACR was stronger in subjects with higher triglyceride levels (≥ 1.7 mmol/L), but for grade 3 HR, this correlation was stronger in subjects with lower triglycerides levels (< 1.7 mmol/L, p for interaction = 0.023). The odds of albuminuria were significantly higher in subjects with HR than in those without HR (grade 1, odds ratio [OR] = 1.57, 95% CI: 1.08, 2.29, p = 0.019; grade 2, OR = 2.02, 95% CI: 1.28, 3.18, p = 0.002; grade 3, OR = 2.12, 95% CI: 0.99, 4.55, p = 0.053). In the subgroup analyses, the association between HR grades 1 and 2 and albuminuria was stronger in subjects with higher triglycerides levels (≥ 1.7 mmol/L), but for grade 3 HR, this correlation was stronger in subjects with lower triglyceride levels (< 1.7 mmol/L, p for interaction = 0.014). CONCLUSION: HR was positively correlated with albuminuria in hypertensive Chinese adults. This correlation was more remarkable when the population was stratified by triglycerides levels and smoking status. HR can be used as an indicator of early renal injury.

Adaptive Aquila Optimizer Combining Niche Thought with Dispersed Chaotic Swarm.

The Aquila Optimizer (AO) is a new bio-inspired meta-heuristic algorithm inspired by Aquila's hunting behavior. Adaptive Aquila Optimizer Combining Niche Thought with Dispersed Chaotic Swarm (NCAAO) is proposed to address the problem that although the Aquila Optimizer (AO) has a strong global exploration capability, it has an insufficient local exploitation capability and a slow convergence rate. First, to improve the diversity of populations in the algorithm and the uniformity of distribution in the search space, DLCS chaotic mapping is used to generate the initial populations so that the algorithm is in a better exploration state. Then, to improve the search accuracy of the algorithm, an adaptive adjustment strategy of de-searching preferences is proposed. The exploration and development phases of the NCAAO algorithm are effectively balanced by changing the search threshold and introducing the position weight parameter to adaptively adjust the search process. Finally, the idea of small habitats is effectively used to promote the exchange of information between groups and accelerate the rapid convergence of groups to the optimal solution. To verify the optimization performance of the NCAAO algorithm, the improved algorithm was tested on 15 standard benchmark functions, the Wilcoxon rank sum test, and engineering optimization problems to test the optimization-seeking ability of the improved algorithm. The experimental results show that the NCAAO algorithm has better search performance and faster convergence speed compared with other intelligent algorithms.

Change in the Estimated Glomerular Filtration Rate Over Time and Risk of First Stroke in Hypertensive Patients.

BACKGROUND: The association between changes in estimated glomerular filtration rate (eGFR) over time and the risk of stroke remains inconclusive. We aimed to evaluate the relation of eGFR change during the China Stroke Primary Prevention Trial (CSPPT) with the risk of first stroke during the subsequent post-trial follow-up. METHODS: A total of 11,742 hypertensive participants with two eGFR measurements (median measure interval, 4.4; interquartile range, 4.2-4.6 years) and without a history of stroke from the CSPPT were included in this analysis. RESULTS: Over a median post-trial follow-up of 4.4 years, 729 first strokes were identified, of which 635 were ischemic, 88 were hemorrhagic, and 6 were uncertain types of strokes. Compared with those with 1 to <2% per year increase in eGFR (with the lowest stroke risk), those with an increase in eGFR of ≥4% per year had significantly increased risks of first stroke (adjusted hazard ratio [HR] 1.96; 95% confidence interval [CI], 1.10-3.50) and first ischemic stroke (adjusted HR 2.14; 95% CI, 1.17-3.90). Similarly, those with a decline in eGFR of ≥5% per year also had significantly increased first stroke (adjusted HR 2.13; 95% CI, 1.37-3.31) and first ischemic stroke (adjusted HR 1.89; 95% CI, 1.19-3.02) risk. However, there was no significant association between eGFR change and first hemorrhagic stroke. A similar result was found when the change in eGFR was quantified as an absolute annual change. CONCLUSION: In Chinese hypertensive patients, both the decline and increase of eGFR levels were independently associated with the risks of first stroke or first ischemic stroke.

Geographical, Sex, Age, and Seasonal Differences in Serum Manganese Status Among Chinese Adults with Hypertension.

BACKGROUND: Manganese (Mn) is an essential trace metal element required for optimal human health. However, few studies have assessed the Mn status in hypertensive patients, especially in China. Moreover, factors associated with Mn status have not yet been thoroughly explored. Therefore, we aimed to assess the serum Mn status of adults with hypertension in China and its association with demographic factors. METHODS: An observational, cross-sectional study was conducted to assess serum Mn concentrations in 14 provinces of China. A total of 2597 patients with hypertension were randomly identified by sex, age, and district, and serum Mn concentrations were quantified using inductively coupled plasma mass spectrometry (ICP-MS). RESULTS: In our study population, the median serum Mn levels were 1.60 (interquartile range (IQR), 0.94-2.85) µg/L for males and 1.51 (IQR, 0.86-2.69) µg/L for females. In adjusted linear regression models, significantly higher serum Mn concentrations were found in summer (compared with spring, ß, 1.06 µg/L, 95% CI: 0.62 to 1.50), and those living in Guangxi (compared with Heilongjiang, ß, 0.81, 95% CI: 0.06 to 1.56), Shanxi (compared with Heilongjiang, ß, 0.75, 95% CI: 0.01 to 1.50), and Liaoning (compared with Heilongjiang, ß, 1.65, 95% CI: 0.91 to 2.38), and significantly lower serum Mn concentrations were found in patients who aged 60-70 years (compared with those aged < 60 years, ß, - 0.40 µg/L, 95% CI: - 0.76 to - 0.05). CONCLUSION: Our findings observed high serum Mn status among Chinese adults with hypertension, and revealed the association between terms of age, region, and season with serum Mn.