Tracking cubic ice at molecular resolution.

Ice is present everywhere on Earth and has an essential role in several areas, such as cloud physics, climate change and cryopreservation. The role of ice is determined by its formation behaviour and associated structure. However, these are not fully understood1. In particular, there is a long-standing debate about whether water can freeze to form cubic ice-a currently undescribed phase in the phase space of ordinary hexagonal ice2-6. The mainstream view inferred from a collection of laboratory data attributes this divergence to the inability to discern cubic ice from stacking-disordered ice-a mixture of cubic and hexagonal sequences7-11. Using cryogenic transmission electron microscopy combined with low-dose imaging, we show here the preferential nucleation of cubic ice at low-temperature interfaces, resulting in two types of separate crystallization of cubic ice and hexagonal ice from water vapour deposition at 102 K. Moreover, we identify a series of cubic-ice defects, including two types of stacking disorder, revealing the structure evolution dynamics supported by molecular dynamics simulations. The realization of direct, real-space imaging of ice formation and its dynamic behaviour at the molecular level provides an opportunity for ice research at the molecular level using transmission electron microscopy, which may be extended to other hydrogen-bonding crystals.

Associations of different isomeric forms of serum lycopene with cardiovascular disease and all-cause mortality.

Background: The effect of serum lycopene on the progression of cardiovascular diseases (CVDs) and their longevity remains a controversial topic. The purpose of this study was to evaluate the associations of different isomeric forms of serum lycopene with CVD and all-cause mortality in the American population. Methods: The National Health and Nutrition Examination Survey (NHANES) is a large population survey to investigate public health in the US. We analyzed data from 2003-2006 linked with mortality data obtained in 2015. Cox proportional hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated to assess the risk of CVD and all-cause mortality caused by serum lycopene. Results: Among 7452 participants (aged 20-85 years, 46.7% male), 298 died from CVDs among the total 1213 deaths during a median follow-up of 10.7 years. Serum lycopene is a protective factor for all-cause and CVD mortality. In multivariable-adjusted models, the hazard ratio (with 95% confidence intervals) associated with Q4 compared to Q1 of serum total-lycopene, trans-lycopene and cis-lycopene was 0.49 (0.38,0.63), 0.49 (0.39,0.63) and 0.55 (0.43,0.70) for all-cause mortality (Ptrend<0.05), and was 0.53 (0.32,0.96), 0.48 (0.32,0.72) and 0.63 (0.41,0.97) for CVD mortality (Ptrend<0.05). The subgroup analyses showed that different isomeric forms of lycopene showed varied associations with CVD and all-cause mortality based on age, drinking status, history of hypertension and diabetes. Conclusions: Serum lycopene concentration was significantly associated with the risk of CVD and all-cause mortality. Cis-lycopene had a U-shaped relationship with mortality, while trans-lycopene had an inverse relationship with it.

Association between outdoor artificial light at night and sleep duration among older adults in China: A cross-sectional study.

BACKGROUND: Light after dusk disrupts the circadian rhythms and shifts the timing of sleep later; but it is unknown whether outdoor artificial light at night (ALAN) affects sleep quality. This study aimed to explore the association between residential outdoor ALAN and sleep duration in a nationally representative sample of Chinese older adults. METHODS: We examined the cross-sectional associations of outdoor ALAN with self-reported sleep duration in 13,474 older adults participating in the 2017-2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Outdoor ALAN exposure was estimated at the residence level using satellite images. We applied generalized linear mixed models to investigate the association between ALAN exposure and sleep duration. We performed stratified analyses by age, sex, education, and household income levels. Moreover, we used multi-level logistic regression models to investigate the effects of ALAN on the short sleep duration (≤6 h) and the long sleep duration (>8 h), respectively, in reference to sleep for >6-8 h per day. RESULTS: We found a significant association between outdoor ALAN intensity and sleep duration. The highest quartile of ALAN was associated with 17.04 (95% CI: 9.42-24.78) fewer minutes of sleep as compared to the lowest quartile. The reductions in sleep duration per quartile change in ALAN were greater in the young old (≥65-85 years) and in those with higher levels of education, and those with higher household income, respectively. We did not detect a sex difference. In addition, those in the highest quartile of ALAN were more likely to report a 25% (95% CI: 10%-42%) increase in short sleep (<6 h), and a 21% (95% CI: 9%-31%) decrease in long sleep (>8 h). CONCLUSIONS: Increasing outdoor nighttime light intensity surrounding residences was associated with shorter sleep duration in older residents in China. This finding implies the importance of urban outdoor artificial light management as a potential means to lower the public health burden of sleep disorders.

YOLOv5-AC: Attention Mechanism-Based Lightweight YOLOv5 for Track Pedestrian Detection.

In response to the dangerous behavior of pedestrians roaming freely on unsupervised train tracks, the real-time detection of pedestrians is urgently required to ensure the safety of trains and people. Aiming to improve the low accuracy of railway pedestrian detection, the high missed-detection rate of target pedestrians, and the poor retention of non-redundant boxes, YOLOv5 is adopted as the baseline to improve the effectiveness of pedestrian detection. First of all, L1 regularization is deployed before the BN layer, and the layers with smaller influence factors are removed through sparse training to achieve the effect of model pruning. In the next moment, the context extraction module is applied to the feature extraction network, and the input features are fully extracted using receptive fields of different sizes. In addition, both the context attention module CxAM and the content attention module CnAM are added to the FPN part to correct the target position deviation in the process of feature extraction so that the accuracy of detection can be improved. What is more, DIoU_NMS is employed to replace NMS as the prediction frame screening algorithm to improve the problem of detection target loss in the case of high target coincidence. Experimental results show that compared with YOLOv5, the AP of our YOLOv5-AC model for pedestrians is 95.14%, the recall is 94.22%, and the counting frame rate is 63.1 FPS. Among them, AP and recall increased by 3.78% and 3.92%, respectively, while the detection speed increased by 57.8%. The experimental results verify that our YOLOv5-AC is an effective and accurate method for pedestrian detection in railways.

Consumption of soy products and cardiovascular mortality in people with and without cardiovascular disease: a prospective cohort study of 0.5 million individuals.

PURPOSE: We sought to examine the association of soy product consumption with risk of cardiovascular death in Chinese individuals with and without a history of cardiovascular disease (CVD). METHODS: The current analysis included 487,034 individuals free of CVD and 22,923 individuals with a history of CVD at study baseline. Data on consumption of soy products were collected by a food frequency questionnaire. The Cox regression was used to obtain the hazard ratios (HRs) of cardiovascular mortality associated with soy product consumption among people with and without a history of CVD at baseline. RESULTS: During the period of follow-up, 12,582 and 2860 cardiovascular deaths were recorded among people without and with a history of CVD. Compared with those who never or rarely ate soy products, the multivariable HRs (95% CIs) were 1.02 (0.96, 1.08) for those who ate soy products monthly, 1.01 (0.95, 1.07) for those who ate soy products 1-3 days per week, 0.95 (0.88, 1.04) for those who ate soy products ≥ 4 days per week. For cause-specific mortality, soy product consumption was inversely associated with mortality from acute myocardial infarction (HR [95% CI] = 0.75 [0.61, 0.92]). Among people with a history of CVD, higher soy product consumption was not associated with cardiovascular mortality. CONCLUSIONS: Soy consumption ≥ 4 days per week was associated with a significantly lower risk of mortality from acute myocardial infarction in comparison with never or rarely consumption among people without a history of CVD. Among people with a history of CVD, higher soy product consumption was not associated with cardiovascular mortality.

Alcohol Consumption and Risk of Gastric Cancer: The Japan Collaborative Cohort Study.

BACKGROUND: Alcohol consumption is a potential risk factor for gastric cancer. However, findings from cohort studies that examined the relationship between alcohol consumption and gastric cancer risk among Japanese population are not conclusive. METHODS: A total of 54,682 Japanese men and women participating in the Japan Collaborative Cohort study completed a questionnaire, including alcohol consumption information. The Cox proportional hazard model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: After a median 13.4-year follow-up, we documented 801 men and 466 women incident cases of gastric cancer. Alcohol consumption was associated with increased risk of gastric cancer among men (HRs in ex-drinkers and current alcohol consumption of <23 g, 23-<46 g, 46-<69 g, and ≥69 g/d categories versus never drinkers were 1.82; 95% CI, 1.38-2.42, 1.41; 95% CI, 1.10-1.80, 1.47; 95% CI, 1.17-1.85, 1.88; 95% CI, 1.48-2.38, and 1.85; 95% CI, 1.35-2.53, respectively, and that for 10 g increment of alcohol consumption after excluding ex-drinkers was 1.07; 95% CI, 1.04-1.10). The association in men was observed for cardia and non-cardia gastric cancer (HRs in the highest alcohol consumption category versus never drinkers were 9.96; 95% CI, 2.22-44.67 for cardia cancer and 2.40; 95% CI, 1.64-3.52 for non-cardia cancer). However, no such trend was observed in women. CONCLUSIONS: Alcohol consumption is associated with increased risk of gastric cancer among Japanese men, regardless of anatomical subsite of the cancer.

Simultaneous measurement of the absolute and relative time delay of a tiled-aperture coherent beam combination via the double-humped spectral beam interferometry.

Coherent beam combination (CBC) is a promising technology for achieving several hundred petawatts and even EW-level lasers. However, the measurement of the synchronization error and the time jitter of CBC is one of key technical issues, especially in the few-cycle PW-level laser facilities. In this paper, we demonstrate that the absolute time delay (ATD) and the relative time delay (RTD) for a tiled-aperture CBC can simultaneously be measured by using the double-humped spectral beam interferometry. The experimental study also was demonstrated. A root-mean-square deviation of approximately λ/38 (70 as) and a combining efficiency of 87.3% at 1 Hz closed feedback loop was obtained, respectively. Due to the wide adjustment range and a vast resisting beam energy disturbance capacity, this technique provide an effective and practical solution for measuring simultaneously the ATD and the RTD in the few-cycle PW-level laser pulses CBC.

An SDS-PAGE based method for the quantification of carbon black in biological samples.

Carbon black (CB) has a wide range of industrial applications and recently has been used as the basic model for environmental health studies on airborne particulate matters (PM). Exposure characterization of CB is always the first and most important step towards a better understanding of its effects on human health. However, efforts were largely limited by the lack of valid methods capable of quantifying CB in biological samples. Here, we developed a new method based on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) for CB quantification in bio-samples, with a detection limit of 4.3 ng. The method is so economical and convenient that it can be performed in most biology labs. The application of the method was successfully demonstrated in three different cell models (mouse macrophage cells (Raw264.7), human epithelial cells (A549) and mouse mesenchymal stem cells (MSC)) and the results showed that the uptake rates decrease in the order of MSC > Raw264.7 > A549. The surprisingly highest uptake rate of MSC deserves further investigation. The novel method provides a complementary quantitative tool to the use of conventional methods such as radioactive and fluorescent labeling and may facilitate related toxicological studies.

Eco-Corona vs Protein Corona: Effects of Humic Substances on Corona Formation and Nanoplastic Particle Toxicity in Daphnia magna.

Despite many studies on the toxicity of nanoplastic particles (NPPs) to aquatic invertebrates, the effects of ecological constituents such as humic substances (HSs) are often neglected. In our study, Daphnia magna was used to evaluate the effects of three HSs, natural organic matter (NOM), fulvic acid (FA), and humic acid (HA), on NPP toxicity and corona formation. Acute toxicities of NPPs were reduced by all HSs at environmentally relevant concentrations. NPPs elicited the upregulation of all genes related to detoxification, oxidative stress, and endocrine activity after 7 days of exposure. The presence of NOM or HA resulted in the mitigation of gene expression, whereas significantly higher upregulation of all of the genes was observed with FA. The presence of FA led to increased protein adsorption on NPPs in D. magna culture medium (eco-corona, EC) and homogenates (protein corona, PC), while there was less adsorption in the presence of HA. The highly abundant proteins identified in EC are involved in immune defense, cell maintenance, and antipredator response, while those in PC are responsible for lipid transport, antioxidant effects, and estrogen mediation. Our findings revealed the key influence of HSs on the toxicity of NPPs and provide an analytical and conceptual foundation for future study.

Diabetes and Mortality From Respiratory Diseases: The Japan Collaborative Cohort Study.

BACKGROUND: Little evidence is available about the association between diabetes and respiratory disease mortality among Japanese populations. We aimed to explore the association between diabetes and the risk of respiratory diseases mortality through a nationwide prospective study in Japan. METHODS: We followed 95,056 participants (39,925 men and 55,131 women) for a median 17.1 years. The information about diabetes status, sociodemographic characteristics, and lifestyles was collected at baseline. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) of mortality from respiratory diseases associated with baseline diabetes status. RESULTS: We identified 2,838 deaths from total respiratory diseases (1,759 respiratory infection, 432 chronic obstructive pulmonary disease, and 647 other respiratory diseases). The association between diabetes and total respiratory disease mortality was statistically significant among women (HR 1.81; 95% CI, 1.39-2.37) but of borderline statistical significance in men (P for interaction <0.01). Besides, there were significant associations between diabetes and mortality from respiratory infection among both men and women (HR 1.39; 95% CI, 1.10-1.76 and HR 2.30; 95% CI, 1.71-3.11, respectively; P for interaction <0.001). However, we failed to detect any statistically significant association between diabetes and COPD mortality. Moreover, the subgroup analysis revealed that the association between diabetes and total respiratory disease mortality was stronger in never smokers when compared with ever smokers (P for interaction = 0.02). CONCLUSIONS: Significant association was observed between diabetes and the risk of total respiratory disease mortality, in particular from respiratory infection. Prevention and control of respiratory diseases, especially respiratory infection, should be paid more attention among people with diabetes in clinical and public health practice.

Age-Period-Cohort Analysis of Stroke Mortality Attributable to High Sodium Intake in China and Japan.

Background and Purpose- The aim of this study is to assess the long-term trends in stroke mortality attributable to high sodium intake in China and Japan during the period 1990 to 2016. Methods- The mortality data were obtained from the GBD study (Global Burden of Disease) 2016 and were analyzed using an age-period-cohort method. Results- The age-standardized mortality rates showed declining trends for high sodium intake-related stroke mortality. The overall net drifts per year were -3.1% for Chinese men and -5.0% for Chinese women; and -4.6% for Japanese men and -5.7% for Japanese women. The local drift values were below zero in all age groups for both sexes in both countries, and all local drift values of female participants were below their counterparts of male participants. The longitudinal age curves of high sodium intake-attributable stroke mortality increased rapidly for both sexes in China, whereas those of Japanese were slowly rising. The period and cohort rate ratios were found to have similar downward patterns for both sexes in both countries, with a quicker decline for women than for men (significantly with P<0.05 for all). Conclusions- The age-standardized mortality rates, the period effect and the cohort effect of stroke mortality attributable to high sodium intake in China and Japan have been declining in both sexes and all age groups from 1990 to 2016. Consequently, sodium-reduction strategies are of low cost and effective for the prevention of stroke. It is necessary to educate the nation with the correct knowledge on healthy diet and techniques to reduce salt consumption.

Sleep duration and risk of breast cancer: The JACC Study.

PURPOSE: The evidence on beneficial or adverse effects of sleep duration on risk of breast cancer remains controversial and limited, especially in Asia. METHODS: A prospective study of 34,350 women aged 40-79 years in whom sleep duration, and menstrual and reproductive histories were determined by a self-administered questionnaire. The follow-up period was from 1988 to 2009, and hazard ratios (HRs) with 95% confidence intervals (CIs) of breast cancer incidence were calculated for shorter sleep duration in reference to sleep duration of ≥ 8 h/day by Cox proportional hazard models. RESULTS: During 19.2-year median follow-up (236 cases), we found a significant inverse association between sleep duration and risk of breast cancer, especially among postmenopausal women and women with low parity (nulliparous and women with < 3 children); the multivariable HRs (95% CIs) among postmenopausal women who reported 7 h/day and ≤ 6 h/day of sleep in reference to ≥ 8 h/day were 1.49 (0.81-2.76) and 1.98 (1.08-3.70) (P for trend = 0.028), respectively, and the corresponding values among women with low parity were 1.50 (0.96-2.35) and 1.76 (1.01-2.79) (P for trend = 0.018). CONCLUSIONS: Short sleep duration was associated with increased risk of incident breast cancer, especially among postmenopausal women and women with low parity.

Physical Activity and Bladder Cancer Risk: Findings of the Japan Collaborative Cohort Study.

PURPOSE: The association of physical activity with the risk of bladder cancer remains inconsistent among Asian populations. We aimed to examine the association in a large Japanese cohort. MATERIALS AND METHODS: In a population-based prospective cohort study, a total of 50,374 Japanese adults aged 40-79 years without a history of cancer or cardiovascular disease who had information on physical activity from self-administrated questionnaires were used for analysis. We performed Cox proportional hazard models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident bladder cancer after adjusting for several potential confounders. RESULTS: During the median 17.5 years of follow-up, 153 incident bladder cancers (116 men and 37 women) were identified. After the multivariable adjustment, HRs (95% CI) of bladder cancer concerning those with recreational sports participation of 1-2 hr/wk, 3-4 hr/wk, and 5 hr/wk and more were 0.67 (0.38-1.20), 0.79 (0.36-1.74), and 0.28 (0.09-0.89), respectively (p for trend=0.017). Compared with mostly sitting at the workplace, occupational physical activity of standing and walking were associated with a lower risk of bladder cancer (HR, 0.53 [95% CI, 0.32 to 0.85]). Hours of daily walking were not associated with the risk. The lower risk of bladder cancer was more evident for recreational sports (HR, 0.33 [95% CI, 0.10 to 1.00]), and for occupational standing and walking activity at work (HR, 0.57 [95% CI, 0.33 to 0.98]) among men. CONCLUSION: Recreational sports participation and occupational physical activity were inversely associated with the risk of bladder cancer among Japanese, especially in men.

Depression and the Risk of Dementia and All-Cause Mortality Among Japanese Older Adults: A 9-Year Longitudinal Study From JAGES.

BACKGROUND: This study aims to investigate the association and dose-response relationship between depression, dementia, and all-cause mortality based on a national cohort study of older adults in Japan. METHODS: We conducted a longitudinal study of 44,546 participants ≥65 years from 2010-2019 Japanese Gerontological Evaluation Study. The Geriatric Depression Scale-15 was used to assess depressive symptoms and the long-term care insurance was used to assess dementia. Fine-Gray models and Cox proportional hazard models were used to explore the effect of depression severity on the incidence of dementia and all-cause mortality, respectively. Causal mediation analysis were used to explore the extent of association between dementia-mediated depression and all-cause mortality. RESULTS: We found that both minor and major depressive symptoms were associated with the increased cumulative incidence of dementia and all-cause mortality, especially major depressive symptoms (p < .001). The multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for dementia were 1.25 (1.19-1.32) for minor depressive symptoms and 1.42 (1.30-1.54) for major depressive symptoms in comparison to non-depression; p for trend < .001. The multivariable-adjusted HRs and 95% CIs for all-cause mortality were 1.27 (1.21-1.33) for minor depressive symptoms and 1.51 (1.41-1.62) for major depressive symptoms in comparison to non-depression; p for trend < .001. Depression has a stronger impact on dementia and all-cause mortality among the younger group. In addition, dementia significantly mediated the association between depression and all-cause mortality. DISCUSSION: Interventions targeting major depression may be an effective strategy for preventing dementia and premature death.

Associations of dietary linoleic acid and alpha linolenic acid intake with cardiovascular, cancer and all-cause mortalities in patients with diabetes: NHANES 1999-2008.

Objective: To investigate the association between the dietary intake of linoleic acid (LA) and alpha linolenic acid (ALA) with mortality outcomes in patients with diabetes. Participants: 3,112 U.S. adults aged≥20 years. Setting: Basic information was collected at baseline of the National Health and Nutrition Examination Survey (NHANES). Serum CRP (mg/dL), total protein (g/L), waist circumference (cm), fasting blood glucose (mmol/L), white blood cell count, serum LDL-C, and serum HDL-C were also measured. Daily diets were also recorded using a 24-hour dietary review to produce the individuals' intake of LA and ALA. The association between tertiles of LA and ALA intake with mortality was analyzed by weighted Cox models adjusted for the main confounders. Main outcome measures: The study included 3,112 adults with diabetes from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2008. Death outcomes were ascertained by linkage to the database records through 31 December 2015. Results: Subjects with a high intake of LA (T3) had 17% [hazard ratio (HR) 0.83, 95% CI 0.70 to 0.99) and 48% (HR=0.52, 0.35 to 0.80)] reductions in all-cause mortality and cardiovascular mortality, respectively, compared with subjects with lowest intake (T1). Similar results were observed for ALA, HR of cardiovascular mortality was 0.55 (0.38 to 0.81) and for all-cause mortality was 0.85 (0.69 to 1.04) comparing the highest to lowest intake tertiles. Conclusion: Higher intakes of LA and ALA were inversely associated with CVD and all-cause deaths in patients with diabetes. Proper dietary intakes of LA and ALA could contribute to the cardiovascular health and the long-term survival of patients with diabetes.

Navigating Hurdles: A Review of the Obstacles Facing the Development of the Pandemic Treaty.

INTRODUCTION: The emergence of the COVID-19 pandemic has served as a call for enhanced global cooperation and a more robust pandemic preparedness and response framework. As a result of this pressing demand, dialogues were initiated to establish a pandemic treaty designed to foster a synchronized global strategy for addressing forthcoming health emergencies. In this review, we discussed the main obstacles to this treaty. RESULTS: Among several challenges facing the pandemic treaty, we highlighted (1) global cooperation and political will, (2) equity in access to resources and treatments, (3) sustainable financing, (4) compliance and enforcement mechanisms, (5) sovereignty concerns, and (6) data sharing and transparency. CONCLUSION: Navigating the hurdles facing the development of the pandemic treaty requires concerted efforts, diplomatic finesse, and a shared commitment to global solidarity. Addressing challenges in global cooperation, equitable access, transparency, compliance, financing, and sovereignty is essential for forging a comprehensive and effective framework for pandemic preparedness and response on the global stage.

Mechanistic insight on water dissociation on pristine low-index TiO2 surfaces from machine learning molecular dynamics simulations.

Water adsorption and dissociation processes on pristine low-index TiO2 interfaces are important but poorly understood outside the well-studied anatase (101) and rutile (110). To understand these, we construct three sets of machine learning potentials that are simultaneously applicable to various TiO2 surfaces, based on three density-functional-theory approximations. Here we show the water dissociation free energies on seven pristine TiO2 surfaces, and predict that anatase (100), anatase (110), rutile (001), and rutile (011) favor water dissociation, anatase (101) and rutile (100) have mostly molecular adsorption, while the simulations of rutile (110) sensitively depend on the slab thickness and molecular adsorption is preferred with thick slabs. Moreover, using an automated algorithm, we reveal that these surfaces follow different types of atomistic mechanisms for proton transfer and water dissociation: one-step, two-step, or both. These mechanisms can be rationalized based on the arrangements of water molecules on the different surfaces. Our finding thus demonstrates that the different pristine TiO2 surfaces react with water in distinct ways, and cannot be represented using just the low-energy anatase (101) and rutile (110) surfaces.

Arm Circumference, Arm-to-Waist Ratio in Relation to Cardiovascular and All-Cause Mortality among Patients with Diabetes Mellitus.

Among patients with diabetes mellitus, limited studies have investigated the relationship between anthropometric parameters and cardiovascular disease (CVD), with all-cause mortality. We examined the associations of arm circumference (AC), arm-to-waist ratio (AC/WC), and CVD, with all-cause mortality among patients with diabetes. This is a cohort study of 5497 diabetic individuals aged 20 or over who were recruited in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014. Cox proportional hazards regression models were used to analyze the associations between AC, AC/WC, and CVD, with all-cause mortality. We also conducted stratified analyses and explored the possible non-linear relation by restricted cubic splines. During a median follow-up of 7.2 years, there were 271 and 1093 cases of CVD and all-cause death. The multivariable adjusted hazard ratios (HRs) with 95% confidence intervals (Cis) of CVD mortality in Q2, Q3, and Q4 groups compared with Q1 group were 0.37 (0.22, 0.62), 0.24 (0.12, 0.48), 0.18 (0.07, 0.46) for AC, and 0.18 (0.07, 0.46), 0.34 (0.20, 0.60), 0.28 (0.15, 0.53) for AC/WC. Similar results were observed in the analysis for all-cause mortality risk. AC and AC/WC were both inversely associated with CVD and all-cause mortality among individuals with diabetes. It is important to pay attention to these anthropometric parameters of diabetic patients.

Association of Blood Urea Nitrogen with Cardiovascular Diseases and All-Cause Mortality in USA Adults: Results from NHANES 1999-2006.

In the general population, there is little evidence of a link between blood urea nitrogen (BUN) and long-term mortality. The goal of this study was to explore whether higher BUN concentration is a predictor of cardiovascular disease (CVD) and all-cause mortality. From 1999 to 2006, the National Health and Nutrition Examination Survey (NHANES) included 17,719 adult individuals. Death outcomes were ascertained by linkage to the database records through 31 December 2015. The Cox proportional hazard regression model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD and all-cause mortality in individuals. We also performed stratified analyses based on age, gender, drinking, smoking, history of hypertension and diabetes. During a mean follow-up 11.65 years, a total of 3628 deaths were documented, of which 859 were due to CVD. Participants with higher BUN had a higher risk of CVD and all-cause death compared to those with lower BUN. After multifactor adjustment for demographics, major lifestyle factors, and hypertension and diabetes history, higher BUN levels compared with lower levels were significantly associated with higher risk of CVD (HR: 1.48 [1.08, 2.02], P-trend < 0.001) and all-cause mortality (HR: 1.48 [1.28, 1.72], P-trend < 0.001). In subgroup analyses, we found that the trend in the association of BUN with the risk of death remained strong in female subjects. Greater BUN levels were linked to higher CVD and all-cause mortality in the NHANES of American adults. The importance of BUN in predicting death is supported by our research.