The spatial-temporal variations and influencing factors of COVID-19 case fatality rate: a worldwide study in 30 countries from February 2021 to May 2022.

To evaluate the variations in COVID-19 case fatality rates (CFRs) across different regions and waves, and the impact of public health interventions, social and economic characteristics, and demographic factors on COVID-19 CFRs, we collected data from 30 countries with the highest incidence rate in three waves. We summarized the CFRs of different countries and continents in each wave through meta-analysis. Spearman's correlation and multiple linear regression were employed to estimate the correlation between influencing factors and reduction rates of CFRs. Significant differences in CFRs were observed among different regions during the three waves (P < 0.001). An association was found between the changes in fully vaccinated rates (r s  = 0.41), population density (r s  = 0.43), the proportion of individuals over 65 years old (r s  = 0.43), and the reduction rates of case fatality rate. Compared to Wave 1, the reduction rates in Wave 2 were associated with population density (ß = 0.19, 95%CI: 0.05-0.33) and smoking rates (ß = -4.66, 95%CI: -8.98 - -0.33), while in Wave 3 it was associated with booster vaccine rates (ß = 0.60, 95%CI: 0.11-1.09) and hospital beds per thousand people (ß = 4.15, 95%CI: 1.41-6.89). These findings suggest that the COVID-19 CFRs varied across different countries and waves, and promoting booster vaccinations, increasing hospital bed capacity, and implementing tobacco control measures can help reduce CFRs.

Evaluating the spatiotemporal land ecological changes in the Yangtze-to-Huaihe Water Diversion Project area.

As a fundamental component of human existence, land is inextricably linked to human development, and its ecological functions are closely associated with multiple sustainable development goals. This paper presents a framework for constructing and optimizing ecological function space, with the Yangtze-to-Huaihe Water Diversion Project area serving as a case study. A comprehensive land ecological index system is established, encompassing natural foundation, land degradation, land production, ecological structure, and ecological protection. An identity-discrepancy-contrary connection method is employed to investigate changes in regional land ecological functions before (2013) and during (2017, 2020, and 2022) the project's construction based on remote sensing data. The results indicated that the mean values of the land ecological index for each period were 0.1883, 0.1981, 0.2253, and 0.1370, respectively. The study calculated the connection, differences, and contradictions in the land ecological impacts across the counties, revealing a gradual decrease in differences and a growing prominence of contradictions. The land ecology of the Yangtze-to-Huaihe Water Diversion Project area is affected by the project construction, particularly within the construction area, showing an overall improvement. Most counties exhibited a trend of ecological improvement compared to the land ecology before the project's construction. However, after the project implementation, most districts demonstrated a trend of ecological deterioration. As the distance from the construction canal increases, the characteristics of each section and stage vary, generally exhibiting an exponential decrease in the land ecological index. The study highlighted the significance of enhancing the land ecological pattern, improving water quality, increasing water supply along the project, and alleviating groundwater overexploitation. The study can serve as a reference for land ecological protection and restoration in water transfer areas and river basins worldwide.

Super-resolution ultrasound imaging reveals temporal cerebrovascular changes with disease progression in female 5×FAD mouse model of Alzheimer's disease: correlation with pathological impairments.

BACKGROUND: Vascular dysfunction is closely associated with the progression of Alzheimer's disease (AD). A critical research gap exists that no studies have explored the in vivo temporal changes of cerebrovascular alterations with AD progression in mouse models, encompassing both structure and flow dynamics at micron-scale resolution across the early, middle, and late stages of the disease. METHODS: In this study, ultrasound localisation microscopy (ULM) was applied to image the cerebrovascular alterations of the transgenic female 5×FAD mouse model across different stages of disease progression: early (4 months), moderate (7 months), and late (12 months). Age-matched non-transgenic (non-Tg) littermates were used as controls. Immunohistology examinations were performed to evaluate the influence of disease progression on the ß-amyloid (Aß) load and microvascular alterations, including morphological changes and the blood-brain barrier (BBB) leakage. FINDINGS: Our findings revealed a significant decline in both vascular density and flow velocity in the retrosplenial cortex of 5×FAD mice at an early stage, which subsequently became more pronounced in the visual cortex and hippocampus as the disease progressed. Additionally, we observed a reduction in vascular length preceding diminished flow velocities in cortical penetrating arterioles during the early stages. The quantification of vascular metrics derived from ULM imaging showed significant correlations with those obtained from vascular histological images. Immunofluorescence staining identified early vascular abnormalities in the retrosplenial cortex. As the disease advanced, there was an exacerbation of Aß accumulation and BBB disruption in a regionally variable manner. The vascular changes observed through ULM imaging exhibited a negative correlation with amyloid load and were associated with the compromise of the BBB integrity. INTERPRETATION: Through high-resolution, in vivo imaging of cerebrovasculature, this study reveals significant spatiotemporal dysfunction in cerebrovascular dynamics accompanying disease progression in a mouse model of AD, enhancing our understanding of its pathophysiology. FUNDING: This study is supported by grants from National Key Research and Development Program of China (2020YFA0908800), National Natural Science Foundation of China (12074269, 82272014, 82327804, 62071310), Shenzhen Basic Science Research (20220808185138001, JCYJ20220818095612027, JCYJ20210324093006017), STI 2030-Major Projects (2021ZD0200500) and Guangdong Natural Science Foundation (2024A1515012591, 2024A1515011342).

Temporal changes in survival among adult patients with acute lymphoblastic leukaemia diagnosed in the period 1998-2020 - A Danish nationwide population-based cohort study.

BACKGROUND: Previous studies have shown continuous improved overall survival (OS) up to 2015 for young adults with acute lymphoblastic leukaemia (ALL). However, recently several important advances have been made justifying a more contemporary analysis of outcomes in adult with ALL. METHODS: In this nationwide population-based cohort study, we included patients above 18 years of age diagnosed with ALL between January 1, 1998, and December 31, 2020. Patients were followed until December 31, 2022. By employing flexible parametric survival models, we quantified progress in OS using the key endpoint of 2-year age standardized OS for all patients and clinical subgroups of interest. FINDINGS: This study includes 657 patients and demonstrates a significant improvement in OS over time with the 2-year age standardized OS increasing from 36·4 % (95 % CI, 27·0-45·8 %) for patients diagnosed in 1998 to 68·6 % (95 % CI, 60·2-76·9)for patients diagnosed in 2020, corresponding to an absolute increase in 2-year OS of 32·2 % points (95 % CI, 19·1-45·2). Stratified analysis revealed improvements for both Philadelphia chromosome positive and negative ALL, across cytogenetic risk groups, and for B- and T-cell ALL, whereas the latter did not reach statistical significance. Improvements were seen across all ages; however, most pronounced for Philadelphia chromosome positive ALL and patients below 60 years of age. INTERPRETATION: These results show a universal and continuous improvement in the treatment of adult ALL. Currently, novel treatment combination and advances in cellular therapy occur rapidly, and we expect even further improvements in the years to come. FUNDING: Northern Region of Denmark.

Tissue distribution and temporal and spatial assessment of per- and polyfluoroalkyl substances (PFAS) in smallmouth bass (Micropterus dolomieu) in the mid-Atlantic United States.

Per- and polyfluoroalkyl substances (PFAS) have become an environmental issue worldwide. A first step to assessing potential adverse effects on fish populations is to determine if concentrations of concern are present in a region and if so, in which watersheds. Hence, plasma from adult smallmouth bass Micropterus dolomieu collected at 10 sites within 4 river systems in the mid-Atlantic region of the United States, from 2014 to 2019, was analyzed for 13 PFAS. These analyses were directed at better understanding the presence and associations with land use attributes in an important sportfish. Four substances, PFOS, PFDA, PFUnA, and PFDoA, were detected in every plasma sample, with PFOS having the highest concentrations. Sites with mean plasma concentrations of PFOS below 100 ng/ml had the lowest percentage of developed landcover in the upstream catchments. Sites with moderate plasma concentrations (mean PFOS concentrations between 220 and 240 ng/ml) had low (< 7.0) percentages of developed land use but high (> 30) percentages of agricultural land use. Sites with mean plasma concentrations of PFOS > 350 ng/ml had the highest percentage of developed land use and the highest number PFAS facilities that included military installations and airports. Four of the sites were part of a long-term monitoring project, and PFAS concentrations of samples collected in spring 2017, 2018, and 2019 were compared. Significant annual differences in plasma concentrations were noted that may relate to sources and climatic factors. Samples were also collected at two sites for tissue (plasma, whole blood, liver, gonad, muscle) distribution analyses with an expanded analyte list of 28 PFAS. Relative tissue distributions were not consistent even within one species of similar ages. Although the long-chained legacy PFAS were generally detected more frequently and at higher concentrations, emerging compounds such as 6:2 FTS and GEN X were detected in a variety of tissues.

Temporal changes in the physical fitness of Chinese adolescents aged 13-18 years: an analysis of eight national successive surveys over three decades.

Objective: The aim of this study was to assess temporal changes in physical fitness of Chinese adolescents aged 13-18 years from 1985 to 2019. Methods: Body size /composition and physical fitness indicators, including body height, weight, body mass index (BMI), speed, power, flexibility, muscular endurance, and cardiorespiratory fitness (CRF), were selected from Chinese boys and girls aged 13-18 years from eight Chinese National Surveillance on Students' Constitution and Health from 1985 to 2019. Temporal changes in means were estimated by sample-weighted linear regression at the test × sex × age level, and national trends were estimated by a post-stratification population weighting procedure. Results: Overall mean body height, weight and BMI increased significantly for Chinese adolescents over 34 years. There was a small improvement for boys in speed (Effect size [ES] = -0.21, 95% confidence interval [CI] = -0.44 ~ 0.02), a small improvement for boys in power (ES = 0.24, 95% CI = -0.20 ~ 0.69), a small improvement for girls in flexibility (ES = 0.45, 95% CI = 0.15 ~ 0.76), a moderate decline for boys (ES = -0.53 95% CI = -0.84 ~ -0.21) and a moderate improvement for girls (ES = 0.61, 95% CI = -0.03 ~ 1.26) in muscular endurance, and large declines in cardiorespiratory fitness (CRF) for boys (ES = 0.93, 95% CI = 0.64 ~ 1.21) and girls (ES = 0.93, 95% CI = 0.58 ~ 1.27) from 1985 to 2019. These trends in each component of fitness were more positive for adolescents aged 13-15 years than that of adolescents aged 16-18 years in both sexes, except for girls in flexibility. Conclusion: The decline in CRF was most pronounced among Chinese children and adolescents from 1985 to 2019, suggesting a future decline in population health that needs attention.

Spectral Power Distribution of Heart Rate Variability in Contiguous Short-Term Intervals.

INTRODUCTION: Heart rate variability (HRV) is determined by the variation of consecutive cardiac electrical excitations, usually from RR intervals of an EKG. The sequence of intervals is a time series that yields three HRV parameter categories: time domain, frequency domain, and nonlinear. Parameter estimates are based on widely different EKG sample times: short-term (~5-10 minutes), longer (24 hours), and ultra-short (<5 minutes). Five-minute intervals are useful to evaluate intervention effects that change HRV in a single session by comparing pre-to-post values. This approach relies on knowing the minimal detectible change (MDC) that indicates a real change in clinical and research studies. The specific aims of this pilot study were to (1) evaluate HRV power and its spectral distribution among contiguous five-minute intervals, (2) compare the power distribution in a five-minute interval with a full 45-minute assessment, and (3) provide data to aid estimation of the MDC between pre- and post-interventions during a single session.  Methods: Twelve self-reported healthy young adults participated after signing an approved consent. Participation required subjects who had no history of cardiovascular disease or were taking vasoactive substances. Persons with diabetes were not eligible. While subjects were supine, EKG leads were placed, and EKG was recorded for 45 minutes at 1000 samples/sec. The 45 minutes were divided into nine five-minute contiguous intervals, and the spectral density in each was determined. Total power and spectral percentages within each interval were assessed in the very low (VLF, 0.003-0.04 Hz), low (LF, 0.04-0.15 Hz), and high (HF, 0.15-0.4 Hz) frequency bands. These were compared among intervals and to the full 45-minute sample. The MDC was determined by comparing powers in five-minute intervals separated by 10 minutes. The standard error of the measurement (SEME) for each pair was calculated from the square root of the mean square error (√MSE). MSE was based on a two-factor analysis of variance, and MDC was 2×√2×SEME. RESULTS: Differences in total power and spectral power distribution among intervals were not statistically significant. The total mean power±SD was 4561±1434 ms². The maximum difference in total power was 7.85%. The mean power for the VLF, LF, and HF bands was respectively 1713±1736 ms², 1574±1072 ms², and 1257±1016 ms². The maximum percentage difference in spectral power across all intervals for VLF, LF, and HF was respectively 3.75%, 8.5%, and 7.4%. The percentage of power in the VLF, LF, and HF bands was respectively 37.9%, 36.1%, and 25.9%. The ratios of spectral to total power for VLF, LF, and HF bands were respectively 0.80±0.07, 1.20±0.11, and 1.22±0.10. MDC percentage values were 21.0±4.9% for the HF band, 25.7±1.4% for the LF band, and 30.4±5.5% for the VLF band. CONCLUSION: Results offer initial estimates of variations in HRV power in the VLF, LF, and HF bands in contiguous five-minute intervals and estimates of the minimum detectible "real" changes between intervals separated by 10 minutes. The pattern of variation and data are useful in experimental planning in which HRV spectral power changes are assessed subsequent to a short-duration intervention during a single session. MDC values (21.0% in the HF band to 30.4% in the VLF band) provide initial estimates useful for estimating the number of participants needed to evaluate the impact of an intervention on spectral components of HRV.

Decadal variation and temporal stability of the macrobenthic community in the Bohai Sea, China.

Biodiversity in the Bohai Sea is threatened by climate change and human activities. An analysis based on decadal macrobenthic community data was conducted to assess the ecological health. These findings revealed the temporal and spatial variations in species composition and biodiversity, which were primarily influenced by depth, temperature and dissolved oxygen content. The community structure in 2014 exhibited a 70 % dissimilarity compared to other years, and biodiversity was lower in 2014. The dominant species showed a trend towards miniaturization. Abundance-biomass comparison curves indicated that community disturbance improved by implementing various policies. Overall, communities in the Bohai Sea remained stable, except in the Bohai Strait (BH), where synchronous fluctuations with an increasing trend were observed. Enhancing biodiversity and addressing the risks associated with losing single species are essential for maintaining community stability. The community also displayed synchronous tendencies in Laizhou Bay, emphasizing the need for continued long-term monitoring.

Global analysis of spatio-temporal variation in mineral nutritional quality of pepper (Capsicum spp.) fruit and its regulatory variables: A meta-analysis.

Pepper (Capsicum spp.) is an important fruit vegetable worldwide, and it is a rich dietary source of minerals for human being. Yet, the spatio-temporal distribution of pepper fruit mineral composition and the factors influencing such variations at global scale remain unknown. A global meta-analysis of 140 publications providing 649, 562, 690, 811 datapoints was conducted to quantify and evaluate the nutritional quality, comprising potassium (K), magnesium (Mg), iron (Fe) and zinc (Zn), of pepper fruits and its influencing variables. The analysis showed that the global average of K, Mg, Fe and Zn content in pepper fruits was 20-25 g kg-1, 1-1.5 g kg-1, 80-100 mg kg-1, and 20-40 mg kg-1, respectively. There had been a downward trend in pepper fruit nutritional quality over the last decade, especially for Fe and Zn. And, the concentration of all these four nutrients were at lower levels in less developed regions, especially in Africa. Our results showed that the vegetable "green pepper" contains more K, Mg, Fe and Zn than the "hot pepper" used as spice. The concentration of K, Mg, Fe and Zn were increased with fruit yield but that of Fe and Zn were decreased with increase in single fruit weight. Nutritional quality was optimal at mean annual temperature of 10 ℃ - 20 ℃, and was adversely affected when mean annual precipitation was < 500 mm. Pepper fruits produced at pH 6.5-7.5 had higher fruit K concentration while acidic soils (pH<6.5) favored higher Fe and Zn concentrations. The higher soil organic matter (SOM) generally improved the nutritional quality of the pepper. Our results suggest that systematic selection of superior varieties and soil amelioration (adjusting pH and SOM) of the soil-crop system are needed to achieve higher nutritional quality of pepper fruit.

Temporal changes in postural control strategy through single-leg stance practice with active restriction of knee movement.

[Purpose] This study aimed to examine and verify temporal changes in lower limb joint action after 2 weeks of single-leg stance training under active restriction of knee movement. [Participants and Methods] The participants included 28 healthy adult females (mean age, 19.6 ± 1.0 years). A stabile meter was used to measure the center of pressure sway as an index of ankle joint action. In addition, a triaxial accelerometer was used to measure pelvic and knee sways as indices of hip and knee joint actions, respectively. We established two experimental groups: an active-restriction group and an unrestricted group. Measurements of lower limb joint actions were recorded thrice during single-leg stance exercises during the first session of practice, the third session 1 week later, and the sixth session 2 weeks later. [Results] Both groups exhibited shorter total trajectory lengths in sessions three and six than in the first session. The active restriction group showed less knee sway in later sessions, whereas the unrestricted group showed reduced pelvic sway in the third session. [Conclusion] Single-leg stance exercises with active restriction of knee movement may alter the strategy of lower limb joint action.

Comparison of Different Reverse Transcriptase-Polymerase Chain Reaction-Based Methods for Wastewater Surveillance of SARS-CoV-2: Exploratory Study.

BACKGROUND: Many countries have applied the wastewater surveillance of the COVID-19 pandemic to their national public health monitoring measures. The most used methods for detecting SARS-CoV-2 in wastewater are quantitative reverse transcriptase-polymerase chain reaction (RT-qPCR) and reverse transcriptase-droplet digital polymerase chain reaction (RT-ddPCR). Previous comparison studies have produced conflicting results, thus more research on the subject is required. OBJECTIVE: This study aims to compare RT-qPCR and RT-ddPCR for detecting SARS-CoV-2 in wastewater. It also aimed to investigate the effect of changes in the analytical pipeline, including the RNA extraction kit, RT-PCR kit, and target gene assay, on the results. Another aim was to find a detection method for low-resource settings. METHODS: We compared 2 RT-qPCR kits, TaqMan RT-qPCR and QuantiTect RT-qPCR, and RT-ddPCR based on sensitivity, positivity rates, variability, and correlation of SARS-CoV-2 gene copy numbers in wastewater to the incidence of COVID-19. Furthermore, we compared 2 RNA extraction methods, column- and magnetic-bead-based. In addition, we assessed 2 target gene assays for RT-qPCR, N1 and N2, and 2 target gene assays for ddPCR N1 and E. Reverse transcription strand invasion-based amplification (RT-SIBA) was used to detect SARS-CoV-2 from wastewater qualitatively. RESULTS: Our results indicated that the most sensitive method to detect SARS-CoV-2 in wastewater was RT-ddPCR. It had the highest positivity rate (26/30), and its limit of detection was the lowest (0.06 gene copies/µL). However, we obtained the best correlation between COVID-19 incidence and SARS-CoV-2 gene copy number in wastewater using TaqMan RT-qPCR (correlation coefficient [CC]=0.697, P<.001). We found a significant difference in sensitivity between the TaqMan RT-qPCR kit and the QuantiTect RT-qPCR kit, the first having a significantly lower limit of detection and a higher positivity rate than the latter. Furthermore, the N1 target gene assay was the most sensitive for both RT-qPCR kits, while no significant difference was found between the gene targets using RT-ddPCR. In addition, the use of different RNA extraction kits affected the result when the TaqMan RT-qPCR kit was used. RT-SIBA was able to detect SARS-CoV-2 RNA in wastewater. CONCLUSIONS: As our study, as well as most of the previous studies, has shown RT-ddPCR to be more sensitive than RT-qPCR, its use in the wastewater surveillance of SARS-CoV-2 should be considered, especially if the amount of SARS-CoV-2 circulating in the population was low. All the analysis steps must be optimized for wastewater surveillance as our study showed that all the analysis steps including the compatibility of the RNA extraction, the RT-PCR kit, and the target gene assay influence the results. In addition, our study showed that RT-SIBA could be used to detect SARS-CoV-2 in wastewater if a qualitative result is sufficient.

Profiling of viral load, antibody and inflammatory response of people with monkeypox during hospitalization: a prospective longitudinal cohort study in China.

BACKGROUND: The dynamics of viral shedding and the specific humoral response against monkeypox virus (MPXV) have not been well characterized in patients across their disease course during hospitalisation. The aim of this study was to determine the viral load and the levels of antibodies against MPXV using longitudinal paired-collected samples from hospitalized patients. METHODS: Patients who were hospitalised with mpox were recruited at Beijing Ditan Hospital Capital Medical University in China between June 2 and September 23, 2023. Paired samples, including samples from skin lesions, the oropharynx, saliva, faeces, urine, plasma, and serum, were serially collected at days 1, 3, 7, and 14 after admission until discharge. Not all of the patients had samples obtained at all of the timepoints. All the samples were analysed via quantitative PCR. Virus isolation was performed by using clinical samples and Vero cells. The presence of IgM, IgA, IgG, and neutralising antibodies (NAbs) against MPXV was evaluated. The first collected plasma sample was taken when the patient was hospitalised, and the levels of cytokines and chemokines were measured in the sample. The demographic data, smallpox vaccination status, history of known exposure to MPVX, HIV status and other clinical data were collected using a standard case report form. FINDINGS: A total of 510 specimens were serially collected from 39 recruited people with mpox. Among all the samples, the skin lesions had the highest viral DNA detection rates and viral loads, and the saliva samples had the second highest rates and viral loads. One day before discharge, 85% of the dry scrabs (median Ct 28.2, range 19.0-38.3) and 70% of the saliva samples (median Ct 32.4, range 24.5-38.1) were positive for viral DNA, Of which, 23.1% of dry scrabs were positive in viral culture. The rate of viral DNA detection in the oropharyngeal, saliva, and faecal samples decreased with time, while the rates in the plasma, serum, and urine samples increased quickly before 10 days post symptom onset (PSO). The median days of appearance of MPXV-IgM, MPXV-IgA, MPXV-IgG, and NAb were at 8 (interquartile range [IQR] 7-9), 9 (7-10), 12 (9-15), and 12 (9-15) PSO, respectively. The IgM, IgA, IgG, and NAb titres increased with time. Between days 11 and 21 PSO, the NAb titres were lower in people living with HIV (PWH) than in people living without HIV (PWOH). Increased NAb titres were associated with decreased viral loads in the saliva (r = 0.28, p = 0.025), faeces (r = 0.35, p = 0.021), plasma (r = 0.30, p = 0.0044), and serum samples (r = 0.37, p = 0.001). Compared with PWOH, PWH had higher plasma levels of MIP-1α, MIP-1ß, G-CSF, IL-4, and FGF-basic. INTERPRETATION: The high positive viral culture rate of clinical samples of patients when they are discharged from the hospital indicates that effective public health management strategies are needed for people with mpox. The low NAb titres and high levels of cytokines in PWH shows that earlier treatment is needed to control inflammation in high-risk populations. FUNDING: National Natural Science Foundation of China, Chinese Academy of Medical Sciences, Fundamental Research Funds for the Central Universities for Peking Union Medical College, National Key R&D Program of China.

Does citing early SIDS research skew contemporary conclusions?

Research on infants who have allegedly succumbed to sudden infant death syndrome (SIDS) has been of variable quality over the years. Even now peer-reviewed papers are being published on cases termed 'SIDS' without autopsies having been performed, despite this being a requirement of the three major definitions for over five decades. Clearly cases used in earlier research studies could not have complied with the requirements of as-yet unpublished definitions/guidelines. For this reason care must be taken in citing initial papers as their results may have been skewed by the presence of non-SIDS cases. This may have particular relevance for meta analyses. Reviewing the literature on substance P and its relationship to SIDS provides an excellent example of how diametrically opposed conclusions were reached at different time points. Early studies on SIDS, and studies that use cases that were classified before the standard NICHD and San Diego definitions, should, therefore, be approached with a degree of scepticism and not cited in contemporary papers or at meetings as they have the potential to confuse rather than clarify.

Trends in Fruit and Vegetable Intake Among the Labor Force Population - China, 2010-2018.

Introduction: This research investigates trends pertaining to the prevalence of low fruit and vegetable consumption among the labor force population in China. The study considered data derived from four nationally representative cross-sectional surveys. Methods: The data under review for this study was derived from the China Chronic Disease and Risk Factor Surveillance (CCDRFS) carried out in 2010, 2013, 2015, and 2018, correspondingly. We utilized a food frequency questionnaire to evaluate the quantity and frequency of fruit and vegetable consumption. The estimated prevalence of low fruit and vegetable consumption was calculated for each survey, while considering factors such as sex, age, location, and socioeconomic status (SES). Participants' SES was ascertained via latent class analysis, serving to identify distinct classes based on criteria such as education, occupation, and household income per capita. Logistic regression was deployed to determine the statistical significance of trends. Results: From 2010 to 2018, there was a notable increase in the average daily consumption of vegetables and fruits among the working population, rising from 418.6 g/day to 491.8 g/day (P<0.01 for trend). During the same period, the prevalence of low fruit and vegetable intake declined from 51.1% to 43.5% [P<0.001 for trend; -1.6% average annual percent change (AAPC)]. This downward trend was prevalent across genders, however, certain subgroups of adults (e.g., those living in rural areas or those of low SES) saw stable consumption levels throughout this period (P>0.05 for trend). Conclusion: Over the past nine years, there has been a notable decline in the prevalence of low fruit and vegetable consumption among the labor force population in China. Moreover, the comparatively deficient intake of fruits and vegetables evident among individuals of lower SES warrants further attention.

Regime shift in microalgal dynamics: Impact of water level changes on planktonic and benthic algal biomass.

Whole-lake microalgal biomass surveys were carried out in Lake Balaton to investigate the seasonal, spatial, and temporal changes of benthic algae, as well as to identify the drivers of the phytobenthos. Phytobenthos was controlled mainly by light: the highest benthic algal biomass was in the shallow littoral region characterized by large grain size (sand) with good light availability but lower nutrient content in the sediment. During the investigated period, phytoplankton biomass showed a significant decrease in almost the entire lake. At the same time, the biomass of benthic algae increased significantly in the eastern areas, increasing the contribution of total lake microalgae biomass (from 20 % to 27 %). Benthic algal biomass increase can be explained by the better light supply, owing to the artificially maintained high water level which greatly mitigates water mixing. The decrease in planktonic algal biomass could be attributed to increased zooplankton grazing, which is otherwise negatively affected by mixing. As a result of the high water level, the trophic structure of the lake has been rearranged in recent decades with a shift from the planktonic life form to the benthic one while the nutrient supply has largely remained unchanged.

Variability of the treated biomedical waste disposal behaviours during the COVID lockdowns.

Literature review suggests that studies on biomedical waste generation and disposal behaviors in North America are limited. Given the infectious nature of the materials, effective biomedical waste management is vital to the public health and safety of the residents. This study explicitly examines seasonal variations of treated biomedical waste (TBMW) disposal rates in the City of Regina, Canada, from 2013 to 2022. Immediately before the onset of COVID-19, the City exhibited a steady pattern of TBMW disposal rate at about 6.6 kg∙capita-1∙year-1. However, the COVID-19 pandemic and its associated lockdowns brought about an abrupt and persistent decline in TBMW disposal rates. Inconsistent fluctuations in both magnitude and variability of the monthly TBMW load weights were also observed. The TBMW load weight became particularly variable in 2020, with an interquartile range 4 times higher than 2019. The average TBMW load weight was also the lowest (5.1 tonnes∙month-1∙truckload-1) in 2020, possibly due to an overall decline in non-COVID-19 medical emergencies, cancellation of elective surgeries, and availability of telehealth options to residents. In general, the TBMW disposal rates peaked during the summer and fall seasons. The day-to-day TBMW disposal contribution patterns between the pre-pandemic and post-pandemic are similar, with 97.5% of total TBMW being disposed of on fixed days. Results from this Canadian case study indicate that there were observable temporal changes in TBMW disposal behaviors during and after the COVID-19 lockdowns.

Changes in bile acid subtypes and improvements in lipid metabolism and atherosclerotic cardiovascular disease risk: the Preventing Overweight Using Novel Dietary Strategies (POUNDS Lost) trial.

BACKGROUND: Distinct circulating bile acid (BA) subtypes may play roles in regulating lipid homeostasis and atherosclerosis. OBJECTIVES: We investigated whether changes in circulating BA subtypes induced by weight-loss dietary interventions were associated with improved lipid profiles and atherosclerotic cardiovascular disease (ASCVD) risk estimates. METHODS: This study included adults with overweight or obesity (n = 536) who participated in a randomized weight-loss dietary intervention trial. Circulating primary and secondary unconjugated BAs and their taurine-/glycine-conjugates were measured at baseline and 6 mo after the weight-loss diet intervention. The ASCVD risk estimates were calculated using the validated equations. RESULTS: At baseline, higher concentrations of specific BA subtypes were related to higher concentrations of atherogenic very low-density lipoprotein lipid subtypes and ASCVD risk estimates. Weight-loss diet-induced decreases in primary BAs were related to larger reductions in triglycerides and total cholesterol [every 1 standard deviation (SD) decrease of glycocholate, glycochenodeoxycholate, or taurochenodeoxycholate was related to ß (standard error) -3.3 (1.3), -3.4 (1.3), or -3.8 (1.3) mg/dL, respectively; PFDR < 0.05 for all]. Greater decreases in specific secondary BA subtypes were also associated with improved lipid metabolism at 6 mo; there was ß -4.0 (1.1) mg/dL per 1-SD decrease of glycoursodeoxycholate (PFDR =0.003) for changes in low-density lipoprotein cholesterol. We found significant interactions (P-interaction < 0.05) between dietary fat intake and changes in BA subtypes on changes in ASCVD risk estimates; decreases in primary and secondary BAs (such as conjugated cholate or deoxycholate) were significantly associated with improved ASCVD risk after consuming a high-fat diet, but not after consuming a low-fat diet. CONCLUSIONS: Decreases in distinct BA subtypes were associated with improved lipid profiles and ASCVD risk estimates, highlighting the importance of changes in circulating BA subtypes as significant factors linked to improved lipid metabolism and ASCVD risk estimates in response to weight-loss dietary interventions. Habitual dietary fat intake may modify the associations of changes in BAs with ASCVD risk. This trial was registered at clinicaltrials.gov as NCT00072995.

Spatial and temporal variability and risk assessment of organophosphate esters in seawater and sediments of the Yangtze River estuary.

Organophosphate esters (OPEs) as substitutes for PBDEs have been widely detected in the marine environment, while little is known about the pollution characteristics and variation of OPEs in estuarine environments with complex hydrodynamic conditions and land-based input. Yangtze River Estuary (YRE) is a typical highly urbanized and industrialized estuary, with a complex hydrological environment and geochemical behavior. This study found that the concentrations of OPEs in both seawater and sediments in the YRE were higher in spring than in summer. Alkyl OPEs were the first contributor, with TnBP and TiBP as the main components, where the contribution of alkyl OPEs had exceeded 75 % in both seawater and sediments in spring, and 60 % in summer seawater, and even 80 % in sediments. In spring, OPEs peaked in the central to southern region near the YRE. In summer, OPEs were mainly concentrated in the southern branch waterway and southern nearshore area of the YRE and showed a decreasing trend to the northeast. The OPEs in the sediments were mainly concentrated in the Yangtze River Mud Area (YREMA) and the Zhe-Min Coastal Mud Area (ZMCMA). Based on the fugacity model and principal component analysis, sediments could be released into the aquatic environment as an endogenous source, and exogenous sources were mainly municipal and industrial sewage discharge sources, urban and marine traffic discharge sources, and atmospheric deposition sources. The ecological risk analysis showed that the Σ14OPEs had exhibited a low to moderate ecological risk in the southern branch waterway and the south-central region offshore.

The putatively high-altitude adaptation of macaque monkeys: Evidence from the fecal metabolome and gut microbiome.

Animals living in high-altitude environments, such as the Tibetan Plateau, must face harsh environmental conditions (e.g., hypoxia, cold, and strong UV radiation). These animals' physiological adaptations (e.g., increased red cell production and turnover rate) might also be associated with the gut microbial response. Bilirubin is a component of red blood cell turnover or destruction and is excreted into the intestine and reduced to urobilinoids and/or urobilinogen by gut bacteria. Here, we found that the feces of macaques living in high-altitude regions look significantly browner (with a high concentration of stercobilin, a component from urobilinoids) than those living in low-altitude regions. We also found that gut microbes involved in urobilinogen reduction (e.g., beta-glucuronidase) were enriched in the high-altitude mammal population compared to the low-altitude population. Moreover, the spatial-temporal change in gut microbial function was more profound in the low-altitude macaques than in the high-altitude population, which might be attributed to profound changes in food resources in the low-altitude regions. Therefore, we conclude that a high-altitude environment's stress influences living animals and their symbiotic microbiota.

Temporal Trends in Diagnostic Hemodynamics and Survival of Patients with Pulmonary Hypertension: A Single-Center Study.

Advances in the diagnosis and treatment of pulmonary hypertension (PH) have gradually improved the disease course. This retrospective cohort study aims to explore the diagnostic hemodynamic profile and survival of PH patients and their temporal changes, as well as investigate potential prognostic factors. Overall, 257 adult patients were diagnosed with PH following right heart catheterization (RHC) from January 2008 to June 2023 according to the hemodynamic cut-off values proposed by the corresponding ESC/ERS guidelines at the time RHC was performed. Of these patients, 46.3% were Group 1, 17.8% Group 2, 14.0% Group 3, 18.0% Group 4, and 3.0% Group 5 PH. Temporal improvement in both diagnostic hemodynamic profile and survival of patients with PH and pulmonary arterial hypertension (PAH) was identified after 2013. Survival analysis demonstrated 5-year survival rates of 65% in Group 1 PH (90.3% in idiopathic PAH) and 77% in Group 4 PH. PAH patients being at low risk at diagnosis presented a similar 1-year all-cause mortality rate (12.4%) with high-risk ones (12.8%), primarily due to non-PH-related causes of death (62%), while high-risk patients died mostly due to PH (67%). The observed improvements in diagnostic hemodynamic profiles and overall survival highlight the importance of timely diagnosis and successful treatment strategies in PH.