Rapid non-destructive monitoring and quality assessment of the fumigation process of Shanxi aged vinegar based on Vis-NIR hyperspectral imaging combined with multiple chemometric algorithms.

The quality of the grains during the fumigation process can significantly affect the flavour and nutritional value of Shanxi aged vinegar (SAV). Hyperspectral imaging (HSI) was used to monitor the extent of fumigated grains, and it was combined with chemometrics to quantitatively predict three key physicochemical constituents: moisture content (MC), total acid (TA) and amino acid nitrogen (AAN). The noise reduction effects of five spectral preprocessing methods were compared, followed by the screening of optimal wavelengths using competitive adaptive reweighted sampling. Support vector machine classification was employed to establish a model for discriminating fumigated grains, and the best recognition accuracy reached 100%. Furthermore, the results of partial least squares regression slightly outperformed support vector machine regression, with correlation coefficient for prediction (Rp) of 0.9697, 0.9716, and 0.9098 for MC, TA, and AAN, respectively. The study demonstrates that HSI can be employed for rapid non-destructive monitoring and quality assessment of the fumigation process in SAV.

The double-edged effect of social mobility belief on socioeconomically disadvantaged adolescents' health: The mediating role of intentional self-regulation.

PURPOSE: This study aimed to examine the double-edged effect of social mobility belief on socioeconomically disadvantaged adolescents' mental and physical health and further explore whether intentional self-regulation is the common psychological mechanism of social mobility belief affecting physical and mental health. METHOD: A total of 469 adolescents (Mage = 13.96 years, 49.3% boys) from two rural public schools in China were included in this study. Adolescents completed questionnaires measuring social mobility belief and mental health (life satisfaction, self-esteem, and depression). Physical health (allostatic load) was reflected by six indicators (resting diastolic and systolic blood pressure, body mass index, epinephrine, norepinephrine, and cortisol). RESULTS: Social mobility belief was positively correlated with adolescents' life satisfaction and self-esteem but negatively correlated with depression. Intentional self-regulation mediated the relationships between social mobility belief and mental health. In addition, the results showed that intentional self-regulation mediated the relationship between social mobility belief and adolescents' physical health. CONCLUSIONS: Social mobility belief may be a "skin-deep" resilience resource positively related to mental health but negatively correlated with physical health through intentional self-regulation among socioeconomically disadvantaged adolescents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Protective mechanism of quercetin in alleviating sepsis-related acute respiratory distress syndrome based on network pharmacology and in vitro experiments.

BACKGROUND: Sepsis-related acute respiratory distress syndrome (ARDS) has a high mortality rate, and no effective treatment is available currently. Quercetin is a natural plant product with many pharmacological activities, such as antioxidative, anti-apoptotic, and anti-inflammatory effects. This study aimed to elucidate the protective mechanism of quercetin against sepsis-related ARDS. METHODS: In this study, network pharmacology and in vitro experiments were used to investigate the underlying mechanisms of quercetin against sepsis-related ARDS. Core targets and signaling pathways of quercetin against sepsis-related ARDS were screened and were verified by in vitro experiments. RESULTS: A total of 4,230 targets of quercetin, 360 disease targets of sepsis-related ARDS, and 211 intersection targets were obtained via database screening. Among the 211 intersection targets, interleukin-6 (IL-6), tumor necrosis factor (TNF), albumin (ALB), AKT serine/threonine kinase 1 (AKT1), and interleukin-1ß (IL-1ß) were identified as the core targets. A Gene Ontology (GO) enrichment analysis revealed 894 genes involved in the inflammatory response, apoptosis regulation, and response to hypoxia. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis identified 106 pathways. After eliminating and generalizing, the hypoxia-inducible factor-1 (HIF-1), TNF, nuclear factor-κB (NF-κB), and nucleotide-binding and oligomerization domain (NOD)-like receptor signaling pathways were identified. Molecular docking revealed that quercetin had good binding activity with the core targets. Moreover, quercetin blocked the HIF-1, TNF, NF-κB, and NOD-like receptor signaling pathways in lipopolysaccharide (LPS)-induced murine alveolar macrophage (MH-S) cells. It also suppressed the inflammatory response, oxidative reactions, and cell apoptosis. CONCLUSION: Quercetin ameliorates sepsis-related ARDS by binding to its core targets and blocking the HIF-1, TNF, NF-κB, and NOD-like receptor signaling pathways to reduce inflammation, cell apoptosis, and oxidative stress.

A Countable-Type Branching Process Model for the Tug-of-War Cancer Cell Dynamics.

We consider a time-continuous Markov branching process of proliferating cells with a countable collection of types. Among-type transitions are inspired by the Tug-of-War process introduced by McFarland et al. (Proc Natl Acad Sci 111(42):15138-15143, 2014) as a mathematical model for competition of advantageous driver mutations and deleterious passenger mutations in cancer cells. We introduce a version of the model in which a driver mutation pushes the type of the cell L-units up, while a passenger mutation pulls it 1-unit down. The distribution of time to divisions depends on the type (fitness) of cell, which is an integer. The extinction probability given any initial cell type is strictly less than 1, which allows us to investigate the transition between types (type transition) in an infinitely long cell lineage of cells. The analysis leads to the result that under driver dominance, the type transition process escapes to infinity, while under passenger dominance, it leads to a limit distribution. Implications in cancer cell dynamics and population genetics are discussed.

The trend of hypertension-related chronic kidney disease from 1990 to 2019 and its predictions over 25 years: an analysis of the Global Burden of Disease Study 2019.

BACKGROUND: High blood pressure is a key pathogenetic factor that contributes to the deterioration of kidney function. However, the incidence trend of hypertension-related chronic kidney disease (CKD) has rarely been studied; therefore, we aimed to analyze the global, regional, and national patterns, temporal trends as well as burden of hypertension-related CKD. METHODS: We extracted data on hypertension-related CKD from the Global Burden of Disease (GBD) study database, including the incidence, prevalence, disability-adjusted life years (DALYs), and mortality numbers and rates (per 100,000 population) and further described according to year, location, sex, age, and socio-demographic index (SDI). The estimated annual percentage changes (EAPCs) were calculated to assess the variation in incidence, DALYs, and mortality. We used an age-period-cohort (APC) model framework to analyze the underlying trends in prevalence by age, period, and birth cohort. Nordpred APC analysis was performed to predict the future morbidity and mortality of hypertension-related CKD. RESULTS: In 2019, a total of over 1.57 million new hypertension-related CKD cases were reported worldwide, a 161.97% increase from 1990. Compared to 1990, the age-standardized incidence rates (ASIR) increased in all 21 regions in 2019. In all countries and territories except Iceland, the EAPC in ASIR and the lower boundary of its 95% confidence interval (CI) were higher than 0. ASIR, age-standardized prevalence rates (ASPR), age-standardized DALYs rates (ASDR), and age-standardized mortality rates (ASMR) were not identical among countries with different SDI regions in 2019; additionally, ASIR and ASMR were significantly different among sexes in all SDI regions in 2019. The predicted incidence and mortality counts globally continue to increase to 2044, and there is an upward trend in ASIR for both men and women. CONCLUSIONS: Between 1990 and 2019, the ASIR of hypertension-related CKD demonstrated an ascending trend, and according to our projections, it would remain on the rise for the next 25 years. With remarkable global population growth, aging, and an increasing number of patients with hypertension, the burden of disease caused by hypertension-related CKD continues to increase.

Postnatal feeding with high-fat combined with high-glucose diet induces precocious puberty in Sprague‒Dawley rat pups.

With economic development and overnutrition, including high-fat diets (HFD) and high-glucose diets (HGD), the incidence of obesity in children is increasing, and thus, the incidence of precocious puberty is increasing. Therefore, it is of great importance to construct a suitable animal model of overnutrition-induced precocious puberty for further in-depth study. Here, we fed a HFD, HGD, or HFD combined with a HGD to pups after P-21 weaning, while weaned pups fed a normal diet served as the control group. The results showed that HFD combined with a HGD increased the body weight (BW) of weaned rat pups. In addition, a HFD, HGD, and HFD combined with a HGD lowered the age at which vaginal opening occurred and accelerated the vaginal cell cycle. Furthermore, a HFD combined with a HGD increased the weight of the uterus and ovaries of weaned rat pups. Additionally, a HFD combined with a HGD promoted the development of reproductive organs in weaned female rat pups. Ultimately, a HFD combined with a HGD was found to elevate the serum levels of gonadotropin-releasing hormone (GnRH), luteinizing hormone (LH), follicle stimulating hormone (FSH), leptin, adiponectin, and oestradiol (E2) and increase hypothalamic GnRH, Kiss-1, and GPR54 expression levels in weaned female rat pups. The current study found that overnutrition, such as that through a HFD combined with HGD, could induce precocious puberty in weaned female rat pups. In addition, a rat model of overnutrition-induced precocious puberty was established.

Financial Toxicity and Quality of Life in Patients Undergoing Stem-Cell Transplant Evaluation: A Single-Center Analysis.

PURPOSE: We investigated the prevalence of financial toxicity in a population undergoing hematopoietic cell transplantation (HCT) evaluation and measured its impact on post-transplant clinical and health-related quality-of-life outcomes. MATERIALS AND METHODS: This was a prospective study in patients undergoing evaluation for allogeneic HCT between January 1, 2018, and September 23, 2020, at a large academic medical center. Financial health was measured via a baseline survey and the comprehensive score for financial toxicity-functional assessment of chronic illness therapy (COST-FACIT) survey. The cohort was divided into three groups: none (grade 0), mild (grade 1), and moderate-high financial toxicity (grades 2-3). Health-related quality of life outcomes were measured at multiple time points. Multivariate logistic regression analysis evaluated factors associated with financial toxicity. Kaplan-Meier curves and log-rank tests was used to evaluate overall survival (OS) and nonrelapse survival. RESULTS: Of 245 patients evaluated for transplant, 176 (71.8%) completed both questionnaires (median age was 57 years, 63.1% were male, 72.2% were White, and 39.2% had myelodysplastic syndrome, 38.1% leukemia, and 13.6% lymphoma). At initial evaluation, 83 (47.2%) patients reported no financial toxicity, 51 (29.0%) with mild, and 42 (23.9%) with moderate-high financial toxicity. Patients with financial toxicity reported significant cost-cutting behaviors, including reduced spending on food or clothing, using their savings, or not filling a prescription because of costs (P < .0001). Quality of life was lower in patients with moderate-high financial toxicity at 6 months (P = .0007) and 1 year (P = .0075) after transplant. Older age (>62; odds ratio [OR], 0.33 [95% CI, 0.13 to 0.79]; P = .04) and income ≥$60,000 in US dollars (USD) (OR, 0.17 [95% CI, 0.08 to 0.38]; P < .0001) were associated with lower odds of financial toxicity. No association was noted between financial toxicity and selection for transplant, OS, or nonrelapse mortality. CONCLUSION: Financial toxicity was highly correlated with patient-reported changes in compensatory behavior, with notable impact on patient quality of life after transplant.

Quality Assessment of Ultrasound and Magnetic Resonance Imaging for Hepatocellular Carcinoma Surveillance: A Systematic Review and Meta-Analysis.

INTRODUCTION: To achieve early detection and curative treatment options, surveillance imaging for hepatocellular carcinoma (HCC) must remain of quality and without substantial limitations in liver visualization. However, the prevalence of limited liver visualization during HCC surveillance imaging has not been systematically assessed. Utilizing a systematic review and meta-analytic approach, we aimed to determine the prevalence of limited liver visualization during HCC surveillance imaging. METHODS: MEDLINE and Embase electronic databases were searched to identify published data on liver visualization limitations of HCC surveillance imaging. An analysis of proportions was pooled using a generalized linear mixed model with Clopper-Pearson intervals. Risk factors were analysed using a generalized mixed model with a logit link and inverse variance weightage. RESULTS: Of 683 records, 10 studies (7,131 patients) met inclusion criteria. Seven studies provided data on liver visualization limitations on ultrasound (US) surveillance exams: prevalence of limited liver visualization was 48.9% (95% CI: 23.5-74.9%) in the overall analysis and 59.2% (95% CI: 24.2-86.9%) in a sensitivity analysis for cirrhotic patients. Meta-regression determined that non-alcoholic fatty liver disease was associated with limited liver visualization on US. Four studies provided data for liver visualization limitations in abbreviated magnetic resonance imaging (aMRI), with inadequate visualization ranging from 5.8% to 19.0%. One study provided data for complete MRI and none for computed tomography. CONCLUSION: A substantial proportion of US exams performed for HCC surveillance provide limited liver visualization, especially in cirrhosis, which may hinder detection of small observations. Alternative surveillance strategies including aMRI may be appropriate for patients with limited US visualization.

Qualitative and quantitative assessment of flavor quality of Chinese soybean paste using multiple sensor technologies combined with chemometrics and a data fusion strategy.

Multiple sensor technologies including electronic nose (E-nose), electronic tongue (E-tongue), colorimeter and texture analyzer combined with chemometrics and dada fusion strategies were applied to characterize the flavor quality of traditional Chinese fermented soybean paste. Principal components analysis (PCA) was performed to divide the selected soybean pastes into three clusters which was not completely consistent with geographical regions of selected samples. Support vector machine regression (SVR) outperformed partial least squares regression (PLSR) in quantitatively predicting sensory attributes. Additionally, prediction of overall flavor of soybean paste based on data fusion of multiple sensor information, with a correlation coefficient of prediction (Rp) of 0.9636 based on SVR, was better than prediction of E-nose and E-tongue data fusion (Rp = 0.9267). This study suggested multiple sensor technologies coupled with chemometrics can be a promising tool for flavor assessment and characterization of fermented soybean paste or other food matrixes.

Assessment of shoulder range of motion using a commercially available wearable sensor-a validation study.

Background: Our study aims to validate a commercially available inertial measurement unit (IMU) system against a standard laboratory-based optical motion capture (OMC) system for shoulder measurements in a clinical context. Methods: The validation analyses were conducted on 19 healthy male volunteers. Twelve reflective markers were placed on each participant's trunk, scapula and across the arm and one IMU was attached via a self-adhesive strap on the forearm. A single tester simultaneously collected shoulder kinematic data for four shoulder movements: flexion, extension, external rotation, and abduction. Agreement between OMC system and IMU measurements was assessed with Bland-Altman analyses. Secondary analysis included mean biases, root mean square error (RMSE) analysis and Welch's t-test. Results: Bland-Altman limits of agreement (LoA) exceeded the acceptable range of mean difference for 95% of the population (-22.27°, 11.31°). The mean bias showed high levels of agreement within 8° for all four movements. More than 60% of participants demonstrated mean bias less than 10° between methods. Statistically significant differences were found between measurements for abduction (P<0.001) and flexion (P=0.027) but not for extension and external rotation (P≥0.05). Conclusions: Our study shows preliminary evidence for acceptable accuracy of a commercially available IMU against an OMC system for assessment of shoulder movements by a single tester. The IMU also exhibits similar whole degree of error compared to a standard goniometer with potential for application in remote rehabilitation.

Factors early in life associated with hepatic steatosis.

BACKGROUND: The rise in prevalence of non-alcoholic fatty liver disease (NAFLD) mirrors the obesity epidemic. NAFLD is insidious but may gradually progress from simple steatosis to steatohepatitis, fibrosis and cirrhosis and/or hepatocellular carcinoma. Intervention strategies to ameliorate developmental programming of NAFLD may be more efficacious during critical windows of developmental plasticity. AIM: To review the early developmental factors associated with NAFLD. METHODS: Databases MEDLINE via PubMed, and EMBASE and Reference Citation Analysis were searched and relevant publications up to April 30, 2021 were assessed. Original research studies that included risk factors associated with early development of NAFLD in human subjects were included. These factors include: Maternal factors, intrauterine and prenatal factors, post-natal factors, genetic and ethnic predisposition, childhood and adolescence environmental factors. Studies were excluded if they were review articles or animal studies, case reports or conference abstracts, or if NAFLD was not clearly defined and assessed radiologically. RESULTS: Of 1530 citations identified by electronic search, 420 duplicates were removed. Of the 1110 citations screened from title and abstract, 80 articles were included in the final analysis. Genetic polymorphisms such as patatin-like phospholipase domain-containing protein 3 (PNPLA3) and membrane-bound O-acyltransferase domain-containing protein 7 (MBOAT7) were associated with increased risk of NAFLD. Familial factors such as maternal obesogenic environment and parental history of hepatic steatosis was associated with offspring NAFLD. Longer duration of exclusive breastfeeding in infancy was associated with a lower risk of developing NAFLD later in life while metabolic dysfunction and/or obesity in adolescence was associated with increased risk of NAFLD. Studies relating to socioeconomic factors and its association with NAFLD reported confounding results. CONCLUSION: Maternal metabolic dysfunction during pregnancy, being exclusively breastfed for a longer time postnatally, diet and physical activity in childhood and adolescence are potential areas of intervention to decrease risk of NAFLD.

Financial incentives to increase stool collection rates for microbiome studies in adult bone marrow transplant patients.

INTRODUCTION: In order to study the role of the microbiome in hematopoietic stem cell transplantation (HCT), researchers collect stool samples from patients at various time points throughout HCT. However, stool collection requires active subject participation and may be limited by patient reluctance to handling stool. METHODS: We performed a prospective study on the impact of financial incentives on stool collection rates. The intervention group consisted of allogeneic HCT patients from 05/2017-05/2018 who were compensated with a $10 gas gift card for each stool sample. The intervention group was compared to a historical control group of allogeneic HCT patients from 11/2016-05/2017 who provided stool samples before the incentive was implemented. To control for possible changes in collections over time, we also compared a contemporaneous control group of autologous HCT patients from 05/2017-05/2018 with a historical control group of autologous HCT patients from 11/2016-05/2017; neither autologous HCT group was compensated. The collection rate was defined as the number of samples provided divided by the number of time points we attempted to obtain stool. RESULTS: There were 35 allogeneic HCT patients in the intervention group, 19 allogeneic HCT patients in the historical control group, 142 autologous HCT patients in the contemporaneous control group (that did not receive a financial incentive), and 75 autologous HCT patients in the historical control group. Allogeneic HCT patients in the intervention group had significantly higher average overall collection rates when compared to the historical control group allogeneic HCT patients (80% vs 37%, p<0.0001). There were no significant differences in overall average collection rates between the autologous HCT patients in the contemporaneous control and historical control groups (36% vs 32%, p = 0.2760). CONCLUSION: Our results demonstrate that a modest incentive can significantly increase collection rates. These results may help to inform the design of future studies involving stool collection.

Geriatric Assessment Reveals Actionable Impairments in Hematopoietic Stem Cell Transplantation Candidates Age 18 to 80 Years.

Allogeneic hematopoietic stem cell transplantation (HCT) is a potentially curative treatment for both malignant and nonmalignant hematologic diseases; however, reported rates of treatment-related mortality approach 30%. Outcomes are worse in patients who begin HCT with functional impairments. To detect such impairments, a geriatric assessment (GA) is recommended in adults age ≥65 years. Younger HCT candidates also may be impaired because of chemotherapy regimens pre-HCT. Therefore, we hypothesized that GA can be beneficial for adult patients of all ages and subsequently created a clinical pretransplantation optimization program to assess all HCT candidates using a modified GA. One-hundred fifty-seven patients were evaluated in 4 functional domains- physical, cognitive, nutritional, and psychological-at 2 time points prior to HCT-new patient evaluation (NPE) and sign-off (SO)-between October 2017 and January 2020. At NPE, 80.9% of the patients had at least 1 domain with a functional impairment, and physical (P = .006), cognitive (P = .04), and psychological (P = .04) impairments were associated with an increased likelihood of not proceeding to HCT. In addition, patients age 18 to 39 years were more likely than older patients to have a physical function impairment (P = .001). Between NPE and SO, 51.9% of the patients had resolution of 1 or more impairments, and nutritional impairment at SO was predictive of worse overall survival (P = .01). Our study shows that GA can identify functional impairments in patients of all ages. Early identification of impairments could facilitate referrals to supportive care and resolution of impairments prior to HCT, suggesting that GA could be recommended for HCT candidates of all ages.

Atypical symptoms of malignant hyperthermia: A rare causative mutation in the RYR1 gene.

Malignant hyperthermia (MH) is an autosomal dominant genetic condition of the skeletal muscle triggered by inhaled general anesthetic agents or succinylcholine and associated with a hypermetabolic state and skeletal muscle rigidity. Tachycardia, increased carbon dioxide production, hypercarbia, hyperthermia, acidosis, hyperkalemia, cardiac arrhythmias, muscle rigidity, and rhabdomyolysis are common symptoms of MH. As the progression of the syndrome could be rapid or less evident, even experienced physicians have difficulty in diagnosing MH, which can lead to delays in treatment and increased mortality. We report a rare case of a 36-year-old man, who underwent open reduction and internal fixation of the left clavicle after inhaled anesthetics. The patient developed dyspnea, hypotension, unremitting hyperthermia, tachycardia, and elevated serum myoglobin, and finally died of pyemia and disseminated intravascular coagulation. We reviewed the process of disease development, summarized the steps of diagnosis, and improved genetic testing. Exome sequencing revealed a new mutation c.8519G>A (p.arg2840 GLN) in the RYR1 gene that could be associated with MH. The gene mutation was also found in his daughter's genetic test. This case emphasized the importance of the awareness of MH and its atypical clinical symptoms. The presence of dyspnea, hypotension, unremitting hyperthermia, tachycardia, and raised myoglobin in serum might further strengthen the clinical diagnosis of suspected MH.

An input-output structural decomposition analysis of changes in China's renewable energy consumption.

Governments actively encourage renewable energy use to deal with climate change and achieve carbon emission reduction targets. It is crucial to find out the driving factors that affect the utilization of renewable energy. Therefore, based on China's 2010-2016 input-output table, this paper uses the input-output model and structural decomposition analysis (SDA) to analyze the driving factors of renewable energy changes in the production end, household end, and the aggregate economy. The results show that the changes in the consumption structure (F) is the most crucial factor for renewable energy use, followed by technology progress (T) and final demand per capita (V). Sector SEHW (supply of electric power, heat power, and water) and MCRP (manufacture of coke and refined petroleum products) are the two vital sectors to achieve China's energy transition of the production level. However, as for households, the proportion of renewable energy has been declining. Hence, the government should promote renewable energy use and achieve the green transition in production and household levels.

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Optimization of sampling design can reduce survey cost, ensure the accuracy of survey data, and get the maximum benefit of survey design. In this study, survey voyage was added into sampling survey design optimization as the evaluation index to quantify the survey cost. Computer simulation and resampling technique were used to simulate the survey plan. Simulation annealing algorithm was used to find the survey design with the shortest voyage. Based on the survey data collected from the bottom trawl survey conducted in the Haizhou Bay and its adjacent waters in spring and autumn from 2013 to 2015, Kriging interpolation was used to simulate the relative abundance distribution of Conger myriaster, Enedrias fangi, and Hexagrammos otakii in the bay in two seasons as their 'true' values. Resampling was conducted using stratified random sampling with different sample sizes for simulation study, and the abundance indices of each target species were estimated based on the simulated data. The relative bias (RB) was used to evaluate the accuracy of estimation of abundance index. The average survey cost and probability of budget overshoot (P) were used to measure the cost of survey. Integrated evaluation index (IEI) was developed to measure the survey cost and estimation accuracy comprehensively. The results showed RB values of all target species decreased with sample size. Different target species had different RB values with the same sample size. The optimal numbers of station determined by different evaluation indices were different. The optimal sample size determined by RB was relatively high, while the cost exceeded the budget of survey. The optimal sample size determined by probability of exceeding survey budget was relatively low but the accuracy and precision of estimation was low. IEI balanced the survey cost and estimation accuracy, and the optimal sample size defined by IEI was at intermediate level. The sampling design considering survey cost and route planning could not only determine the optimal sample size, but also record the potential station location, the survey sequence and the corresponding survey cost of simulations. According to the actual cost budget, the desired survey design with low cost and low RB of estimation from simulations could be chosen for fishery-independent surveys.

Temporal trend and attributable risk factors of stroke burden in China, 1990-2019: an analysis for the Global Burden of Disease Study 2019.

BACKGROUND: Understanding the temporal trend of the disease burden of stroke and its attributable risk factors in China, especially at provincial levels, is important for effective prevention strategies and improvement. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) is to investigate the disease burden of stroke and its risk factors at national and provincial levels in China from 1990 to 2019. METHODS: Following the methodology in the GBD 2019, the incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) of stroke cases in the Chinese population were estimated by sex, age, year, stroke subtypes (ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage), and across 33 provincial administrative units in China from 1990 to 2019. Attributable mortality and DALYs of underlying risk factors were calculated by a comparative risk assessment. FINDINGS: In 2019, there were 3·94 million (95% uncertainty interval 3·43-4·58) new stroke cases in China. The incidence rate of stroke increased by 86·0% (73·2-99·0) from 1990, reaching 276·7 (241·3-322·0) per 100 000 population in 2019. The age-standardised incidence rate declined by 9·3% (3·3-15·5) from 1990 to 2019. Among 28·76 million (25·60-32·21) prevalent cases of stroke in 2019, 24·18 million (20·80-27·87) were ischaemic stroke, 4·36 million (3·69-5·05) were intracerebral haemorrhage, and 1·58 million (1·32-1·91) were subarachnoid haemorrhage. The prevalence rate increased by 106·0% (93·7-118·8) and age-standardised prevalence rate increased by 13·2% (7·7-19·1) from 1990 to 2019. In 2019, there were 2·19 million (1·89-2·51) deaths and 45·9 million (39·8-52·3) DALYs due to stroke. The mortality rate increased by 32·3% (8·6-59·0) from 1990 to 2019. Over the same period, the age-standardised mortality rate decreased by 39·8% (28·6-50·7) and the DALY rate decreased by 41·6% (30·7-50·9). High systolic blood pressure, ambient particulate matter pollution exposure, smoking, and diet high in sodium were four major risk factors for stroke burden in 2019. Moreover, we found marked differences of stroke burden and attributable risk factors across provinces in China from 1990 to 2019. INTERPRETATION: The disease burden of stroke is still severe in China, although the age-standardised incidence and mortality rates have decreased since 1990. The stroke burden in China might be reduced through blood pressure management, lifestyle interventions, and air pollution control. Moreover, because substantial heterogeneity of stroke burden existed in different provinces, improved health care is needed in provinces with heavy stroke burden. FUNDING: National Key Research and Development Program of China and Taikang Yicai Public Health and Epidemic Control Fund.

FDI, economic growth, and carbon emissions of the Chinese steel industry: new evidence from a 3SLS model.

Determine the main factors affecting carbon emissions of the Chinese steel industry is indispensable commitments to achieve the sustainable development of China. Hereby, based on the Stochastic Impacts by Regression on Population, Affluence and Technology (STIPRAT) model, this paper combines the economic growth function, carbon emission production function, and the FDI function of the Chinese steel industry, and uses the three-stage least square equation model (3SLS) to analyze the relationship between China's economic growth, carbon emissions in the steel industry, and FDI (foreign direct investment) inflows. The results document a complete two-way causal relationship of three variables in the whole country and the Western region, while the relationship in the Eastern region and the Central region is not complete. Moreover, there are no bidirectional causal relationship between carbon emissions and FDI in the Eastern region, while only bidirectional causality between carbon emissions and FDI in the Central region. These findings are of great significance for the Chinese steel industry to formulate effective emission reduction policies.

Family socio-economic status and children's executive function: The moderating effects of parental subjective socio-economic status and children's subjective social mobility.

Family socio-economic status (SES) is significantly related to disparities in children's executive function. Children from economically disadvantaged backgrounds perform worse on executive function tasks than their peers from high-SES families. The protective factors in the relationship between SES and executive function have not been sufficiently investigated, especially from the perspective of parents' and children's perceptions and expectations regarding SES. Therefore, this study aimed to examine whether parental subjective SES and children's subjective social mobility separately moderated the relationship between family SES and children's executive function among 885 participants aged 9-13 years. The results showed that family SES was positively related to the three components of executive function (cognitive flexibility, inhibitory control, and working memory). Moreover, the relationship between SES and cognitive flexibility was weak among the children with a high level of subjective social mobility or those whose parents had high levels of subjective SES. Among children from families with economic hardship, subjective social mobility is a potential protective factor mitigating the negative effects of low family SES on their cognitive flexibility.

Assessment of Glycometabolism Impairment and Glucose Variability Using Flash Glucose Monitoring System in Patients With Adrenal Diseases.

Background: This study aimed to investigate the characteristics and extent of glycometabolism impairment in patients with adrenal diseases, including Cushing syndrome, primary aldosteronism, pheochromocytoma, and nonfunctional adrenal incidentaloma. Methods: This study enrolled thirty-two patients with adrenal diseases as adrenal disease groups and eight healthy individuals as healthy controls. Blood glucose levels were indicated by glucose concentration in interstitial fluid, which was documented using flash glucose monitoring system. According to flash glucose monitoring system data, parameters representing general blood glucose alterations, within-day and day-to-day glucose variability, and glucose-target-rate were calculated. Furthermore, blood glucose levels at nocturnal, fasting, and postprandial periods were analyzed. Besides, islet ß-cell function and insulin resistance were assessed. Results: Analysis of flash glucose monitoring system-related parameters indicated impaired glycometabolism in patients with adrenal diseases compared with that of healthy controls at general blood glucose, within-day and day-to-day glucose variability, and glucose-target-rate levels. Furthermore, the dynamic glucose monitoring data revealed that significantly affected blood glucose levels compared with that of healthy controls were observed at postprandial periods in the Cushing syndrome and primary aldosteronism groups; at nocturnal, fasting and postprandial periods in the pheochromocytoma group. Significant insulin resistance and abnormal ß-cell function were observed in the Cushing syndrome group compared with that in healthy controls. Conclusion: Adrenal diseases can negatively affect glucose metabolism. Patients diagnosed with adrenal diseases should receive timely and appropriate treatment to avoid adverse cardiovascular events linked to hyperglycemia and insulin resistance.