Head-to-head comparison of three different US-based quantitative parameters for hepatic steatosis assessment: a prospective study.

PURPOSE: To evaluate the diagnostic performance of attenuation coefficient (AC), hepato-renal index (HRI) and controlled attenuation parameter (CAP) in quantitative assessment of hepatic steatosis by employing histopathology as reference standard. METHODS: Participants with suspected metabolic-associated fatty liver disease (MAFLD) who underwent US-based parameter examinations and liver biopsy were prospectively recruited. The distributions of US parameters across different grades of steatosis were calculated, and diagnostic performance was determined based on the areas under the receiver operating characteristic curve (AUC). RESULTS: A total of 73 participants were included, with hepatic steatosis grades S0, S1, S2, and S3 distributed as follows: 13, 20, 27, and 13 respectively. The correlation coefficients for CAP, AC, and HRI ranged from 0.67 to 0.74. AC and HRI showed a strong correlation with steatosis grade. The AUC for CAP and AC in diagnosing steatosis ≥ S1 were significantly higher at 0.99 and 0.98 compared to HRI's value. For diagnosing steatosis ≥ S2, the AUC of CAP (AUC: 0.85) was lower than that of AC (AUC: 0.94), and HRI (AUC: 0.94). Similarly for diagnosing steatosis S3, the AUC of CAP (AUC: 0.68) was lower than that of AC (AUC: 0.88), and HRI (AUC: 0.88). CONCLUSION: The AC and HRI values increased with the progression of hepatic steatosis grade, while CAP increased from S0 to S2 but not from S2 to S3. For mild steatosis diagnosis, CAP and AC showed superior diagnostic performance compared to HRI, while AC and HRI were more advantageous in differentiating moderate and severe steatosis.

Cost-Effectiveness of a Workplace-Based Hypertension Management Program in Real-World Practice in the Kailuan Study.

BACKGROUND: In 2009, a workplace-based hypertension management program was launched among men with hypertension in the Kailuan study. This program involved monitoring blood pressure semimonthly, providing free antihypertensive medications, and offering personalized health consultations. However, the cost-effectiveness of this program remains unclear. METHODS AND RESULTS: This analysis included 12 240 participants, with 6120 in each of the management and control groups. Using a microsimulation model derived from 10-year follow-up data, we estimated costs, quality-adjusted life years (QALYs), life-years, and incremental cost-effectiveness ratios (ICERs) for workplace-based management compared with routine care in both the study period and over a lifetime. Analyses are conducted from the societal perspective. Over the 10-year follow-up, patients in the management group experienced an average gain of 0.06 QALYs with associated incremental costs of $633.17 (4366.85 RMB). Projecting over a lifetime, the management group was estimated to increase by 0.88 QALYs or 0.92 life-years compared with the control group, with an incremental cost of $1638.64 (11 301.37 RMB). This results in an incremental cost-effectiveness ratio of $1855.47 per QALY gained and $1780.27 per life-year gained, respectively, when comparing workplace-based management with routine care. In probabilistic sensitivity analyses, with a threshold willingness-to-pay of $30 765 per QALY (3 times 2019 gross domestic product per capita), the management group showed a 100% likelihood of being cost-effective in 10 000 samples. CONCLUSIONS: Workplace-based management, compared with routine care for Chinese men with hypertension, could be cost-effective both during the study period and over a lifetime, and might be considered in working populations in China and elsewhere.

[Contamination levels of perfluorinated and polyfluoroalkyl compounds in breast milk and assessment of their exposure risk to infants].

The purposes of this study are to explore the contamination levels of perfluorinated and polyfluoroalkyl substances (PFASs) in breast milk and assess their exposure risk to infants. Based on data from a birth cohort study conducted in Yingcheng, Hubei Province, from 2018 to 2021, the contents of 23 types of PFASs in the breast milk of 324 pregnant women were determined using isotope dilution-high performance liquid chromatography-tandem mass spectrometry. Multiple linear regression was then performed to analyze the effects of various demographic characteristics and eating habits on the concentration of PFASs in breast milk. The daily PFASs intake of infants through breast milk was estimated, and the exposure risk of infants was also assessed. The results revealed that 23 types of PFASs in breast milk had good linear relationships in the range of 0.2-100 ng/mL, with correlation coefficients greater than 0.992. The limits of detection were 5-42 pg/mL, the limits of quantification were 15-126 pg/mL, the recoveries were 65.6%-108.1%, and the relative standard deviations were 1.6%-12.8%. Perfluorooctane sulfonic acid (PFOS), perfluorooctanoate acid (PFOA), and perfluorohexanesulfonic acid (PFHxS), with median concentrations of 200.7, 63.5, and 25.2 pg/mL, respectively, were the main PFASs found in breast milk. The detection rates of these three contaminants were higher than 80%, whereas the detection rates of other compounds were lower than 45%. The results of multiple linear regression showed that older pregnant women and a higher frequency of pickled food intake may be related to increased PFAS levels in breast milk whereas a higher frequency of legume intake may be related to decreased PFAS levels in breast milk. The median estimated daily intakes (EDIs) of PFOS, PFOA, and PFHxS for infants were 25.1, 7.9, and 3.2 ng/(kg·d), respectively. In summary, this study found notable PFAS levels in breast milk in Yingcheng, Hubei Province. Among these PFASs, PFOS, PFOA, and PFHxS were the main contaminants. Maternal age as well as pickled food and legume intake may affect the PFAS level in breast milk. The health risk of PFAS intake through breast milk to some infants is worthy of attention and further study.

Determining priority control toxic metal for different protection targets based on source-oriented ecological and human health risk assessment around gold smelting area.

Determining the priority control source and pollutant is the key for the eco-health protection and risk management around gold smelting area. To this end, a case study was conducted to explore the pollution characteristics, source apportionment, ecological risk and human health risk of toxic metals (TMs) in agricultural soils surrounding a gold smelting enterprise. Three effective receptor models, including positive matrix factorization model (PMF), ecological risk assessment (ERA), and probabilistic risk assessment (PRA) have been combined to apportion eco-human risks for different targets. More than 95.0% of samples had a Nemerow pollution index (NPI) > 2 (NPImean=4.27), indicating moderately or highly soil TMs contamination. Four pollution sources including gold smelting activity, mining source, agricultural activity and atmosphere deposition were identified as the major sources, with the contribution rate of 17.52%, 44.16%, 13.91%, and 24.41%, respectively. For ecological risk, atmosphere deposition accounting for 30.8% was the greatest contributor, which was mainly loaded on Hg of 51.35%. The probabilistic health risk assessment revealed that Carcinogenic risks and Non-carcinogenic risks of all population were unacceptable, and children suffered from a greater health risk than adults. Gold smelting activity (69.2%) and mining source (42.0%) were the largest contributors to Carcinogenic risks and Non-carcinogenic risks, respectively, corresponding to As and Cr as the target pollutants. The priority pollution sources and target pollutants were different for the eco-health protection. This work put forward a new perspective for soil risk control and management, which is very beneficial for appropriate soil remediation under limited resources and costs.

Global Burden of Ischemic Heart Disease in Adolescents and Young Adults, 1990-2019.

INTRODUCTION: Few studies have evaluated the global burden of ischemic heart disease (IHD) in adolescents and young adults (AYAs). METHODS: Age-standardized rates (ASRs) of incidence (ASIR), mortality (ASMR) and Disability-Adjusted Life Years (DALYs) (ASDR) were used to describe the burden of IHD in AYAs. Estimated Annual Percentage Changes (EAPCs) of ASRs were used to describe the trend from 1990 to 2019. Risk factors were calculated by population attributable fractions (PAFs). Analyses were conducted in 2023. RESULTS: In 2019, the ASIR, ASMR, and ASDR of IHD in AYAs were 26.81 (95% uncertainty interval [UI]: 20.36-34.54) per 100,000, 7.15 (95% UI: 6.56-7.87) per 100,000 and 409.51 (95% UI: 376.57-449.59) per 100,000. The ASIR and ASMR were higher among men than among women. From 1990 to 2019, the ASIR increased (EAPC=0.18%, 95% CI 0.14%-0.22%), while the ASMR (EAPC=-0.39%, -0.50% to -0.27%) and ASDR (EAPC=-0.40%, -0.52% to -0.29%) decreased. The largest increase in ASIR was observed in countries with a middle sociodemographic index (SDI) (EAPC=0.56%, 0.51%-0.60%). Globally, the proportional contribution of risk factors for DALY varied across regions, with the highest proportions of high low-density lipoprotein cholesterol in high SDI regions (PAF=74.26%) and high-middle (PAF=71.30%) and the highest proportions of air pollution in low (PAF=41.79%) and low-middle SDI regions (PAF=40.90%). CONCLUSIONS: The burden of IHD in AYAs remains high globally, and varies by age, sex, (male/female), region, and country. Targeted measures are needed to address the rising burden of IHD in AYAs, focusing on prevention, early diagnosis, and reduction in disparities.

Ornidazole Transfer into Colostrum and Assessment of Exposure Risk for Breastfeeding Infant: A Population Pharmacokinetic Analysis.

Ornidazole is frequently used for the prevention and treatment of anaerobic infections after caesarean section. There is still a lack of data on the excretion of ornidazole in breast milk. Therefore, the aim of this study was to investigate the transfer of ornidazole into colostrum and to assess the risk of infant exposure to the drug via breast milk. Population pharmacokinetic analysis was conducted using datasets of plasma and milk concentrations obtained from 77 breastfeeding women to examine the excretion kinetics of ornidazole. Various factors that may affect the excretion of ornidazole were investigated. The final model was then used to simulate ornidazole concentration-time profiles in both plasma and milk. The drug exposure in body fluids and the potential risk for breastfeeding were assessed based on the safety threshold. Plasma ornidazole concentration data could be described well by a one-compartment model, and concentrations in breast milk were linked to this model using an estimated milk-to-plasma concentration ratio (MPRcon). Significant variables that influenced drug exposure and MPRcon were identified as total bilirubin levels (TBIL) and postnatal sampling time, respectively. Simulations showed that women with abnormal liver function (TBIL > 17 µmol/L) had higher ornidazole levels in plasma and milk than those with normal liver function (TBIL < 17 µmol/L), but the exposures through colostrum of lactating women from both groups were below the safety threshold. This work provides a simple and feasible strategy for the prediction of drug exposure in breast milk and the assessment of breastfeeding safety.

Cost-effectiveness of drug treatment for young and middle-aged stage 1 hypertensive patients with high risk.

Background: Drug treatment was recommended for stage 1 hypertensive patients (blood pressure of 130-139 / 80-89 millimetres of mercury (mmHg)) with high cardiovascular disease (CVD) risk in the 2017 Hypertension Clinical Practice Guidelines, 2018 Chinese guidelines and 2021 World Health Organization guidelines, but not in other guidelines. However, evidence on the cost-effectiveness of drug treatment among young and middle-aged patients remains scarce. This study aimed to compare the cost-effectiveness of drug treatment vs. non-drug treatment for stage 1 hypertensive patients aged <60 years with high CVD risk. Methods: A microsimulation model projected quality-adjusted life years (QALYs), health care costs, and incremental cost-effectiveness ratios for drug treatment from a societal perspective. Transition probabilities were estimated from the Kailuan study with a sample size of 34 093 patients aged <60 years with high CVD risk. Costs and health utilities were obtained from the Kailuan study, national statistics reports and published literature. Results: Over a 15-year time horizon, the model predicted that drug treatment generated QALY of 9.36 and was associated with expected costs of 3735 US dollars ($) compared with 9.07 and $3923 produced by non-drug treatment among stage 1 hypertensive patients, resulting in a cost-saving for drug treatment. At a willingness-to-pay threshold of $10439/QALY (one gross domestic product (GDP) per capita in 2020), drug treatment had a 99.99% probability of being cost-effective for 10 000 samples of probabilistic sensitivity analysis. Sensitivity analyses by different values of transition probability, cost, utility and discount rate did not appreciably change the results. Shortening the time horizon to the average follow-up period of eight years resulted in ICER of $189/QALY for drug treatment (<1 × GDP/QALY). Conclusions: Our results suggested that drug treatment was a dominant strategy for stage 1 hypertensive patients aged <60 years with high CVD risk in China, which may provide evidence for policymakers and clinicians when weighing the pros and cons of drug treatment for young and middle-aged stage 1 hypertensive patients.

[Distribution Characteristics and Risk Assessment of Microplastics in Farmland Soil in Guyuan].

The farmland ecosystem faces the emerging risk of microplastic pollution. To investigate the distribution characteristics of microplastics in agricultural soils in Guyuan City, the abundance, type, color, size, and shape of microplastics in Guyuan City agricultural soils were analyzed using field survey, microscopic observation, and Fourier transform infrared spectroscopy. In addition, the risk of microplastic pollution was assessed using the pollution load index method (PLI). The results showed that the microplastic abundance of agricultural soils (0-20 cm) in Guyuan City ranged from 186.32 to 1286.24 n·kg-1, and the microplastic abundance of soils in facility agriculture increased significantly by 35.56% and 228.91% compared with those in non-facility agriculture with and without film, respectively, and the microplastic abundance in the arable layer was 0.31 times higher than that in the plough pan layer. PE (26.42% to 62.83%) and PP (27.64% to 42.62%) were the main microplastic polymer types, and the number of soil polymer species was significantly greater in facility agriculture than that in non-facility agriculture. Microplastics <100 µm accounted for 32.21%-42.52%, whereas >1000 µm accounted for only 0.28%-12.31%. The particle size of microplastics in the arable layer was 47.39% higher than that in the plough pan layer, and the particle size of microplastics was the largest in facility agriculture and the smallest in non-facility film-free planting. Microplastics were mostly in the form of films, fibers, fragments, and microbeads, with the greatest abundance in the form of fibers and the second largest in the form of films. A total of seven colors of microplastics were monitored, mainly white and black. The overall risk of contamination in the study area was low, and the highest risk of microplastic contamination was found in the soil of facility agriculture. The results of the study will provide data reference for the assessment of microplastic contamination in agricultural soils and microplastic soil environmental behavior in China.

[Contamination and Probabilistic Health Risk Assessment of Heavy Metals in Agricultural Soils Around a Lead-Zinc Smelter].

In order to identify the contamination and health risks of heavy metals in agricultural soils, a total of 56 surface soil samples (0-20 cm) were collected around a Pb-Zn smelter in Yunnan Province, and six heavy metals (Pb, Cd, Zn, As, Cu, and Hg) and pH were analyzed to assess heavy metal status, ecological risk, and probabilistic health risk. The results revealed that the average contents of six heavy metals (Pb:4413.93 mg·kg-1, Cd:6.89 mg·kg-1, Zn:1672.76 mg·kg-1, As:44.45 mg·kg-1, Cu:47.61 mg·kg-1, and Hg:0.21 mg·kg-1) were higher than their background values in Yunnan Province. Cd had the highest mean geo-accumulation index (Igeo) of 0.24, the highest mean pollution index (Pi) of 30.42, and the greatest average ecological risk index (Er) of 1312.60, indicating that Cd was the primary enriched and highest-ecological risk pollutant. The mean hazard index (HI) through exposure to six HMs was 2.42E-01 and 9.36E-01 for adults and children, respectively, with 36.63% of HI values for children exceeding the risk threshold of 1. Moreover, the mean total cancer risks (TCR) were 6.98E-05 and 5.93E-04 for adults and children, respectively, with 86.85% of TCR values for children exceeding the guideline value of 1E-04. The probabilistic health risk assessment suggested that Cd and As were the main contributors for the non-carcinogenic risks and carcinogenic risks. This work will provide scientific reference for the precise risk management and effective remediation strategy of soil heavy metal pollution in this study area.

Immunogenicity of inactivated rotavirus in rhesus monkey, and assessment of immunologic mechanisms.

Rotavirus is one of the main pathogens causing severe diarrhea in infants and young children < 5 years of age. The development of the next-generation rotavirus vaccine is of great significance for preventing rotavirus infection and reducing severe mortality. The current study aimed to develop and evaluate the immunogenicity of inactivated rotavirus vaccine (IRV) in rhesus monkeys. Monkeys received two or three IRV injections intramuscularly at a 4-week interval. Neutralizing antibodies, cellular immunity, PBMC gene expression profiling, and immune persistence were evaluated. Three-dose immunization of IRV induced a higher level of neutralizing, IgG and IgA antibodies compared to two-dose immunization. IRV induced IFN-γ secretion to mediate cellular immune responses, including robust pro-inflammatory and antiviral responses. Chemokine-mediated signaling pathways and immune response were broadly activated by IRV injection. The IRV-induced neutralizing antibodies resulting from two doses returned to baseline levels 20 weeks after full immunization, while those resulting from three doses returned to baseline levels 44 weeks after full immunization. Increasing immunization dose and injection number will help to improve IRV immunogenicity and neutralizing antibody persistence.

Predictive Value of Ablative Margin Assessment After Microwave Ablation for Local Tumor Progression in Medium and Large Hepatocellular Carcinoma: Computed Tomography-Computed Tomography Image Fusion Method Versus Side-by-Side Method.

OBJECTIVE: This study aimed to explore the feasibility and predictive value for local tumor progression (LTP) of the computed tomography (CT)-CT image fusion method versus side-by-side method to assess ablative margin (AM) in hepatocellular carcinoma ≥3 cm in diameter. MATERIALS AND METHODS: We selected patients with hepatocellular carcinoma ≥3 cm in diameter who underwent microwave ablation and had complete tumor ablation. We used the CT-CT image fusion method and side-by-side method to assess AM separately and divided the lesions into 3 groups: group I, minimum ablative margin (min-AM) <0 mm (the ablation zone did not fully cover the tumor); group II, 0 mm ≤ min-AM <5 mm; and group III, min-AM ≥5 mm. RESULTS: A total of 71 patients involving 71 lesions were included. The κ coefficient for the agreement between the CT-CT image fusion method and the side-by-side method in assessing min-AM was 0.14 (P = 0.028). Cumulative LTP rate was significantly different between groups by min-AM from the CT-CT image fusion method (P < 0.05) but not by min-AM from the side-by-side method (P = 0.807). Seventeen of the 20 LTP lesions were located at min-AM on fused CT images, with consistency rate of 85%. CONCLUSIONS: Compared with the side-by-side method, the CT-CT image fusion method is more accurate in assessing the AM of eccentrically ablated lesions and shows better predictive value for LTP. The min-AM based on CT-CT image fusion assessment is an important influencing factor for LTP.

How does export composition improvement affect carbon dioxide emissions in BRI countries? The mediating role of industrial structure upgrading and the moderating role of intellectual property protection.

Climate change, caused by carbon dioxide (CO2) emissions, has become increasingly severe and is a serious constraint on the sustainable development of the global economy. Economists are aware of the close relationship between export trade and the growth of CO2 emissions, especially for the Belt and Road Initiative countries that are experiencing economic growth and transformation. Extant literature also agrees that the composition of the export basket is one of the crucial factors influencing CO2 emissions, but the mechanisms by which changes in the export basket affect carbon emissions from a sustainable production perspective remain unexplored. Based on international trade theory, this study examines how shifts in production patterns affect subsequent CO2 emissions through the lens of exogenously driven changes in the composition of a country's exports, with the consideration of the mediating role of industrial structure upgrading and the moderating role of intellectual property protection simultaneously. The results reveal that export composition improvement contributes to carbon reduction, and industrial structure upgrading plays a significant mediating role in the export composition improvement for carbon reduction. Intellectual property protection moderates the relationship between export composition improvement and industrial structure upgrading. The mediating effect of export composition improvement affecting carbon emissions reduction through industrial structure upgrading is also moderated by intellectual property protection.

Medications and medical costs for diabetes patients with or without chronic respiratory disease in Beijing, China: A retrospective study.

Aims: The cost of drug regimens prescribed to Chinese patients has not been evaluated. This study aims to evaluate the medical costs and hypoglycemic agents for diabetes mellitus patients with or without chronic respiratory disease in Beijing, and to investigate the changes in the costs and number of antidiabetic medications used for diabetes patients with chronic respiratory disease from 2016 to 2018. Methods: This observational, retrospective study included diabetes patients with outpatient medication records from Beijing Medical Insurance between 2016 and 2018. The medications, including hypoglycemic and nonhypoglycemic drugs, insulin dosage, comorbidities, diabetes-related complications, treatment strategies, and annual medical costs, were recorded. Results: This study included 2,853,036 diabetes patients from 2016 to 2018. About 18.95%-20.53% of patients with chronic respiratory disease were predominantly distributed among those aged 45-84 years (88.7%-89.1%). Diabetes patients with chronic respiratory disease used more medications (4.48 ± 2.41 vs. 3.76 ± 2.33) and had higher total annual drug costs (¥12,286 ± 10,385 vs. ¥9700 ± 9202) to treat more comorbidities (2.52 ± 1.53 vs. 2.05 ± 1.85) than those without chronic respiratory disease (p <.0001, respectively). From 2016 to 2018, diabetes patients with chronic respiratory disease had a 4.2% increase in medication, a 1.9% decrease in comorbidities, and a 5.4% decrease in total annual drug costs. Conclusions: In summary, diabetes patients with chronic respiratory disease had more comorbidities, required more hypoglycemic drugs, and had higher medical costs. During 2016-2018, diabetes patients with chronic respiratory disease used more medications and spent less money on medical care.

Assessment of Genetic Diversity of the Salangid, Neosalanx taihuensis, Based on the Mitochondrial COI Gene in Different Chinese River Basins.

The salangid Neosalanx taihuensis (Salangidae) is a commercially important economical fish endemic to China and restricted to large freshwater systems with a wide-ranging distribution. This fish species has continuous distribution ranges and a long-introduced aquaculture history in Chinese basins. However, the research on its population genetic differentiation within and between basins is very limited. In this regard, 197 individuals were sampled from 11 populations in the Nenjiang River Basin (A1-A4), Songhua River Basin (B1), Yellow River Basin (C1-C2), Yangtze River Basin (D1), Lanchang River Basin (E1-E2) and Huaihe River Basin (F1). Based on the COI sequence, the N.taihuensis population's genetic difference within and between river basins was investigated. The haplotypes and their frequency distributions were strongly skewed, with most haplotypes (n = 13) represented only in single samples each and thus restricted to a single population. The most common haplotype (H4, 67/197) was found in all individuals. The analysis of molecular variance (AMOVA) revealed a random pattern in the distribution of genetic diversity, which is inconsistent with contemporary hydrological structure. The mismatch between the distribution and neutrality tests supported the evidence of a population expansion, which occurred during the late Pleistocene (0.041-0.051 million years ago). Significant levels of genetic subdivision were detected among populations within basins rather than between the six basins. Population history dynamics showed that N. taihuensis experienced an expansion during the glacial period in the late Pleistocene. Therefore, different populations should be considered as different management units to achieve effective conservation and management purposes. These results have great significance for the evaluation and exploitation of the germplasm resources of N. taihuensis.

Assessing the environmental impacts and costs of biochar and monitored natural attenuation for groundwater heavily contaminated with volatile organic compounds.

Although biochar (BC) and monitored natural attenuation (MNA) are regarded as green technologies for remediating volatile organic compounds (VOCs) contaminated groundwater, their life cycle environmental impacts and costs have not been systematically quantified. This work assessed the primary and secondary environmental impacts and the cost of three options for remediating the groundwater at a closed pesticide manufacturing plant site, which was contaminated by high levels of multiple VOCs and is undergoing MNA. The studied options include a combination of MNA and BC (MNA + BC), BC, and pump and treat (PT). The environmental impacts were examined through a Life Cycle Assessment (LCA) using the ReCiPe 2016 method. The costs were evaluated using a Life Cycle Cost (LCC) method created in the SimaPro. The LCA results show that the overall environmental impacts follow the sequence of PT > BC > MNA + BC, but MNA + BC shows evident primary impacts. The CO2 eq emissions generated from PT are more than five times of MNA + BC or BC. The cement, electricity, and steel for construction, and the operation energy are the environmental hotspots in PT. In MNA + BC and BC, the electricity for feedstock pyrolysis is the environmental hotspot, while the use of BC by-products to generate heat and power has positive environmental credit that compensates other negative environmental burdens. Incorporating institutional controls, using renewable energy and recycled or alternative materials, and developing BC with superior adsorption capacity are recommended to optimize the remediation strategies. The LCC results show that PT renders the highest cost, with cement and electricity being the two most expensive items. Electricity is the dominant contributor to the costs of MNA + BC and BC, while the avoided heat and power generation can save the cost of other items. Overall, this study provides scientific support to develop and optimize green remediation solutions for VOCs contaminated groundwater.

Overall lifestyles and socioeconomic inequity in mortality and life expectancy in China: the China health and nutrition survey.

BACKGROUND: socioeconomic inequity in mortality and life expectancy remains inconclusive in low- and middle-income countries, and to what extent the associations are mediated or modified by lifestyles remains debatable. METHODS: we included 21,133 adults from China Health and Nutrition Survey (1991-2011) and constructed three parameters to reflect participants' overall individual- (synthesising income, education and occupation) and area-level (urbanisation index) socioeconomic status (SES) and lifestyles (counting the number of smoking, physical inactivity and unhealthy diet and bodyweight). HRs for mortality and life expectancy were estimated by time-dependent Cox model and life table method, respectively. RESULTS: during a median follow-up of 15.2 years, 1,352 deaths were recorded. HRs (95% CIs) for mortality comparing low versus high individual- and area-level SES were 2.38 (1.75-3.24) and 1.84 (1.51-2.24), respectively, corresponding to 5.7 (2.7-8.6) and 5.0 (3.6-6.3) life-year lost at age 50. Lifestyles explained ≤11.5% of socioeconomic disparity in mortality. Higher lifestyle risk scores were associated with higher mortality across all socioeconomic groups. HR (95% CI) for mortality comparing adults with low individual-level SES and 3-4 lifestyle risk factors versus those with high SES and 0-1 lifestyle risk factors was 7.06 (3.47-14.36), corresponding to 19.1 (2.6-35.7) life-year lost at age 50. CONCLUSION: this is the first nationwide cohort study reporting that disadvantaged SES was associated with higher mortality and shorter life expectancy in China, which was slightly mediated by lifestyles. Risk lifestyles were related to higher mortality across all socioeconomic groups, and those with risk lifestyles and disadvantaged SES had much higher mortality risks.

Multimodal deep learning for Alzheimer's disease dementia assessment.

Worldwide, there are nearly 10 million new cases of dementia annually, of which Alzheimer's disease (AD) is the most common. New measures are needed to improve the diagnosis of individuals with cognitive impairment due to various etiologies. Here, we report a deep learning framework that accomplishes multiple diagnostic steps in successive fashion to identify persons with normal cognition (NC), mild cognitive impairment (MCI), AD, and non-AD dementias (nADD). We demonstrate a range of models capable of accepting flexible combinations of routinely collected clinical information, including demographics, medical history, neuropsychological testing, neuroimaging, and functional assessments. We then show that these frameworks compare favorably with the diagnostic accuracy of practicing neurologists and neuroradiologists. Lastly, we apply interpretability methods in computer vision to show that disease-specific patterns detected by our models track distinct patterns of degenerative changes throughout the brain and correspond closely with the presence of neuropathological lesions on autopsy. Our work demonstrates methodologies for validating computational predictions with established standards of medical diagnosis.

Ecological-health risks assessment and source apportionment of heavy metals in agricultural soils around a super-sized lead-zinc smelter with a long production history, in China.

Smelting activities are considered as the primary cause of heavy metal (HM) accumulation in soils, and the human health around the smelter has been a great concern worldwide. In this study, a total of 242 agricultural soil samples were collected around a large scale Pb/Zn smelter in China, and eight HMs (As, Cd, Cr, Cu, Hg, Ni, Pb and Zn) were analyzed to assess HMs status, ecological -health risks, and identify source. Monte Carlo simulation was utilized to evaluate the probabilistic health risks, and positive matrix factorization (PMF) was employed to identify sources. The results revealed the average contents of five heavy metals (Cd 5.28 mg/kg, Pb 203.36 mg/kg, Hg 0.39 mg/kg, Zn 293.45 mg/kg, Cu 37.14 mg/kg) are higher than their background values in Hunan province. Cd had the highest mean pollution index (PI) of 41.8 and the greatest average ecological risk index (Er) of 1256.34, indicating that Cd was the primary enriched pollutant and had a higher ecological risk than other HMs. The mean hazard index (HI) through exposure to eight HMs was 2.95E-01 and 9.74E-01 for adults and children, respectively, with 35.94% of HI values for children exceeding the risk threshold of 1. Moreover, the mean total cancer risks (TCR) were 2.75E-05 and 2.37E-04 for adults and children, respectively, with 75.48% of TCR values for children exceeding the guideline value of 1E-04. In addition, the positive matrix factorization results showed smelting activities, natural sources, agricultural activities and atmospheric deposition were the three sources in soils, with the contribution rate of 48.62%, 22.35%, and 29.03%, respectively. The uncertainty analysis of the PMF indicated that the three-factor solution is reliable. This work will provide scientific reference for the comprehensive prevention of soil HM pollution adjacent to the large smelter.

Low-Cost and Rapid Method of DNA Extraction from Scaled Fish Blood and Skin Mucus.

PCR-based DNA amplification has been one of the major methods in aquaculture research for decades, although its use outside the modern laboratory environment is limited due to the relatively complex methods and high costs. To this end, we investigated a swabbing and disc protocol for the collection of DNA samples from fish which could extract DNA from fish skin mucus by a non-invasion technique costing only $0.02 (USD) and requiring less than 30 seconds. The disc method that we chose could use the cheap filter paper to extract DNA from above 104 crucian carp blood cells, which is comparable to the commercial kit. By using skin mucus swabbing and the disc method, we can obtain amplification-ready DNA from mucus to distinguish different species from our smallest fish (medaka, ~2.5 cm and crucian carp, ~7 cm) to our biggest fish (tilapia, ~15 cm). Furthermore, the viral pathogen Carassius auratus herpesvirus (CaHV) of crucian carp was detected using our method, which would make performing molecular diagnostic assays achievable in limited-resource settings including aquafarms and aqua stores outside the laboratory environment.

The impact of high-tech product export trade on regional carbon performance in China: the mediating roles of industrial structure supererogation, low-carbon technological innovation, and human capital accumulation.

The role of expanding the proportion of high-tech products in the export trade of various countries to identify the appropriate export structure has gradually attracted the attention of governments and scholars. While there is some knowledge on how high-tech product exports affect carbon dioxide emissions, the mechanisms involved in that link have not been adequately addressed in previous studies. This study is based on China's inter-provincial panel data from 2006 to 2017 and uses the stepwise regression method and the bootstrap method to systematically investigate the mediating effects of industrial structure supererogation, low-carbon technological innovation, and human capital accumulation, operating in the impact of high-tech product export trade on regional carbon performance. Since the Pesaran's CD test and the P&Y slope homogeneity test confirm the presence of cross-sectional dependence and slope heterogeneity in the panel data, we use the CADF and CIPS unit root tests to verify the stationarity of the variables and therefore employ the CCEMG and DCCE estimators for regression estimation. The research results show that high-tech product exports can help improve regional carbon performance. The mediating variables, industrial structure supererogation, low-carbon technological innovation, and human capital accumulation separately have positive and complete mediating effects on the link between high-tech product export trade and regional carbon performance. The research results highlight the important part of expanding high-tech product exports in improving regional carbon performance and have significance in promoting China's green and low-carbon transition.