Viral and host factors related to the clinical outcome of COVID-19.

In December 2019, coronavirus disease 2019 (COVID-19), which is caused by the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in Wuhan (Hubei province, China)1; it soon spread across the world. In this ongoing pandemic, public health concerns and the urgent need for effective therapeutic measures require a deep understanding of the epidemiology, transmissibility and pathogenesis of COVID-19. Here we analysed clinical, molecular and immunological data from 326 patients with confirmed SARS-CoV-2 infection in Shanghai. The genomic sequences of SARS-CoV-2, assembled from 112 high-quality samples together with sequences in the Global Initiative on Sharing All Influenza Data (GISAID) dataset, showed a stable evolution and suggested that there were two major lineages with differential exposure history during the early phase of the outbreak in Wuhan. Nevertheless, they exhibited similar virulence and clinical outcomes. Lymphocytopenia, especially reduced CD4+ and CD8+ T cell counts upon hospital admission, was predictive of disease progression. High levels of interleukin (IL)-6 and IL-8 during treatment were observed in patients with severe or critical disease and correlated with decreased lymphocyte count. The determinants of disease severity seemed to stem mostly from host factors such as age and lymphocytopenia (and its associated cytokine storm), whereas viral genetic variation did not significantly affect outcomes.

Fossil and Nonfossil Sources of Winter Organic Aerosols in the Regional Background Atmosphere of China.

Carbonaceous aerosols (CA) from anthropogenic emissions have been significantly reduced in urban China in recent years. However, the relative contributions of fossil and nonfossil sources to CA in rural and background regions of China remain unclear. In this study, the sources of different carbonaceous fractions in fine aerosols (PM2.5) from five background sites of the China Meteorological Administration Atmosphere Watch Network during the winter of 2019 and 2020 were quantified using radiocarbon (14C) and organic markers. The results showed that nonfossil sources contributed 44-69% to total carbon at these five background sites. Fossil fuel combustion was the predominant source of elemental carbon at all sites (73 ± 12%). Nonfossil sources dominated organic carbon (OC) in these background regions (61 ± 13%), with biomass burning or biogenic-derived secondary organic carbon (SOC) as the most important contributors. However, the relative fossil fuel source to OC in China (39 ± 13%) still exceeds those at other regional/background sites in Asia, Europe, and the USA. SOC dominated the fossil fuel-derived OC, highlighting the impact of regional transport from anthropogenic sources on background aerosol levels. It is therefore imperative to develop and implement aerosol reduction policies and technologies tailored to both the anthropogenic and biogenic emissions to mitigate the environmental and health risks of aerosol pollution across China.

The Effect of Salvianolic Acid A on Tumor-Associated Macrophage Polarization and Its Mechanisms in the Tumor Microenvironment of Triple-Negative Breast Cancer.

Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer, with a high degree of malignancy and poor prognosis. Tumor-associated macrophages (TAMs) have been identified as significant contributors to the growth and metastasis of TNBC through the secretion of various growth factors and chemokines. Salvianolic acid A (SAA) has been shown to have anti-cancer activities. However, the potential activity of SAA on re-polarized TAMs remains unclear. As there is a correlation between the TAMs and TNBC, this study investigates the effect of SAA on TAMs in the TNBC microenvironment. For that purpose, M2 TAM polarization was induced by two kinds of TNBC-conditioned medium (TNBC-TCM) in the absence or presence of SAA. The gene and protein expression of TAM markers were analyzed by qPCR, FCM, IF, ELISA, and Western blot. The protein expression levels of ERK and p-ERK in M2-like TAMs were analyzed by Western blot. The migration and invasion properties of M2-like TAMs were analyzed by Transwell assays. Here, we demonstrated that SAA increased the expression levels of CD86, IL-1ß, and iNOS in M2-like TAMs and, conversely, decreased the expression levels of Arg-1 and CD206. Moreover, SAA inhibited the migration and invasion properties of M2-like TAMs effectively and decreased the protein expression of TGF-ß1 and p-ERK in a concentration-dependent manner, as well as TGF-ß1 gene expression and secretion. Our current findings for the first time demonstrated that SAA inhibits macrophage polarization to M2-like TAMs by inhibiting the ERK pathway and promotes M2-like TAM re-polarization to the M1 TAMs, which may exert its anti-tumor effect by regulating M1/M2 TAM polarization. These findings highlight SAA as a potential regulator of M2 TAMs and the possibility of utilizing SAA to reprogram M2 TAMs offers promising insights for the clinical management of TNBC.

[Changes in mild cognitive impairment and sociodemographic disparity among adults aged 55 years and above in 4 provinces of China].

OBJECTIVE: To investigate the changes in mild cognitive impairment(MCI) and sociodemographic disparity among adults aged 55 years and above in 4 provinces of China. METHODS: A total of 4687 adults aged 55 years and above from Community-based Cohort Study on Nervous System Disease who did not have Alzheimer's disease, participated in both rounds of the survey, and had complete baseline sociodemographic data and two rounds of data on cognitive function were selected. Generalized estimation equations were used to analyse the effect of sociodemographic factors on MCI. RESULTS: The detection rates of MCI in adults aged 55 years and above without Alzheimer's disease in 4 provinces of China in 2018 and 2020 were 48.56% and 42.56% respectively. MCI occurred in 30.11% of those with normal cognition(NC) at baseline, and 44.24% of those with MCI at baseline reverted to NC. The risk of MCI increased and the likelihood of MCI reversion decreased with increasing age and decreasing per capita monthly household income. In the baseline NC population, the risk of MCI in the junior high school and above group was 35% lower than that in the illiterate group(RR=0.65, 95%CI 0.53-0.80), the risk of MCI was lower in those living in rural areas(RR=0.56, 95%CI 0.49-0.65), and the risk of MCI was 1.17 times(95%CI 1.03-1.32) higher in those with a history of chronic diseases than in those without it. In the baseline MCI population, the likelihood of MCI reversion increased with education, the likelihood of MCI reversion was 1.04 times higher for workers than for non-workers(95%CI 1.00-1.08). CONCLUSION: The incidence and reversal rates of MCI were high in adults aged ≥55 years in four provinces of China. Advanced age, low education and low income level are risk factors for cognitive dysfunction.

MiR-5189-3p Suppresses cell Proliferation, Invasion and Migration Through Targeting EIF5A2 in Laryngeal Squamous Cell Carcinoma.

A growing body of evidence suggests that miR-5189-3p plays a critical role in multiple diseases. This study aimed to investigate the function of miR-5189-3p in laryngeal squamous cell carcinoma (LSCC) and explore its underlying mechanisms. qRT-PCR was designed to determine the expression levels of miR-5189-3p and eukaryotic translation initiation factor 5A2 (EIF5A2), while CCK-8 assay was performed to measure the effects of miR-5189-3p on cell proliferation. Transwell assay was performed to evaluate cell invasion as well as migration, and wound healing assay was applied to demonstrate cell migratory ability. Target gene prediction and luciferase reporter assay were developed to screen the possible target gene of miR-5189-3p, and Western blot was designed to measure EIF5A2 protein expression. MiR-5189-3p was down-regulated in LSCC tissues and cell lines. Up-regulation of miR-5189-3p notably inhibited cell proliferation, invasion, and migration in HEP2 and FADU cells. EIF5A2 was the potential downstream gene of miR-5189-3p, and overexpression of miR-5189-3p apparently reduced EIF5A2 expression. Moreover, reintroduction of EIF5A2 rescued the tumor suppressive effects of miR-5189-3p. MiR-5189-3p functions as a tumor inhibitor in LSCC progression via directly regulating EIF5A2 and may be a potential therapeutic target for LSCC.

[Double burden of malnutrition among children and adolescents aged 6-17 years in 15 provinces (autonomous regions, municipalities) of China in 1991-2015].

OBJECTIVE: To analyze the status and the trends of the double burden of malnutrition among children and adolescents aged 6-17 years in 15 provinces(autonomous regions and municipalities) of China in 1991, 2000, 2009 and 2015. METHODS: The data of China Health and Nutrition Surveys in 1991, 2000, 2009 and 2015 were used, children and adolescents aged 6-17 years were selected as the research objects. After excluding those with missing demographic, dietary data and physical measurement data, 2464, 2094, 929 and 1555 children and adolescents were included in the study in each year. The subjects were divided into lean, normal, overweight and obese groups. The dietary information was collected by 3-day 24-hour dietary recall, and edible oil and condiment intakes were collected by weighing method. The dietary micronutrient intake of children and adolescents was calculated according to the food composition table. The estimated average requirement(EAR) was used as the cut-offs of dietary micronutrient intake insufficiency to analyze the situation of micronutrient intake deficiency and double burden of malnutrition. RESULTS: The prevalence of underweight of children and adolescents aged 6-17 years in 15 provinces(autonomous regions and municipalities) during 1991-2015 showed a downward trend, while the prevalence of overweight and obesity showed an upward trend(all P<0.05). The prevalence of double burden of malnutrition increased from 6.5% in 1991 to 24.6% in 2015. In 1991, 2000, 2009 and 2015, 94.2%, 92.8%, 97.2% and 93.4% of children and adolescents had insufficient dietary micronutrient intake. In 1991 and 2000, 81.6% and 73.7% of children and adolescents had insufficient intake of 3-7 dietary micronutrients at the same time; In 2009 and 2015, 81.8% and 80.7% of children and adolescents had insufficient intake of 3-9 dietary micronutrients at the same time. CONCLUSION: The prevalence of overweight and obesity of children and adolescents in 15 provinces(autonomous regions and municipalities) of China was on the rise, the prevalence of insufficient intake of dietary micronutrients is higher, and the double burden of malnutrition was serious.

[Cardiovascular health status and related factors among adults aged 20-59 in 15 provinces of China in 2018].

OBJECTIVE: To evaluate the cardiovascular health status of Chinese adults and explore the related influencing factors. METHODS: Adults aged 20-59 from the China Health and Nutrition Survey covering 15 provinces and cities in 2018 were selected as the study subjects. The average score of 8 health factors was calculated using the definition of the "Life's Essential 8" for cardiovascular health released by the American Heart Association in 2022. Cardiovascular health was classified according to the score. Multinomial logit model was used to analyze the impact of demographic characteristics on cardiovascular health. RESULTS: A total of 5977 subjects were included in this study. The total score of cardiovascular health was 73.62. The single factor analysis showed that sleep and physical activity scored higher(91.69 and 87.39, respectively), while blood pressure and diet scored lower(58.88 and 44.16, respectively). Clustering analysis found that only 0.45% of the people with full score of all eight indicators, The average number of full score indicators was 4.22, and the full score indicators were more among 20-44, female, college or above, and urban residents. In addition, the number of people with high, moderate and poor cardiovascular health status were 35.70%, 59.58% and 4.72%, respectively. Multinomial logit analysis showed that compared with low cardiovascular health status, the people with high in 45-59 were 66%(95% CI 0.25-0.45) lower than those in 20-44. Women with moderate and high were 9.93(95%CI 6.44-15.33) and 41.82(95% CI 26.87-65.08) times higher than men, respectively. The moderate cardiovascular health of the people with middle income was 1.47(95% CI 1.07-2.01) times higher than those with low income. People in the south with moderate and high were 31%(95% CI 0.53-0.91) and 38%(95% CI 0.46-0.82) lower than those in the north, respectively. CONCLUSION: Adults in our country were in the moderate cardiovascular health. People aged 20-44, female, people with higher income and living in the north had better cardiovascular health.

[Analysis of differentiated regional dietary structures of adults aged 18-64 years in 15 provinces (autonomous regions, municipalities) of China in 2018].

OBJECTIVE: To analyze the status of energy and macronutrient intake among adults aged 18 to 64 years old in 15 provinces(autonomous regions and municipalities) of China. METHODS: A sample of 9481 adults aged 18-64 years from the data of the China Health and Nutrition Survey in 2018 was analyzed. Three consecutive days of 24 h recalls combined with the weighing of household seasonings were used to collect information on food intake and condiment intake. Food consumption was converted into energy and various nutrient intakes by the China Food Composition Table. RESULTS: The median daily intakes of energy were 1942.28 kcal and 1951.14 kcal in urban and rural areas, 1796.94 kcal, 1972.89 kcal, 1989.61 kcal and 1908.98 kcal in northwest, southwest, southeast and northern regions, respectively. The energy supply ratio of protein and fat were 13.61% and 35.85%, respectively, higher than 12.31% and 34.45% in rural areas, while the energy supply ratio of carbohydrates in urban(49.62%) was lower than that in rural areas(52.18%). The energy supply ratios of fat in the southwest and southeast regions were 38.90% and 36.80%, respectively, while the energy supply ratios of carbohydrates were 47.70% and 47.93%. The main food sources of energy, protein, and fat are different in different regions. The percentage of energy, protein, and fat from animal foods decreased with increasing age groups. The adults with low-income levels had a high intake of carbohydrates but a low intake of protein, and the adults with high-income levels had high proportions of energy, protein and fat from animal food sources. CONCLUSION: The total energy intakes of residents in different regions are relatively ideal, but the dietary structures are still unreasonable, and the energy supply ratios of fat are relatively high, especially in the southwest and southeast regions. The intake and food sources of the three macronutrients are varied in different regions and urban and rural areas. Age and income level affect the food choices of residents.

[Analysis of differentiated regional dietary patterns of adults aged 18-64 years in 15 provinces( autonomous regions, municipalities) in 2018].

OBJECTIVE: To analyze the dietary patterns of Chinese adults in 15 provinces and cities in China. METHODS: A total of 9208 adults aged 18-64 from the "China Health and Nutrition Survey" in 2018 were selected as subjects. Food consumption data were collected through 3 d-24 h dietary recalls and weighing household cooking oil and condiments, and the average daily dietary nutrient intake was calculated by the food composition table. Clustering analysis was used to analyze dietary patterns in different regions, and data from the 2009 China Health and Nutrition Survey were used for comparison. RESULTS: Three dietary patterns were obtained in this study, including northern pattern, coastal pattern and southern pattern. The analysis of demographic characteristics showed that the intake of cereals, vegetables and livestock were statistically different among different age groups, and livestock and poultry intake was higher in the 18-49 years; Fruit and milk were higher in women and other foods were higher in men; The intakes of cereals, tubers, legumes and vegetables were higher in rural areas, people with low income and low education levels, and other foods were higher in urban areas, people with high income and high education levels, especially milk. Compared with the dietary guidelines, it was found that the proportion of insufficient intake of dark vegetables, fruits and nuts in three patterns and milk, eggs in the southern pattern and aquatic products in the northern pattern was up to 80%, the other food intake was in 50%-80%; The proportion of excessive intake of livestock and poultry meat in the southern mode was significantly higher, reaching 78%. Nutrient analysis showed that the intake of carbohydrate, dietary fiber and carbohydrate energy ratio, vitamin E, magnesium and manganese were higher in the northern pattern; The intakes of protein, protein energy ratio, riboflavin, potassium, sodium, calcium, phosphorus, copper and selenium were higher in the coastal pattern; The southernpattern had a higher intake of energy, fat, fat energy ratio, niacin, retinol, zinc and vitamin C. In addition, the comparison between 2009 and 2018 showed that the intake of most foods except milk has decreased to varying degrees in the past decade, while the intake of some foods has increased. CONCLUSION: The 15 provinces in China were divided into three dietary patterns. Unbalanced intake of food and nutrients was common among them, and the intake was influenced by different demographic characteristics. In addition, most food intake has declined over the past decade.

[Designing effective front-of-package warning labels for prepackaged food in China:based on Delphi method].

OBJECTIVE: To design front-of-package warning labels for prepackaged food adapted to the Chinese context. METHODS: Delphi method was used to evaluate the first graft of indicatorsof the front-of-package warning labels. The front-of-package warning labels suitable for China's national conditions was selected according to the direct scoring method. RESULTS: 4 sets of front-of-package warning labels for prepackaged food were selected after two rounds of Delphi expert method. CONCLUSION: The final draft of the front-of-package warning labels for prepackaged food is in line with expectations.

[Development and validation of the nutrient-rich food index for China].

OBJECTIVE: To select the nutrient-rich food(NRF) index applicable to the food characteristics of Chinese residents through population-based dietary quality validation. METHODS: Sixteen NRF indices were constructed based on the Chinese Food Composition Table and the Chinese Food Labelling Nutrient Reference Values, using 100 g as the base amount of food for calculation. The NRF indices were validated by the China Prime Diet Quality Score(CPDQS), a dietary quality assessment index, using food intake data collected from 14 068 adult residents in 15 provinces in 2018 under the China Health and Nutrition Survey. The CPDQS was used as the dependent variable and the dietary NRF index score was used as the independent variable. The multiple linear regression models were performed after adjusting the covariates and the NRF index with the largest coefficient of determination R~2 was used as the most appropriate index. RESULTS: Regression analysis showed that the R~2 of NRF8.2 index was the largest, which was 0.16. Dried legumes, fungi and algae, nuts, vegetables, eggs and aquatic products scored higher on the NRF8.2 index. The high scoring subgroups had higher average daily intakes of cereals and potatoes, vegetables, fruits, soybeans and nuts, dairy, eggs and aquatic products, as well as lower consumption of livestock and poultry meat, beverages, salt and cooking oil, compared to the low scoring subgroup on the Dietary NRF8.2 Index. In terms of nutrient intake, the medium and high NRF8.2 subgroups had relatively high intakes of energy, protein, vitamins and minerals and relatively low intakes of fat and sodium. CONCLUSION: The NRF8.2 index explains the maximum variation in CPDQS and is a relatively suitable NRF index for the Chinese population.

Association of gut microbiota with glycaemic traits and incident type 2 diabetes, and modulation by habitual diet: a population-based longitudinal cohort study in Chinese adults.

AIMS/HYPOTHESIS: The gut microbiome is mainly shaped by diet, and varies across geographical regions. Little is known about the longitudinal association of gut microbiota with glycaemic control. We aimed to identify gut microbiota prospectively associated with glycaemic traits and type 2 diabetes in a geographically diverse population, and examined the cross-sectional association of dietary or lifestyle factors with the identified gut microbiota. METHODS: The China Health and Nutrition Survey is a population-based longitudinal cohort covering 15 provinces/megacities across China. Of the participants in that study, 2772 diabetes-free participants with a gut microbiota profile based on 16S rRNA analysis were included in the present study (age 50.8 ± 12.7 years, mean ± SD). Using a multivariable-adjusted linear mixed-effects model, we examined the prospective association of gut microbiota with glycaemic traits (fasting glucose, fasting insulin, HbA1c and HOMA-IR). We constructed a healthy microbiome index (HMI), and used Poisson regression to examine the relationship between the HMI and incident type 2 diabetes. We evaluated the association of dietary or lifestyle factors with the glycaemic trait-related gut microbiota using a multivariable-adjusted linear regression model. RESULTS: After follow-up for 3 years, 123 incident type 2 diabetes cases were identified. We identified 25 gut microbial genera positively or inversely associated with glycaemic traits. The newly created HMI (per SD unit) was inversely associated with incident type 2 diabetes (risk ratio 0.69, 95% CI 0.58, 0.84). Furthermore, we found that several microbial genera that were favourable for the glycaemic trait were consistently associated with healthy dietary habits (higher consumption of vegetable, fruit, fish and nuts). CONCLUSIONS/INTERPRETATION: Our results revealed multiple gut microbiota prospectively associated with glycaemic traits and type 2 diabetes in a geographically diverse population, and highlighted the potential of gut microbiota-based diagnosis or therapy for type 2 diabetes. DATA AVAILABILITY: The code for data analysis associated with the current study is available at https://github.com/wenutrition/Microbiota-T2D-CHNS.

Gut microbiota signatures of long-term and short-term plant-based dietary pattern and cardiometabolic health: a prospective cohort study.

BACKGROUND: The interplay among the plant-based dietary pattern, gut microbiota, and cardiometabolic health is still unclear, and evidence from large prospective cohorts is rare. We aimed to examine the association of long-term and short-term plant-based dietary patterns with gut microbiota and to assess the prospective association of the identified microbial features with cardiometabolic biomarkers. METHODS: Using a population-based prospective cohort study: the China Health and Nutrition Survey, we included 3096 participants from 15 provinces/megacities across China. We created an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI). The average PDIs were calculated using repeat food frequency questionnaires collected in 2011 and 2015 to represent a long-term dietary pattern. Short-term dietary pattern was estimated using 3-day 24-h dietary recalls collected in 2015. Fecal samples were collected in 2015 and measured using 16S rRNA sequencing. We investigated the association of long-term and short-term plant-based dietary patterns with gut microbial diversity, taxonomies, and functional pathways using linear mixed models. Furthermore, we assessed the prospective associations between the identified gut microbiome signatures and cardiometabolic biomarkers (measured in 2018) using linear regression. RESULTS: We found a significant association of short-term hPDI with microbial alpha-diversity. Both long-term and short-term plant-based diet indices were correlated with microbial overall structure, whereas long-term estimates explained more variance. Long-term and short-term PDIs were differently associated with microbial taxonomic composition, yet only microbes related to long-term estimates showed association with future cardiometabolic biomarkers. Higher long-term PDI was associated with the lower relative abundance of Peptostreptococcus, while this microbe was positively correlated with the high-sensitivity C-reactive protein and inversely associated with high-density lipoprotein cholesterol. CONCLUSIONS: We found shared and distinct gut microbial signatures of long-term and short-term plant-based dietary patterns. The identified microbial genera may provide insights into the protective role of long-term plant-based dietary pattern for cardiometabolic health, and replication in large independent cohorts is needed.

Modifiable factors of 20-year blood pressure trajectories among normotensives and their associations with hypertension : a prospective study.

Little is known about the impact of modifiable risk factors on blood pressure (BP) trajectories and their associations with hypertension (HTN). We aimed to identify BP trajectories in normotensive Chinese adults and explore their influencing factors and associations with HTN. We used data from 3436 adults with at least four BP measurements between 1989 and 2018 in the China Health and Nutrition Survey, an ongoing cohort study. We measured BP using mercury sphygmomanometers with appropriate cuff sizes in all surveys. We used group-based trajectory modelling to identify BP trajectories between 1989 and 2009 and multiple logistic and Cox regression models to analyse their influencing factors and associations with HTN in 2011-2018. We identified five systolic blood pressure (SBP) trajectories, 'Low-increasing (LI)', 'Low-stable (LS)', 'Moderate-increasing (MI)', 'High-stable (HS)' and 'Moderate-decreasing (MD)', and four diastolic blood pressure (DBP) trajectories classified as 'Low-increasing (LI)', 'Moderate-stable (MS)', 'Low-stable (LS)' and 'High-increasing (HI)'. People with higher physical activity (PA) levels and lower waist circumferences (WC) were less likely to be in the SBP LI, MI, HS and MD groups (P < 0·05). People with higher fruit and vegetable intakes, lower WCs and salt intakes and higher PA levels were less likely to be in the DBP LI, MS and HI groups (P < 0·05). Participants in the SBP HS group (hazard ratio (HR) 2·01) or the DBP LI, MS and HI groups (HR 1·38, 1·40, 1·71, respectively) had higher risks of HTN (P < 0·05). This study suggests that BP monitoring is necessary to prevent HTN in the Chinese population.

Trajectories of energy intake distribution and subsequent risk of hyperglycemia among Chinese adults: findings from the China Health and Nutrition Survey (1997-2018).

AIMS: Few studies have examined the secular trend of the energy intake distribution, and its effect on future risk of hyperglycemia. This study aims to describe trajectories of energy intake distribution over 12 years and relate them to subsequent risk of hyperglycemia over 9 years of follow-up. METHODS: Our study used ten waves of data from the CHNS survey, a population-based longitudinal survey in China, ongoing since 1989. We examined a cohort of adult participants who were free from diabetes but had at least three waves of dietary data from 1997 to 2009. We assessed energy intake using three consecutive 24 h recalls. We used these data to identify trajectory groups of energy intake distribution by multi-trajectory model based on energy intake proportions of breakfast, lunch, and dinner. We followed up participants for hyperglycemia, diabetes, and impaired fasting glucose for 9 years from 2009 to 2018. Outcomes were ascertained with fasting glucose, serum HbA1c, and self-report of diabetes and/or glucose-lowering medication. We estimated relative risk (RR) for hyperglycemia, diabetes, and impaired fasting glucose by identified trajectory groups using multilevel mixed-effects modified Poisson regression with robust (sandwich) estimation of variance. Gender difference was additionally examined. RESULTS: A total of 4417 participants were included. Four trajectory groups were identified, characterized and labeled by "Energy evenly distributed with steady trend group" (Group 1), "Dinner and lunch energy dominant with relatively steady trend group" (Group 2), "Dinner energy dominant with increasing trend and breakfast energy with declining trend group" (Group 3), and "breakfast and dinner energy dominant with increasing trend group" (Group 4). During 48,091 person-years, 1053 cases of incident hyperglycemia occurred, 537 cases of incident diabetes occurred, and 516 cases of impaired fasting glucose occurred. Compared with Group 1, Group 3 was associated with higher subsequent risk of incident hyperglycemia in 9 years of follow-up (RR = 1.28, 95% CI = 1.02, 1.61). No association was found for incident diabetes and impaired fasting glucose. Among males, Group 3 was associated with higher risk of incident hyperglycemia in 9 years of follow-up (RR = 1.44, 95% CI = 1.07, 1.94). No relationship was found in females. CONCLUSIONS: Energy intake distribution characterized by over 40% of energy intake from dinner with a rising trend over years was associated with higher long-term risk of hyperglycemia in Chinese adults.

Designing SnS/MoS2 van der Waals heterojunction for direct Z-scheme photocatalytic overall water-splitting by DFT investigation.

Construction of direct Z-scheme photocatalytic heterojunctions with an internal electric field has been proposed as an outstanding method to achieve efficient utilization of solar energy for photocatalytic overall water-splitting. In this work, the properties of van der Waals (vdW) heterojunctions formed by group-IV mono-chalcogenides (MXs) (M = Ge, Sn; X = S, Se, Te) and MoS2 are systematically studied by first-principles calculations, including the vdW binding energy, the direction of an internal electric field and the electronic structure. The results predict that GeS/MoS2, GeSe/MoS2 and SnS/MoS2 vdW heterojunctions are potential direct Z-scheme water-splitting photocatalysts with appropriate band alignments, a wide light absorption range and low effective charge-carrier mass. Furthermore, the hydrogen evolution reaction (HER) and the oxygen evolution reaction (OER) activities of the heterojunctions as photocatalysts are predicted. The results indicate that SnS/MoS2 with the Sn vacancy has a low Gibbs free energy of the HER (0.06 eV), and MoS2 with the S edge can offer OER active sites. This study provides a theoretical basis for the further design and preparation of a new two-dimensional overall water-splitting photocatalyst, which is conducive to the development of efficient two-dimensional photocatalysts in the field of clean energy.

Disparities in fresh fruit and vegetable intake by sociodemographic and behavioural factors among adults in China.

OBJECTIVE: To measure the associations of sociodemographic and behavioural factors with fruit and vegetable consumption among adults in China. DESIGN: A cross-sectional study. SETTING: A 2015 wave of the China Health and Nutrition Survey. PARTICIPANTS: Totally, 11 910 adults aged 18 to 64 years. RESULTS: Adjusted log binomial regression analyses showed that adults with higher income levels had higher fruit intake than those with low income levels (medium income group, risk ratio (RR): 1·28; 95 % CI: 1·16, 1·41; high income group, RR: 1·58; 95 % CI: 1·43, 1·74). Current smokers had lower fruit intake than non-smokers (RR: 0·86; 95 % CI: 0·77, 0·96). Adults living in southern China had higher vegetable intake (RR: 1·88; 95 % CI: 1·76, 2·01) but lower fruit intake (RR: 0·85; 95 % CI: 0·79, 0·91) than adults in northern China. With increasing age, adults had higher fruit intake (50-64 years, RR: 1·20; 95 % CI: 1·09, 1·33; reference category 18-34 years) and higher vegetable intake (35-49 years, RR: 1·13; 95 % CI: 1·05, 1·22; 50-64 years, RR: 1·22; 95 % CI: 1·13, 1·31). CONCLUSIONS: Our findings identify a range of sociodemographic and behavioural factors associated with fruit and vegetable consumption among Chinese adults. They also point to the need for public health nutrition interventions for socially disadvantaged populations in China.

Regulation of stem cell fate and function by using bioactive materials with nanoarchitectonics for regenerative medicine.

Nanoarchitectonics has emerged as a post-nanotechnology concept. As one of the applications of nanoarchitectonics, this review paper discusses the control of stem cell fate and function as an important issue. For hybrid nanoarchitectonics involving living cells, it is crucial to understand how biomaterials and their nanoarchitected structures regulate behaviours and fates of stem cells. In this review, biomaterials for the regulation of stem cell fate are firstly discussed. Besides multipotent differentiation, immunomodulation is an important biological function of mesenchymal stem cells (MSCs). MSCs can modulate immune cells to treat multiple immune- and inflammation-mediated diseases. The following sections summarize the recent advances of the regulation of the immunomodulatory functions of MSCs by biophysical signals. In the third part, we discussed how biomaterials direct the self-organization of pluripotent stem cells for organoid. Bioactive materials are constructed which mimic the biophysical cues of in vivo microenvironment such as elasticity, viscoelasticity, biodegradation, fluidity, topography, cell geometry, and etc. Stem cells interpret these biophysical cues by different cytoskeletal forces. The different cytoskeletal forces lead to substantial transcription and protein expression, which affect stem cell fate and function. Regulations of stem cells could not be utilized only for tissue repair and regenerative medicine but also potentially for production of advanced materials systems. Materials nanoarchitectonics with integration of stem cells and related biological substances would have high impacts in science and technology of advanced materials.

[Snacking behaviors of Chinese female adults aged 18 to 49 years old in 2004-2015].

OBJECTIVE: To describe shift in snacking behavior among Chinese female adults aged 18 to 49 years old in 2004-2015, and to analyze the contribution of snacks to energy and nutrients among them. METHODS: The present study used data from "China Health and Nutrition Health" where a multistage stratified cluster design was employed to select a stratified probability sample. A total of 12 523 female participants aged 18-49 years old who participated in surveys conducted in 2004-2015 with completed data of demographic characteristics and dietary measurementswere selectedas subjects. There were 2376, 2149, 2142, 2844 and 3012 subjects in waves of 2004, 2006, 2009, 2011, and 2015, respectively. Multivariate Logistic regression model was used to analyze the relationship between socioeconomic factors and snack consumption. Generalized linear model was used to analyze the energy and nutrient intake of snack consumers and non-snack consumers, as well as the contribution of snacks to energy and nutrients. RESULTS: The consumption rate of snacking for women aged 18 to 49 years old had an increasing trend over time(P<0.05), and the rate was 14.24% in 2015, 3.5 times as high as that in 2004. Participants aged 18 to 29 years old whose snake consumption rates were relatively higher compared to those of other aged groups in general waves; also, female adults from the higher education group, the higher yearly income group, and the higher urbanicity index group, and those with the history of smoking or the alcohol use tended to consumed snacks. The change of the influential factors in relation to the consumption of the participant's snack was observed, and age, income level, education level, living area, and the behavior of smoking and drinking were all important factors of snacking. The daily energy and nutrient intake of female snack consumers aged 18 to 49 years old was higher than that of non-snack consumers. The contribution rate of snacks to energy and nutrients varies significantly between survey years; and the contribution of snacks to energy and main nutrients was more than 20% in 2011. CONCLUSION: Snacks have become an important part of the diet of Chinese women aged 18 to 49 years old. Future health promotion programs should be targeted on nutrition education and intervention to guide a reasonable diet structure.

[Fat intake from pre-packaged foods among Chinese residents of 16 provinces in 2018].

OBJECTIVE: To investigate the impact of prepackaged food consumption on fat intake in 16 provinces of China in 2018. METHODS: Data used in present study was derived from the eleventh round of China Health and Nutrition Survey(CHNS), 17312 residents aged 6 and over were selected and their consumed information of pre-packaged food was collected. The consumption of pre-packaged food and fat intake from pre-packaged food in urban and rural areas, different age groups, different regions and different genders were calculated and compared. RESULTS: The median intake of fat from pre-packaged food among subjects and consumers were 33.6 g/d and 34.7 g/d, respectively.73.5% of the intake of fat from pre-packaged food comes from vegetable oil. CONCLUSION: Vegetable oil was the main source of fat from pre-packaged food for Chinese residents.