Geographic and ethnicity variation in the prevalence of middle-aged and elderly adult obesity in China in 2020.

AIM: The objective of this study is to evaluate the mean body mass index (BMI), general obesity and abdominal obesity in adults aged ≥40 years residing in China in 2020, and to analyse variations in these factors across different geographic areas and subpopulations. METHODS: We utilized data from the National Stroke High-Risk Population Screening programme to calculate and compare the mean BMI and prevalence of obesity across various demographics, including sex, age, urban-rural locality, geographical region (province) and ethnicity status. RESULTS: In our study, we found that the standardized mean BMI level was 24.65 kg/m2 [95% confidence interval (CI): 24.50-22.84] in men and 24.31 kg/m2 (95% CI: 24.15-24.45) in women. Using the criteria from China, we found that the standardized prevalence of general obesity and abdominal obesity was 13.13% (95% CI: 13.05-13.21%) and 33.03% (95 CI: 32.92-33.14%), respectively. Our study also identified significant effects of age, sex, urban-rural locality, province and ethnicity status on the prevalence of obesity. Overall, our study estimated that in 2020, approximately 91.1 million adults aged ≥40 years in China were obese (46.5 million men and 44.6 million women), while 229.2 million adults (110.4 million men and 118.8 million women) were diagnosed with abdominal obesity. CONCLUSION: Our research has revealed compelling new evidence about the obesity epidemic among Chinese adults aged ≥40 years, particularly at the provincial and ethnic levels. As a result, more targeted and effective prevention strategies should be developed to alleviate the burden of obesity.

Endovascular thrombectomy in wake-up stroke guided by arterial spin-labeling and fluid-attenuated inversion recovery versus diffusion-weighted imaging mismatch on MRI.

OBJECTIVE: This purpose of this study is to investigate the effectiveness and safety of utilizing the arterial spin-labeling (ASL) combined with diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) combined with DWI double mismatch in the endovascular treatment of patients diagnosed with wake-up stroke (WUS). METHODS: In this single-center trial, patients diagnosed with WUS underwent thrombectomy if acute ischemic lesions were observed on DWI indicating large precerebral circulation occlusion. Patients with no significant parenchymal hypersignal on FLAIR and ASL imaging showing a hypoperfusion tissue to infarct core volume ratio of at least 1.2 were included. The participants were divided into groups receiving endovascular thrombectomy plus medical therapy or medical therapy alone, based on their subjective preference. Functional outcomes were assessed using the ordinal score on the modified Rankin scale (mRs) at 90 days, along with the rate of functional independence. RESULTS: In this study, a total of 77 patients were included, comprising 38 patients in the endovascular therapy group and 39 patients in the medical therapy group. The endovascular therapy group exhibited more favorable changes in the distribution of functional prognosis measured by mRs at 90 days, compared to the medical therapy group (adjusted common odds ratio, 3.25; 95% CI, 1.03 to 10.26; P < 0.01). Additionally, the endovascular therapy group had a higher proportion of patients achieving functional independence (odds ratio, 4.0; 95% CI, 1.36 to 11.81; P < 0.01). Importantly, there were no significant differences observed in the incidence of intracranial hemorrhage or mortality rates between the two groups. CONCLUSION: Guided by the ASL-DWI and FLAIR-DWI double mismatch, endovascular thrombectomy combined with standard medical treatment appears to yield superior functional outcomes in patients with WUS and large vessel occlusion compared to standard medical treatment alone.

Network localization of transient global amnesia beyond the hippocampus.

BACKGROUND: Transient global amnesia is common in the older adult, but the cause and mechanism remain unclear. Focal brain lesions allow for causal links between the lesion location and resulting symptoms, and we based on the reported TGA-causing lesions and used lesion network mapping to explore the causal neuroanatomical substrate of TGA. METHODS: Fifty-one cases of transient global amnesias with DWI lesions from the literature were identified, and clinical data were extracted and analyzed. Next, we mapped each lesion volume onto a reference brain and computed the network of regions functionally connected to each lesion location using a large normative connectome dataset. RESULTS: Lesions primarily occurred in the hippocampus, and in addition to the hippocampus, there are also other locations of TGA-causing lesions such as the cingulate gyrus, anterior thalamic nucleus (ATN), putamen, caudate nucleus, corpus callosum, fornix. More than 90% of TGA-causing lesions inside the hippocampus were functionally connected with the default mode network (DMN). CONCLUSION: Structural abnormality in the hippocampus was the most consistently reported in TGA, and besides the hippocampus, lesions occurring at several other brain locations also could cause TGA. The DMN may also be involved in the pathophysiology of TGA. According to the clinical and neuroimaging characteristics, TGA may be a syndrome with multiple causes and cannot be treated simply as a subtype of TIA.

Experiment and Theory Clarify: Sc+ Receives One Oxygen Atom from SO2 to Form ScO+ , which Proves to be a Catalyst for the Hidden Oxygen-Exchange with SO2.

Using Fourier-transform ion cyclotron resonance mass spectrometry, it was experimentally determined that Sc+ in the highly diluted gas phase reacts with SO2 to form ScO+ and SO. By 18 O labeling, ScO+ was shown to play the role of a catalyst when further reacting with SO2 in a Mars-van Krevelen-like (MvK) oxygen exchange process, where a solid catalyst actively reacts with the substrate but emerges apparently unchanged at the end of the cycle. High-level quantum chemical calculations confirmed that the multi-step process to form ScO+ and SO is exoergic and that all intermediates and transition states in between are located energetically below the entrance level. The reaction starts from the triplet surface; although three spin-crossing points with minimal energy have been identified by computational means, there is no evidence that a two-state scenario is involved in the course of the reaction, by which the reactants could switch from the triplet to the singlet surface and back. Pivotal to the oxygen exchange reaction of ScO+ with SO2 is the occurrence of a highly symmetric four-membered cyclic intermediate by which two oxygen atoms become equivalent.

Complete cleavage of the N≡N triple bond by Ta2N+ via degenerate ligand exchange at ambient temperature: A perfect catalytic cycle.

An unprecedented, spontaneous, and complete cleavage of the triple bond of N2 in the thermal reaction of 15N2 with Ta214N+ was observed experimentally by Fourier transform ion cyclotron resonance mass spectrometry; mechanistic aspects of the degenerate ligand exchange were addressed by high-level quantum chemical calculations. The "hidden" dis- and reassembly of N2, mediated by Ta2N+, constitutes a full catalytic cycle. A frontier orbital analysis reveals that the scission of the N2 triple bond is essentially governed by the donation of d-electrons from the 2 metal centers into antibonding π*-orbitals of N2 and by the concurrent migration of electrons from bonding π- and σ-orbitals of N2 into empty d-orbitals of the metals. This work may contribute to a rational design of catalysts in order to reduce the still enormous energy demand required for an artificial dinitrogen activation.

Ta2+-mediated ammonia synthesis from N2 and H2 at ambient temperature.

In a full catalytic cycle, bare Ta2+ in the highly diluted gas phase is able to mediate the formation of ammonia in a Haber-Bosch-like process starting from N2 and H2 at ambient temperature. This finding is the result of extensive quantum chemical calculations supported by experiments using Fourier transform ion cyclotron resonance MS. The planar Ta2N2+, consisting of a four-membered ring of alternating Ta and N atoms, proved to be a key intermediate. It is formed in a highly exothermic process either by the reaction of Ta2+ with N2 from the educt side or with two molecules of NH3 from the product side. In the thermal reaction of Ta2+ with N2, the N≡N triple bond of dinitrogen is entirely broken. A detailed analysis of the frontier orbitals involved in the rate-determining step shows that this unexpected reaction is accomplished by the interplay of vacant and doubly occupied d-orbitals, which serve as both electron acceptors and electron donors during the cleavage of the triple bond of N≡N by the ditantalum center. The ability of Ta2+ to serve as a multipurpose tool is further shown by splitting the single bond of H2 in a less exothermic reaction as well. The insight into the microscopic mechanisms obtained may provide guidance for the rational design of polymetallic catalysts to bring about ammonia formation by the activation of molecular nitrogen and hydrogen at ambient conditions.

On the Crucial Role of Isolated Electronic States in the Thermal Reaction of ReC+ with Dihydrogen.

Presented here is that isolated, long-lived electronic states of ReC+ serve as the root cause for distinctly different reactivities of this diatomic ion in the thermal activation of dihydrogen. Detailed high-level quantum chemical calculations support the experimental findings obtained in the highly diluted gas phase using FT-ICR mass spectrometry. The origin for the existence of these long-lived excited electronic states and the resulting implications for the varying mechanisms of dihydrogen splitting are addressed.

Counter-Intuitive Gas-Phase Reactivities of [V2 ]+ and [V2 O]+ towards CO2 Reduction: Insight from Electronic Structure Calculations.

[V2 O]+ remains "invisible" in the thermal gas-phase reaction of bare [V2 ]+ with CO2 giving rise to [V2 O2 ]+ ; this is because the [V2 O]+ intermediate is being consumed more than 230 times faster than it is generated. However, the fleeting existence of [V2 O]+ and its involvement in the [V2 ]+ → [V2 O2 ]+ chemistry are demonstrated by a cross-over labeling experiment with a 1:1 mixture of C16 O2 /C18 O2 , generating the product ions [V2 16 O2 ]+ , [V2 16 O18 O]+ , and [V2 18 O2 ]+ in a 1:2:1 ratio. Density functional theory (DFT) calculations help to understand the remarkable and unexpected reactivity differences of [V2 ]+ versus [V2 O]+ towards CO2 .

Revisiting the Intriguing Electronic Features of the BeOBeC Carbyne and Some Isomers: A Quantum-Chemical Assessment.

Extensive high-level quantum-chemical calculations reveal that the rod-shaped molecule BeOBeC, which was recently generated in matrix experiments, exists in two nearly isoenergetic states, the 5 Σ quintet (5 6) and the 3 Σ triplet (3 6). Their IR features are hardly distinguishable at finite temperature. The major difference concerns the mode of spin coupling between the terminal beryllium and carbon atoms. Further, the ground-state potential-energy surface of the [2Be,C,O] system at 4 K is presented and differences between the photochemical and thermal behaviors are highlighted. Finally, a previously not considered, so far unknown C2v -symmetric rhombus-like four-membered ring 3 [Be(O)(C)Be] (3 5) is predicted to represent the global minimum on the potential-energy surface.

Intrinsic Reactivity of Diatomic 3d Transition-Metal Carbides in the Thermal Activation of Methane: Striking Electronic Structure Effects.

Mechanistic aspects of the C-H bond activation of methane by metal-carbide cations MC+ of the 3d transition-metals Sc-Zn were elucidated by NEVPT2//CASSCF quantum-chemical calculations and verified experimentally for M = Ti, V, Fe, and Cu by using Fourier transform ion-cyclotron resonance mass spectrometry. While MC+ species with M = Sc, Ti, V, Cr, Cu, and Zn activate CH4 at ambient temperature, this is prevented with carbide cations of M = Mn, Fe, and Co by high apparent barriers; NiC+ has a small apparent barrier. Hydrogen-atom transfers from methane to metal-carbide cations were found to proceed via a proton-coupled electron transfer mechanism for M = Sc-Co; wherein the doubly occupied πxz/yz-orbitals between metal and carbon at the carbon site serve as electron donors and the corresponding metal-centered vacant π*xz/yz-orbitals as electron acceptors. Classical hydrogen-atom transfer transpires only in the case of NiC+, while ZnC+ follows a mechanistic scenario, in which a formally hydridic hydrogen is transferred. CuC+ reacts by a synchronous activation of two C-H bonds. While spin density is often so crucial for the reactions of numerous MO+/CH4 couples, it is much less important for the C-H bond activation by carbide cations of the 3d transition-metals, in which one notes large changes in bond dissociation energies, spin states, number of d-electrons, and charge distributions. All these factors jointly affect both the reactivity of the metal carbides and their mechanisms of C-H bond activation.

A Reaction-Induced Localization of Spin Density Enables Thermal C-H Bond Activation of Methane by Pristine FeC4.

The reactivity of the cationic metal-carbon cluster FeC4 + towards methane has been studied experimentally using Fourier-transform ion cyclotron resonance mass spectrometry and computationally by high-level quantum chemical calculations. At room temperature, FeC4 H+ is formed as the main ionic product, and the experimental findings are substantiated by labeling experiments. According to extensive quantum chemical calculations, the C-H bond activation step proceeds through a radical-based hydrogen-atom transfer (HAT) mechanism. This finding is quite unexpected because the initial spin density at the terminal carbon atom of FeC4 + , which serves as the hydrogen acceptor site, is low. However, in the course of forming an encounter complex, an electron from the doubly occupied sp-orbital of the terminal carbon atom of FeC4 + migrates to the singly occupied π*-orbital; the latter is delocalized over the entire carbon chain. Thus, a highly localized spin density is generated in situ at the terminal carbon atom. Consequently, homolytic C-H bond activation occurs without the obligation to pay a considerable energy penalty that is usually required for HAT involving closed-shell acceptor sites. The mechanistic insights provided by this combined experimental/computational study extend the understanding of methane activation by transition-metal carbides and add a new facet to the dizzying mechanistic landscape of hydrogen-atom transfer.

Reassessment of the Mechanisms of Thermal C-H Bond Activation of Methane by Cationic Magnesium Oxides: A Critical Evaluation of the Suitability of Different Density Functionals.

The mechanisms of the thermal reactions of the two iconic magnesium oxide cations MgO.+ and Mg2 O2.+ with methane have been re-evaluated at the CCSD(T)/CBS//CCSD/def2-TZVP level of theory. For the reaction of MgO.+ with CH4 , only the classical hydrogen-atom transfer (HAT) was found; in contrast, for the Mg2 O2.+ /CH4 couple, both HAT and proton-coupled electron-transfer (PCET) exist as mechanistic variants. In order to evaluate the suitability of density functional theory (DFT) methods, the reactions were computed by using 27 density functionals. The results obtained demonstrate that the various DFT methods often deliver rather different results for both geometric and energetic features. As to the prediction of the apparent barriers, pure functionals give the largest mean absolute errors. BMK, ωB97XD, and the double-hybrid functional mPW2PLYP were confirmed to come closest to the results provided by CCSD(T)/CBS. Thus, mechanistic conclusions based on a single DFT method should be viewed with great caution. In summary, this study may assist in the selection of a suitable quantum chemical method to unravel the mechanistic details of C-H bond activation by charged metal oxides.

Thermal O-H Bond Activation of Water As Mediated by Heteronuclear [Al2Mg2O5]•+: Evidence for Oxygen-Atom Scrambling.

Mechanistic insight into the thermal O-H bond activation of water by the cubane-like, prototypical heteronuclear oxide cluster [Al2Mg2O5]•+ has been derived from a combined experimental/computational study. Experiments in the highly diluted gas phase using Fourier transform ion-cyclotron resonance mass spectrometry show that hydrogen-atom abstraction from water by the cluster cation [Al2Mg2O5]•+ occurs at ambient conditions accompanied by the liberation of an OH• radical. Because of a complete randomization of all oxygen atoms prior to fragmentation, about 83% of the oxygen atoms of the hydroxyl radical released originate from the oxide cluster itself. The experimental findings are supported by detailed high-level quantum chemical calculations. The theoretical analysis reveals that the transfer of a formal hydrogen atom from water to the metal-oxide cation can proceed mechanistically via proton- or hydrogen-atom transfer exploiting different active sites of the cluster oxide. In addition to the unprecedented oxygen-atom scrambling, one of the more general and quite unexpected findings concerns the role of spin density at the hydrogen-acceptor oxide atom. While this feature is crucial for [M-O]+/CH4 couples, it is much less important in the O-H bond activation of water.

Electronic Effects on Room-Temperature, Gas-Phase C-H Bond Activations by Cluster Oxides and Metal Carbides: The Methane Challenge.

This Perspective discusses a story of one molecule (methane), a few metal-oxide cationic clusters (MOCCs), dopants, metal-carbide cations, oriented-electric fields (OEFs), and a dizzying mechanistic landscape of methane activation! One mechanism is hydrogen atom transfer (HAT), which occurs whenever the MOCC possesses a localized oxyl radical (M-O•). Whenever the radical is delocalized, e.g., in [MgO]n•+ the HAT barrier increases due to the penalty of radical localization. Adding a dopant (Ga2O3) to [MgO]2•+ localizes the radical and HAT transpires. Whenever the radical is located on the metal centers as in [Al2O2]•+ the mechanism crosses over to proton-coupled electron transfer (PCET), wherein the positive Al center acts as a Lewis acid that coordinates the methane molecule, while one of the bridging oxygen atoms abstracts a proton, and the negatively charged CH3 moiety relocates to the metal fragment. We provide a diagnostic plot of barriers vs reactants' distortion energies, which allows the chemist to distinguish HAT from PCET. Thus, doping of [MgO]2•+ by Al2O3 enables HAT and PCET to compete. Similarly, [ZnO]•+ activates methane by PCET generating many products. Adding a CH3CN ligand to form [(CH3CN)ZnO]•+ leads to a single HAT product. The CH3CN dipole acts as an OEF that switches off PCET. [MC]+ cations (M = Au, Cu) act by different mechanisms, dictated by the M+-C bond covalence. For example, Cu+, which bonds the carbon atom mostly electrostatically, performs coupling of C to methane to yield ethylene, in a single almost barrier-free step, with an unprecedented atomic choreography catalyzed by the OEF of Cu+.

Sequential Gas-Phase Activation of Carbon Dioxide and Methane by [Re(CO)2]+: The Sequence of Events Matters!

The potential of carbonyl rhenium complexes in activating and coupling carbon dioxide and methane has been explored by using a combination of gas-phase experiments (FT-ICR mass spectrometry) and high-level quantum chemical calculations. While the complexes [Re(CO)x]+ (x = 0, 1, 3) are thermally unreactive toward CO2, [Re(CO)2]+ abstracts one oxygen atom from this substrate spontaneously at ambient conditions. Based on 13C and 18O labeling experiments, the newly generated CO ligand is preferentially eliminated, and two mechanistic scenarios are considered to account for this unexpected finding. The oxo complex [ORe(CO)2]+ reacts further with CH4 to produce the dihydridomethylene complex [ORe(CO)(CH2)(H)2]+. However, coupling of the CO and CH2 ligands to form CH2═C═O does not take place. Further, the complexes [Re(CO)x(CH2)]+ (x = 1, 2), generated in the thermal reaction of [Re(CO)x]+ (x = 1, 2) with CH4, are inert toward CO2. Mechanistic insight on the origin of this remarkable reactivity pattern has been derived from detailed quantum chemical calculations.

Electrostatic and Charge-Induced Methane Activation by a Concerted Double C-H Bond Insertion.

A mechanistically unique, simultaneous activation of two C-H bonds of methane has been identified during the course of its reaction with the cationic copper carbide, [Cu-C]+. Detailed high-level quantum chemical calculations support the experimental findings obtained in the highly diluted gas phase using FT-ICR mass spectrometry. The behavior of [Cu-C]+/CH4 contrasts that of [Au-C]+/CH4, for which a stepwise bond-activation scenario prevails. An explanation for the distinct mechanistic differences of the two coinage metal complexes is given. It is demonstrated that the coupling of [Cu-C]+ with methane to form ethylene and Cu+ is modeled very well by the reaction of a carbon atom with methane mediated by an oriented external electric field of a positive point charge.

Bond Activation by Metal-Carbene Complexes in the Gas Phase.

"Bare" metal-carbene complexes, when generated in the gas phase and exposed to thermal reactions under (near) single-collision conditions, exhibit rather unique reactivities in addition to the well-known metathesis and cyclopropanation processes. For example, at room temperature the unligated [AuCH2](+) complex brings about efficient C-C coupling with methane to produce C2Hx (x = 4, 6), and the couple [TaCH2](+)/CO2 gives rise to the generation of the acetic acid equivalent CH2═C═O. Entirely unprecedented is the thermal extrusion of a carbon atom from halobenzenes (X = F, Cl, Br, I) by [MCH2](+) (M = La, Hf, Ta, W, Re, Os) and its coupling with the methylene ligand to deliver C2H2 and [M(X)(C5H5)](+). Among the many noteworthy C-N bond-forming processes, the formation of CH3NH2 from [RhCH2](+)/NH3, the generation of CH2═NH2(+) from [MCH2](+)/NH3 (M = Pt, Au), and the production of [PtCH═NH2](+) from [PtCH2](+)/NH3 are of particular interest. The latter species are likely to be involved as intermediates in the platinum-mediated large-scale production of HCN from CH4/NH3 (the DEGUSSA process). In this context, a few examples are presented that point to the operation of co-operative effects even at a molecular level. For instance, in the coupling of CH4 with NH3 by the heteronuclear clusters [MPt](+) (M = coinage metal), platinum is crucial for the activation of methane, while the coinage metal M controls the branching ratio between the C-N bond-forming step and unwanted soot formation. For most of the gas-phase reactions described in this Account, detailed mechanistic insight has been derived from extensive computational work in conjunction with time-honored labeling and advanced mass-spectrometry-based experiments, and often a coherent description of the experimental findings has been achieved. As for some transition metals, in particular those from the third row, the metal-carbene complexes can be formed directly from methane, coupling of the so-generated [MCH2] species with an inert molecule such as CH4, CO2, or NH3 constitutes a route to activate and functionalize methane under ambient conditions. Clearly, while these gas-phase studies cannot be translated directly to formally related processes in solution or those that occur at a surface, they nevertheless provide a conceptual mechanistic understanding and permit researchers to probe directly the remarkable intrinsic features of these elusive molecules and, in a broader context, help to identify the active site of a catalyst, the so-called "aristocratic atoms".

Striking Doping Effects on Thermal Methane Activation Mediated by the Heteronuclear Metal Oxides [XAlO4 ].+ (X=V, Nb, and Ta).

The thermal reactivity of the heteronuclear metal-oxide cluster cations [XAlO4 ].+ (X=V, Nb, and Ta) towards methane has been studied by using mass spectrometry in conjunction with quantum mechanical calculations. Experimentally, a hydrogen-atom transfer (HAT) from methane is mediated by all the three oxide clusters at ambient conditions. However, [VAlO4 ].+ is unique in that this cluster directly transforms methane into formaldehyde. The absence of this reaction for the Nb and Ta analogues demonstrates a striking doping effect on the chemoselectivity in the conversion of methane. Mechanistic aspects of the two reactions have been elucidated by quantum-chemical calculations. The HAT reactivity can be attributed to the significant spin density localized at the terminal oxygen atom (Ot.- ) of the cluster ions, while the ionic/covalent character of the Lewis acid-base unit [X-Ob ] plays a crucial role for the generation of formaldehyde. The mechanistic insight derived from this combined experimental/computational investigation may provide guidance for a more rational design of catalysts.

A Theoretical Study on Methane C-H Bond Activation by Bare [FeO]+/0/.

The first C-H bond activation of methane by bare diatomic FeO in different charge states (cationic + , neutral 0, and anionic - ) has been studied by means of density functional theory (DFT) and CCSD(T) methods. The structures were optimized by using 10 popular different density functionals (DFs) with different Hartree-Fock exchange fractions, as well as the CCSD method and then were subjected to single point energy calculations at both the DFT level and the CCSD(T) level. The performance of these methods on the energies and structures in different charged states of the systems was discussed. The results show that the cationic system has lower barrier than the neutral and anionic systems. In most cases, the impact of density functionals is larger than that of structures on energies. Among the three charged states, the anionic system is the least sensitive to the density functionals. The electronic structure analysis demonstrates that the cationic and neutral systems proceed by either hydrogen-atom transfer (HAT) or proton-coupled electron transfer (PCET), while the anionic system only employs the proton transfer (PT) mechanism. Knowledge from this study is of value for further studies on methane activation.

On the Origin of the Remarkably Variable Reactivities of [AlCeOx ]+ (x=2-4) towards Methane as a Function of Oxygen Content.

The thermal gas-phase reactions of the closed-shell heteronuclear metal-oxide clusters [AlCeOx ]+ (x=2-4) with methane have been explored by FT-ICR mass spectrometry and high-level quantum-chemical calculation. Whereas [AlCeO2 ]+ and [AlCeO4 ]+ are inert towards methane under ambient conditions, [AlCeO3 ]+ spontaneously abstracts one hydrogen atom from methane. Mechanistic aspects have been addressed to reveal the reasons for the rather distinct reactivities of the [AlCeOx ]+ /CH4 couples, and the electronic origins of the unprecedented single hydrogen-atom abstraction from methane by closed-shell [AlCeO3 ]+ are discussed.