Application of Situational Simulation Teaching Method in Respiratory and Cardiac Arrest Induced by Aspiration in Elderly Patients.

Background: Elderly hospitalized patients often have dysphagia, which can cause a variety of complications, the most common being aspiration. Early detection and timely treatment by nurses are needed in the clinic. Objective: To assess the effect of the situational simulation teaching method in respiratory and cardiac arrest induced by aspiration in elderly patients. Design: This was a retrospective study. Setting: This study was performed in the Department of Geriatrics, The Third Hospital of Hebei Medical University. Participants: Fifty patients with aspiration-induced respiratory and cardiac arrest who were hospitalized in our hospital were chosen and divided into 2 groups according to the composition of rescue nursing staff, and each group had 25 cases. Interventions: The patients who were rescued by nurses without scenario simulation training were the control group (routine emergency nursing group). The patients who were rescued by nurses trained via the scenario simulation teaching method were the experimental group. Primary Outcome Measures: (1) Emergency rescue time, (2) survival rate, (3) duration of adverse events, and (4) nursing satisfaction of patients. Results: Compared to the control group, the emergency rescue time, the duration of asphyxia, duration of respiratory and cardiac arrest, and the duration of malignant arrhythmias caused by cardiac arrest in the experimental group was lower (P < .05), while the survival rate and nursing satisfaction of patients in the experimental group was higher (P < .05). Conclusion: The application of situational simulation teaching method in the rescue of patients with respiratory and cardiac arrest has outstanding effects, which can effectively improve the efficiency of first aid, significantly improve the efficiency and standardization of first aid, and control or prevent the occurrence of poor prognosis, which is worth popularizing.

Trace elements in public drinking water in Chinese cities: Insights from their health risks and mineral nutrition assessments.

The trace elements in the public drinking water have a duality: on the one hand, trace elements play an important role in maintaining human metabolism; on the other hand, high trace elements levels lead to significant health risks. To determine the impacts of trace elements in the public drinking water on physical health in China, water samples were collected from 314 Chinese cities to analyze the concentrations and spatial distributions of trace elements on a national scale. On this basis, the non-carcinogenic health risk assessments and the nutrient-based scores of trace elements (NSTEs) were applied to evaluate the public drinking water quality in terms of safety and nutrition. Most of the water samples were weakly alkaline: pH values fell in the range of 6.62-8.54, with a mean of 7.80. The results indicated that Sr and F- had the highest concentrations in public drinking water, with averages of 0.3604 mg/L and 0.2351 mg/L, respectively. Moreover, hazard index (HI) values in different regions followed the order: northwest China (NWC) > northern China (NC) > Qinghai-Tibetan Plateau (QT) > southern China (SC). The percentages of water samples with HI > 1 in SC, NC, NWC, and QT were 5.49%, 16.82%, 25.81%, and 16.67%, respectively, indicating that the public drinking water in some cities had significant non-carcinogenic health risks. In addition, the intakes of Mn, Fe, Cu, and Rb through public drinking water made negligible contributions to their recommended nutrient intakes. In contrast, trace elements like Sr, F, B, Li, Mo, etc., contributed a lot. The NSTEs in NWC and most parts of NC were relatively high with averages of 8.0300 and 11.2082, respectively; however, the NSTEs in SC and the northeast part of NC were low with averages of 3.3284 and 5.2106, respectively. The results from this study provide a reference for establishing the public drinking water standards and improving drinking water quality.

miR-26a-5p protects against drug-induced liver injury via targeting bid.

BACKGROUNDS: miR-26a-5p is a short noncoding RNA that is abnormally expressed in drug-induced liver injury (DILI), but its pathophysiologic role in the mechanism of disease in DILI is still vague. METHODS: The expression of miR-26a-5p, viability of hepatic stellate cells (HSCs) proliferation, and apoptosis were explored via real-time PCR, CCK-8 assay, Tunel fluorescence, and flow cytometry. The expression of Bid was detected via Western blot assays, real-time PCR, and immunofluorescence. The apoptosis-associated proteins were determined through Western blot. The interaction between miR-26a-5p and Bid was measured via Dual luciferase reporter assay. RESULTS: miR-26a-5p expression was greatly decreased in HSCs and serum treated with azithromycin, simvastatin and diclofenac sodium, respectively. Hepatocyte viability was largely suppressed while hepatocyte apoptosis was markedly increased in DILI. Correspondingly, the apoptosis-associated proteins including Bid, caspase-8 and cytochrome C in HSCs were significantly upregulated when treated with either of these drugs. Moreover, miR-26a-5p interacted with Bid, and hepatocyte proliferation and apoptosis influenced by miR-26a-5p mimics were obviously reversed when co-treated with overexpressed Bid plasmids. CONCLUSIONS: miR-26a-5p played a protective role against DILI via targeting Bid.

Correlates of group sex participation among men who have sex with men in Chongqing, Southwestern China.

BACKGROUND: Findings from specific countries indicated group sex was common among men who have sex with men (MSM), and men who reported group sex participation were at increased risk of human immunodeficiency virus (HIV)/sexually transmitted infections (STIs). The purpose of the current analysis was to describe the prevalence and correlates of group sex participation among a community-based sample of MSM in Chongqing, southwestern China. METHODS: Convenience sampling method was used to recruit participants and data were collected through an anonymous questionnaire. Logistic regression analysis was employed to identify correlates of group sex participation. RESULTS: Overall, 1151 eligible participants were enrolled in the study. 14.7% of MSM reported participating in group sex in their lifetime, and 5.8% reported group sex participation in the prior 6 months. Factors positively associated with group sex participation in both the prior 6 months and the lifetime included: monthly income ≥3000 Yuan (adjusted odds ratios [aOR] = 3.67, 95% confidence interval [CI] 1.25-10.75; aOR = 2.30, 95% CI 1.21-4.35), initiating anal sex before 18 years old (aOR = 1.86, 95% CI 1.03-3.34; aOR = 2.00, 95% CI 1.31-3.05), using gay apps to seek sex partners (aOR = 7.41, 95% CI 2.57-21.33; aOR = 9.75, 95% CI 4.92-19.33), recreational drug use (aOR = 10.10, 95% CI 5.52-18.49; aOR = 4.75, 95% CI 3.20-7.05) and having condomless internal ejaculation (CIE) (aOR = 3.66, 95% CI 2.01-6.68; aOR = 1.61, 95% CI 1.11-2.35). Factors only associated with group sex participation in the lifetime were older age (age between 26 and 35 years old: aOR = 2.06, 95% CI 1.30-3.26; age > 35 years old: aOR = 1.95, 95% CI 1.10-3.46) and history of STIs (aOR = 2.51, 95% CI 1.37-4.62). CONCLUSIONS: The results of this study suggested that group sex participation was a potentially risky context for acquisition and transmission of HIV/STIs. Close attention should be given to MSM who participated in group sex, and appropriate risk reduction interventions should be developed specific to this subgroup of MSM.

A Comparative Study on the Clinical Features of Coronavirus 2019 (COVID-19) Pneumonia With Other Pneumonias.

BACKGROUND: A novel coronavirus (COVID-19) has raised world concern since it emerged in Wuhan, China in December 2019. The infection may result in severe pneumonia with clusters of illness onsets. Its impacts on public health make it paramount to clarify the clinical features with other pneumonias. METHODS: Nineteen COVID-19 and 15 other patients with pneumonia (non-COVID-19) in areas outside of Hubei were involved in this study. Both COVID-19 and non-COVID-19 patients were confirmed to be infected using throat swabs and/or sputa with/without COVID-2019 by real-time RT-PCR. We analyzed the demographic, epidemiological, clinical, and radiological features from those patients, and compared the differences between COVID-19 and non-COVID-19. RESULTS: All patients had a history of exposure to confirmed cases of COVID-19 or travel to Hubei before illness. The median (IQR) duration was 8 (6-11) and 5 (4-11) days from exposure to onset in COVID-19 and non-COVID-19 cases, respectively. The clinical symptoms were similar between COVID-19 and non-COVID-19. The most common symptoms were fever and cough. Fifteen (78.95%) COVID-19 but 4 (26.67%) non-COVID-19 patients had bilateral involvement while 17 COVID-19 patients (89.47%) but 1 non-COVID-19 patient (6.67%) had multiple mottling and ground-glass opacity on chest CT images. Compared with non-COVID-19, COVID-19 presents remarkably more abnormal laboratory tests, including AST, ALT, γ-GT, LDH, and α-HBDH. CONCLUSIONS: The COVID-19 infection has onsets similar to other pneumonias. CT scan may be a reliable test for screening COVID-19 cases. Liver function damage is more frequent in COVID-19 than non-COVID-19 patients. LDH and α-HBDH may be considerable markers for evaluation of COVID-19.

BMI modified the association of current smoking with the incidence of hypertension in Chinese population: a 22-year cohort study.

BACKGROUND: There was little known on how the interaction effect between obesity and current smoking affected the incidence of hypertension. The aim of this study was to investigate how body mass index (BMI) modified the effect of current smoking on the incidence of hypertension. METHODS: Data were obtained from the China Health and Nutrition Survey (CHNS). According to the WHO recommendations for Chinese people, the normal weight, overweight, and obesity were defined using the BMI cutoff values 18.5 kg/m2, 23.0 kg/m2, and 27.5 kg/m, respectively. Current smokers were defined as having smoked at least 100 cigarettes or electronic cigarettes, 20 cigars, or 20 tobacco pipes and other type of tobacco in the last 30 days preceding the survey. Hypertension was defined as systolic blood pressure (SBP)/ diastolic blood pressure (DBP) ≥ 140/90 mmHg, use of anti-hypertensive medications, or a self-reported diagnosis. RESULTS: This study included 12,900 subjects. There were interaction effects between obesity and current smoking in females (P = 0.030) and the 50-59 years group (P = 0.049). Current smoking was a significant predictor of incident hypertension only in the total and female populations with normal weight (HR: 1.119 and 1.274; HR 95% CI: 1.013-1.236 and 1.143-1.415; and P = 0.027 and 0.040, respectively). Stratified by age, current smoking affected the development of hypertension only in the 50-59 years subjects with the normal weight (HR: 1.356; HR 95% CI: 1.084-1.697; and P = 0.008). CONCLUSIONS: Current smoking was a significant predictor of incident hypertension only in the female and middle-age populations with normal weight but not in the overweight and obesity as well as the younger and elder populations.

The influence of diffusion gradient direction on diffusion-weighted imaging of breast mass-like lesions at 3.0T.

Background It has been challenging to achieve ideal breast diffusion-weighted imaging (DWI). The optimization of diffusion gradient direction is of great importance. Purpose To evaluate the effect of diffusion gradient direction on the apparent diffusion coefficient (ADC) values of breast mass-like lesions and the visual grades of image quality, lesion visibility, and sharpness of breast contour at 3.0T. Material and Methods Sixty consecutive patients with mass-like lesions were enrolled in this study. In addition to typical breast magnetic resonance imaging (MRI) protocols, the breasts were scanned with conventional orthogonal DWI (c-DWI), tetrahedral DWI (t-DWI), and 3in1 DWI (3in1-DWI) sequences. The DW images were observed and visually graded by two radiologists independently. For ADC measurement, one radiographer manually selected the region of interest (ROI). Results For both readers, t-DWI had better image quality and sharpness of breast contour than c-DWI. Regarding lesion visibility, no significant differences were observed among three sequences. The mean ADC values were 1.462 × 10-3, 1.490 × 10-3, and 1.446 × 10-3 mm2 s-1 for c-DWI, t-DWI, and 3in1-DWI, respectively. The ADC values extracted from both t-DWI and 3in1-DWI were not statistically different compared with those from c-DWI. In all DWI sequences, the ADC of malignant lesions was significantly reduced compared with benign lesions. Conclusion DWI with tetrahedral or 3in1 diffusion gradients is a more useful technique in clinical breast MRI than c-DWI because the image quality and sharpness of breast contour are improved. ADC is comparable to c-DWI.

Urinary arsenic metabolism in a Western Chinese population exposed to high-dose inorganic arsenic in drinking water: influence of ethnicity and genetic polymorphisms.

To investigate the differences in urinary arsenic metabolism patterns of individuals exposed to a high concentration of inorganic arsenic (iAs) in drinking water, an epidemiological investigation was conducted with 155 individuals living in a village where the arsenic concentration in the drinking water was 969µg/L. Blood and urine samples were collected from 66 individuals including 51 cases with skin lesions and 15 controls without skin lesions. The results showed that monomethylated arsenic (MMA), the percentage of MMA (%MMA) and the ratio of MMA to iAs (MMA/iAs) were significantly increased in patients with skin lesions as compared to controls, while dimethylated arsenic (DMA), the percentage of DMA (%DMA) and the ratio of DMA to MMA (DMA/MMA) were significantly reduced. The percent DMA of individuals with the Ala/Asp genotype of glutathione S-transferase omega 1 (GSTO1) was significantly lower than those with Ala/Ala. The percent MMA of individuals with the A2B/A2B genotype of arsenic (+3 oxidation state) methyltransferase (AS3MT) was significantly lower than those with AB/A2B. The iAs and total arsenic (tAs) content in the urine of a Tibetan population were significantly higher than that of Han and Hui ethnicities, whereas MMA/iAs was significantly lower than that of Han and Hui ethnicities. Our results showed that when exposed to the same arsenic environment, different individuals exhibited different urinary arsenic metabolism patterns. Gender and ethnicity affect these differences and above polymorphisms may be effectors too.

Technical Success and Reliability of Magnetic Resonance Elastography in Patients with Hepatic Iron Overload.

RATIONALE AND OBJECTIVES: This study aimed to evaluate the technical success rate and stiffness measurement reliability of two specific hepatic magnetic resonance elastography (MRE) sequences dedicated to solving susceptibility artifacts in patients with various degrees of hepatic iron overload. MATERIALS AND METHODS: Thirty-seven patients with iron-overloaded liver confirmed by R2* value measurement who underwent two-dimensional (2D) spin-echo (SE) MRE and 2D SE-echo-planar-imaging (EPI) MRE were reviewed retrospectively. According to four categories based on R2* value (mild, moderate, severe elevation, and extremely severe iron overload), we compared the success rate, quality score, and liver stiffness of the two sequences. In addition, Spearman's correlation was performed to evaluate the relationship between the R2* value and liver stiffness. RESULTS: The overall success rates of SE MRE and SE-EPI MRE in patients with hepatic iron overload were 91.89% and 78.38%, respectively, and 100% and 78.57%, respectively, for severe elevation iron overload. In all patients, the MRE quality scores were 54 and 48 for SE MRE and SE-EPI MRE, respectively (P = 0.107). There were no significant differences in liver stiffness measurements between the two MRE methods in patients with mild, moderate, and severe elevation iron-overloaded livers (P > 0.6 for all), respectively. For both MRE methods, R2* value had no significant effect on the liver stiffness measurements (correlation coefficient <0.1, P >0.6 for both). CONCLUSION: In the mild and moderate elevation iron-overloaded liver, both SE MRE and fast SE-EPI MRE can provide successful and reliable liver stiffness measurement. In severe elevation iron-overloaded livers, SE MRE may be a better choice than SE-EPI MRE.

Appropriately Reduced Nitrogen and Increased Phosphorus in Ratooning Rice Increased the Yield and Reduced the Greenhouse Gas Emissions in Southeast China.

Reducing greenhouse gas emissions while improving productivity is the core of sustainable agriculture development. In recent years, rice ratooning has developed rapidly in China and other Asian countries, becoming an effective measure to increase rice production and reduce greenhouse gas emissions in these regions. However, the lower yield of ratooning rice caused by the application of a single nitrogen fertilizer in the ratooning season has become one of the main reasons limiting the further development of rice ratooning. The combined application of nitrogen and phosphorus plays a crucial role in increasing crop yield and reducing greenhouse gas emissions. The effects of combined nitrogen and phosphorus application on ratooning rice remain unclear. Therefore, this paper aimed to investigate the effect of combined nitrogen and phosphorus application on ratooning rice. Two hybrid rice varieties, 'Luyou 1831' and 'Yongyou 1540', were used as experimental materials. A control treatment of nitrogen-only fertilization (187.50 kg·ha-1 N) was set, and six treatments were established by reducing nitrogen fertilizer by 10% (N1) and 20% (N2), and applying three levels of phosphorus fertilizer: N1P1 (168.75 kg·ha-1 N; 13.50 kg·ha-1 P), N1P2 (168.75 kg·ha-1 N; 27.00 kg·ha-1 P), N1P3 (168.75 kg·ha-1 N; 40.50 kg·ha-1 P), N2P1 (150.00 kg·ha-1 N; 13.50 kg·ha-1 P), N2P2 (150.00 kg·ha-1 N; 27.00 kg·ha-1 P), and N2P3 (150.00 kg·ha-1 N; 40.50 kg·ha-1 P). The effects of reduced nitrogen and increased phosphorus treatments in ratooning rice on the yield, the greenhouse gas emissions, and the community structure of rhizosphere soil microbes were examined. The results showed that the yield of ratooning rice in different treatments followed the sequence N1P2 > N1P1 > N1P3 > N2P3 > N2P2 > N2P1 > N. Specifically, under the N1P2 treatment, the average two-year yields of 'Luyou 1831' and 'Yongyou 1540' reached 8520.55 kg·ha-1 and 9184.90 kg·ha-1, respectively, representing increases of 74.30% and 25.79% compared to the N treatment. Different nitrogen and phosphorus application combinations also reduced methane emissions during the ratooning season. Appropriately combined nitrogen and phosphorus application reduced the relative contribution of stochastic processes in microbial community assembly, broadened the niche breadth of microbial communities, enhanced the abundance of functional genes related to methane-oxidizing bacteria and soil ammonia-oxidizing bacteria in the rhizosphere, and decreased the abundance of functional genes related to methanogenic and denitrifying bacteria, thereby reducing greenhouse gas emissions in the ratooning season. The carbon footprint of ratooning rice for 'Luyou 1831' and 'Yongyou 1540' decreased by 25.82% and 38.99%, respectively, under the N1P2 treatment compared to the N treatment. This study offered a new fertilization pattern for the green sustainable development of rice ratooning.

A review of quantitative diffusion-weighted MR imaging for breast cancer: Towards noninvasive biomarker.

Quantitative diffusion-weighted imaging (DWI) is an important adjunct to conventional breast MRI and shows promise as a noninvasive biomarker of breast cancer in multiple clinical scenarios, from the discrimination of benign and malignant lesions, prediction, and evaluation of treatment response to a prognostic assessment of breast cancer. Various quantitative parameters are derived from different DWI models based on special prior knowledge and assumptions, have different meanings, and are easy to confuse. In this review, we describe the quantitative parameters derived from conventional and advanced DWI models commonly used in breast cancer and summarize the promising clinical applications of these quantitative parameters. Although promising, it is still challenging for these quantitative parameters to become clinically useful noninvasive biomarkers in breast cancer, as multiple factors may result in variations in quantitative parameter measurements. Finally, we briefly describe some considerations regarding the factors that cause variations.

Readout-segmented diffusion weighted imaging of the testis at 3.0 T: comparison with single-shot echo-planar imaging.

OBJECTIVE: The current study aimed to explore the feasibility of readout-segmented echo-planar imaging (RS-EPI) of the testis at 3.0 T, by comparing with single-shot echo-planar imaging (SS-EPI) in qualitative image quality and quantitative apparent diffusion coefficient (ADC) values. METHODS: 66 patients undergoing scrotal MRI for various clinical indications were included retrospectively. RS-EPI image quality was rated from 1 (severe distortion or artifact, or nondiagnostic) to 4 (nearly no distortion or artifact, or outstanding). The comparative image quality (RS- vs. SS-EPI) was rated from - 2 (SS-EPI severe or greater conspicuity) to 2 (RS-EPI severe or greater conspicuity). The confidence interval of proportions (CIOP) of comparative image quality and Wilcoxon rank sum test were performed to assess the preferences between RS-EPI and SS-EPI. Paired samples t-test and Bland-Altman analysis were performed to compare the mean ADC values of RS-EPI and SS-EPI. The mean, maximum, and minimum ADC values measured by RS-EPI were compared in normal testicular parenchyma, benign and malignant intratesticular lesions. RESULTS: The evaluation of RS-EPI image quality showed RS-EPI with the characteristics of slight geometric distortion and susceptibility artifact, and good lesion conspicuity. The assessment of comparative image quality showed SS-EPI with obvious geometric distortion and susceptibility artifact, and RS-EPI preferred in lesion conspicuity. The CIOP ranged from 97 to 100% among three readers, with preferring to RS-EPI improving image quality (P < 0.001). There was a strong correlation and good agreement between mean ADC values measured by RS-EPI and SS-EPI. The mean, maximum and minimum ADC values by RS-EPI were significantly different in normal testicular parenchyma, benign and malignant intratesticular lesions. CONCLUSION: RS-EPI DWI of the testis improved image quality in geometric distortion, susceptibility artifacts, and lesion conspicuity, and provided highly correlated and consistent mean ADC values when compared to SS-EPI DWI, indicating the feasibility of RS-EPI DWI of testes.

Total sugar, added sugar, fructose, and sucrose intake and all-cause, cardiovascular, and cancer mortality: A systematic review and dose-response meta-analysis of prospective cohort studies.

OBJECTIVES: We performed a systematic review and dose-response meta-analysis to assess the association of total sugars, added sugars, fructose, and sucrose with all-cause, cardiovascular disease (CVD), and cancer mortality. METHODS: We searched PubMed, Embase, and Web of Science for prospective cohort studies up to May 10, 2022. Pooled relative risks and 95% CIs were calculated by random effect models, and the linear and non-linear dose-response associations were explored by restricted cubic splines. RESULTS: Comparing the highest with the lowest categories of total sugars, the summary RR was 1.09 (95% CI, 1.02-1.15; I2 = 71.9%) for all-cause mortality, 1.10 (1.02-1.18; I2 = 12.7%) for CVD mortality, and 1.00 (0.94-1.05; I2 = 0) for cancer mortality. For fructose, the summary relative risk was 1.09 (1.03-1.16; I2 = 58.4%) for all-cause mortality, 1.11 (1.03-1.20; I2 = 37.4%) for CVD mortality, and 1.00 (0.95-1.06; I2 = 0) for cancer mortality. Restricted cubic splines found non-linear associations of total sugars and fructose with all-cause and CVD mortality (P for non-linearity < 0.001). A significant increment in risk of all-cause and CVD mortality was observed with >10% energy intake to 20% energy intake for total sugars and fructose. No association was found for the added sugars and sucrose with all-cause, CVD, and cancer mortality. CONCLUSIONS: Increased intake of total sugars and fructose is associated with all-cause and CVD mortality but not associated with cancer mortality, which could have implications for guideline recommendations regarding the risk of mortality related to sugar intake.

Assessing the Association of Self-Reported Sleep Duration and Metabolic Syndrome Among Middle-Aged and Older Adults in China from the China Health and Retirement Longitudinal Survey.

Objectives: We aim to investigate the correlation between sleep and metabolic syndrome (MS) among a community population 45 years of age and older in China. Methods: A cross-sectional analysis of 9096 participants from China health and longitudinal study was carried out. MS was defined by consensus criteria. Sleep durations were assessed by self-reported questionnaire. Odds ratio (OR) and 95% confidence intervals (CIs) for MS were obtained using multivariable-adjusted regression analysis. Results: Long habitual daytime sleep had a positive influence on MS (OR = 1.50, 95% CI = 1.10-2.06). For elderly, short daytime sleep significantly increased risk of MS (OR = 2.14, 95% CI = 1.25-3.67). Females with long daytime sleep was associated with increased risk of MS (OR = 1.54, 95% CI = 1.04-2.29). Conclusions: Daytime sleep significantly increased risk of MS for middle-aged and elderly Chinese. The hazard role of daytime sleep on MS was various between age and sex groups. Results of this study needed to be verified by future longitudinal studies.

Dietary intake of total vegetable, fruit, cereal, soluble and insoluble fiber and risk of all-cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of prospective cohort studies.

Objectives: To conduct a systematic review and meta-analysis of prospective cohort studies to investigate the association between total, vegetable, fruit, cereal, soluble and insoluble fiber intake and risk of all causes, cardiovascular disease (CVD), and cancer mortality and quantitatively assess the dose-response relation. Methods: Eligible studies were identified by searching PubMed, Embase and Web of science before August 2023. Random effects models were used to calculate summary relative risk (RR) and 95% confidence intervals (CI) and restricted cubic splines to model the linear/non-linear association. Results: The summary RR for all-cause, CVD and cancer mortality of dietary fiber was 0.90 (95% CI: 0.86,0.93), 0.87 (0.84,0.91), 0.91 (0.88,0.93), respectively. Significant association was observed for all-cause and CVD mortality with fruit, vegetable cereal and soluble fiber intake and cancer mortality with cereal fiber intake. No significant association was found for insoluble fiber, vegetable or fruit fiber intake and cancer mortality. Dose-response analysis showed a significant non-linear relation of dietary fiber intake with all-cause mortality, and linear relation for others. Conclusions: Higher dietary fiber including different type and food sources of fiber intake were associated with lower risk of mortality. Our findings provide more comprehensive evidence on dietary fiber intake with mortality. Systematic review registration: https://www.crd.york.ac.uk/prospero, identifier: CRD42022338837.

Clinical outcomes of high-flow nasal cannula oxygen therapy in acute heart failure patients with hypoxemia: A retrospective cohort study.

Acute heart failure (AHF) is life-threatening medical condition requiring hospital admission and appropriate oxygen therapy. High flow nasal cannula oxygen therapy (HFNC) has gained its popularity in treatment of AHF, however, there were less studies have demonstrated the physiological efficacy of HFNC. Purpose of this study was to evaluated the physiological responses and clinical outcomes of HFNC by comparing with noninvasive positive pressure ventilation (NPPV) therapy. A retrospective cohort investigation was conducted at emergency intensive care unit (EICU) and cardiovascular center of our hospital from June 2019 to March 2022, AHF patients with hypoxemia were reviewed. According to the received oxygen therapy model, patients were divided into HFNC and NPPV groups. Demographic data, arterial blood gas (ABG) parameter, echocardiography findings, complications and other related variables were extracted and collected from the electronic medical records (EMRs) by well-trained investigators. Physiological responses and clinical outcomes within and between 2 groups were analyzed. Finally, 156 patients with a mean age of 69.3 ± 7.1 years were reviewed, there were 82 (52.6%) male and 74 (47.4%) female patients in the sample and 70 (44.9%) and 86 (55.1%) patients classified III and IV score were included in this study, 80 patients received HFNC and 76 underwent NPPV oxygen therapy. There were no significant differences of baseline characteristics for the 2 groups patients. Changes of left ventricular function parameters, ABG and clinical outcomes were all improved satisfactorily after 24 h medical interventions in both group, what's more, patients underwent HFNC therapy could acquire a better amelioration when compared with NPPV groups (P < .05). HFNC may be an ideal model for patients with AHF, particularly those with hypoxemia. HFNC therapy could significantly improve several objective parameters of physiological responses and clinical outcomes.

Adiposity-related risks among the middle-aged and elderly Chinese: the role of siesta and nocturnal sleep duration.

INTRODUCTION: Background: increasingly, research suggests that lack of sleep is linked to adiposity worldwide, but few studies have been conducted in middle-aged and elderly Chinese subjects. The purpose of the present study was to analyze the association of siesta and nocturnal sleep duration with the prevalence of adiposity in middle-aged and elderly Chinese individuals. Methods: a total of 7,891 community dwelling Chinese subjects who had participated in the 2015 China Health and Retirement Longitudinal Study were included. A four-stage random sampling method was used to select participants. Siesta and nocturnal sleep duration was self-reported. Adiposity, including general obesity and abdominal obesity, was assessed. Multiple logistic analyses were conducted to explore the association between siesta, nocturnal sleep duration, and adiposity. Results: people with long siesta durations (≥ 1 hour/day) were significantly associated with an increased risk for abdominal obesity, independently and in all subgroup analyses, when compared to those without regular siesta. ORs after adjustment of confounding factors included: all subjects, OR = 1.45, 95 % CI, 1.23 to 1.70; middle-aged subjects, OR = 1.46, 95 % CI, 1.15 to 1.86; elderly, OR = 1.43, 95 % CI, 1.14 to 1.78. Conclusions: our data show that siesta duration plays a role in the prevalence of age-specific abdominal obesity. Individuals with long siesta durations are more likely to have abdominal obesity among the middle-aged and elderly population when compared to those without regular siesta. The results of this study need to be confirmed by further studies.

INTRODUCCIÓN: Antecedentes: cada vez más investigaciones sugieren que la falta de sueño está relacionada con la adiposidad en todo el mundo, pero pocos estudios se han realizado en población china de mediana edad y ancianos. El propósito del presente estudio fue analizar la asociación de la siesta y la duración del sueño nocturno con la prevalencia de la adiposidad en población china de mediana edad y ancianos. Métodos: se incluyeron en total 7891 sujetos que habían participado en el "Estudio longitudinal de salud y jubilación en China" de 2015. Se utilizó el método de muestreo aleatorio de 4 etapas para seleccionar a los participantes. La duración de la siesta y del sueño nocturno fue autoinformada. Se evaluó la adiposidad, incluidas la obesidad general y la obesidad abdominal. Se realizaron múltiples análisis logísticos para explorar la asociación entre la siesta, la duración del sueño nocturno y la adiposidad. Resultados: las personas con siestas prolongadas (≥ 1 hora al día) se asociaron significativamente a un mayor riesgo de obesidad abdominal, de forma independiente, en todos los análisis de subgrupos, en comparación con aquellos sin siesta regular. Los OR después de ajustar los factores de confusión fueron: todos los sujetos, OR = 1,45, IC del 95 %, 1,23 a 1,70; mediana edad: OR = 1,46, IC del 95 %, 1,15 a 1,86; ancianos: OR = 1,43, IC del 95 %, 1,14 a 1,78. Conclusiones: nuestros datos muestran que la duración de la siesta juega un papel en la prevalencia de la obesidad abdominal específica de cada edad. Las personas con siestas prolongadas tienen más probabilidades de tener obesidad abdominal, entre la población de mediana edad y anciana, que las que no duermen siesta regularmente. Los resultados de este estudio deben ser confirmados por estudios adicionales.

Daytime Sleep as Compensation for the Effects of Reduced Nocturnal Sleep on the Incidence of Hypertension: A Cohort Study.

PURPOSE: The role of sleep duration in the development of hypertension remains controversial. Little is known about the combined effects of nocturnal and daytime sleep. We assessed the association between total sleep duration and the development of hypertension in middle-aged and elderly Chinese adults. PATIENTS AND METHODS: Data were obtained from 3 waves of China Health and Retirement Longitudinal Study surveys. Middle-aged and elderly Chinese initially without hypertension were followed biennially from 2011 to 2015. Sleep duration was self-reported. Hypertension was defined as a systolic and/or diastolic blood pressure ≥ 140/90 (mmHg), the current use of anti-hypertensive medications or self-reported hypertension. RESULTS: Over 31,392 person-years of follow-up, 2682 of 10,176 participants developed hypertension. The multivariable adjusted hazard ratios (HR) (95% confidence intervals, 95% CI) for the development of hypertension between those with 0-30 minutes and ≥30 minutes daytime sleep vs those without daytime sleep were 0.67 (0.58, 0.77), and 0.73 (0.59, 0.92), respectively. The protective role of longer periods of daytime sleep (>30 minutes) varied between different subgroups. Compared with moderate nocturnal sleepers, long nocturnal sleepers (HR: 1.66, 95% CI=1.25-2.21) had an increased risk of hypertension. Compared with moderate nocturnal sleepers without daytime sleep, HRs (95% CI) for hypertension were 0.52 (0.45, 0.59) for short nocturnal sleep plus short daytime sleep and 0.55 (0.49, 0.62) for short nocturnal sleep plus long daytime sleep. People with extremely short (HR: 1.34, 95% CI=1.22-1.48) and long (HR: 1.28, 95% CI=1.13-1.44) combined sleep periods had an increased risk of hypertension. Consistent results were also found in subgroups stratified by age and gender. CONCLUSION: Both extremely long and short total sleep periods were associated with an increased risk of hypertension. People with short or moderate nocturnal sleep durations, especially short nocturnal sleep duration, can benefit from habitual daytime sleep to prevent hypertension.

Strontium in public drinking water and associated public health risks in Chinese cities.

Due to the fact that strontium (Sr) is not involved in the scope of supervision of drinking water in China, the Sr concentration in public drinking water and its related health risks have been neglected for a long time. In this research, public drinking water samples were collected from 314 cities across the country to reveal the concentration and spatial distribution of Sr in public drinking water. In addition, the Monte Carlo method (a statistical simulation method) was applied to evaluate the Sr intake from drinking water and human health risks among different age groups and different regions. As shown in the results, the Sr was in the concentration range of 0.005-3.11 mg/L with a mean value of 0.360 mg/L. There were significant differences in the Sr concentration in different regions; in general, it was high in the north and low in the south. The Sr intakes of infants, children, teens, and adults from drinking water were 0.273, 0.503, 0.633, and 0.784 mg/day, respectively. There was a significant positive correlation between Sr concentration in drinking water and bone mineral density (BMD) in the elderly. Especially, the correlation coefficients (r) between Sr concentration and the BMD of the elderly whose age fell in the range of 60-70 years were 0.692 (male) and 0.483 (female). In addition, the Sr concentration in drinking water was positively correlated with the incidence of children's rickets (r = 0.411), while the Ca/Br ratio was negatively correlated with the incidence of children's rickets (r = - 0.410). According to the health risk assessment, among people of different ages, infants' hazard index (HI) value was the highest. The mean value and 95th percentile value were 0.066 and 0.247. Non-carcinogenic risk of Sr through drinking water among different people in different regions was less than 1, which meant no significant damage to human health. This study is the first time to systematically investigate Sr in public drinking water across the whole country. More importantly, the conclusions can be applied to risk control and management of public drinking water.