The global and regional prevalence of restless legs syndrome among adults: A systematic review and modelling analysis.

Background: Restless legs syndrome (RLS) is a prevalent neuro-sensory disorder that impairs quality of life. In this systematic review and modelling study, we estimated the global and regional prevalence of RLS and its associated factors. Methods: We searched PubMed, Embase, and Medline for population-based studies on RLS prevalence published up to 12 November 2023. The included studies reported prevalence using the International Restless Leg Syndrome Study Group's (IRLSSG) minimal diagnostic criteria without limitations on frequency, duration, or severity. We applied a multilevel multivariable mixed-effects meta-regression to generate the age-specific and sex-specific prevalence of RLS for high socio-demographic index (H-SDI) and low and middle socio-demographic index (LM-SDI) regions. We pooled odds ratios (ORs) for RLS associated factors using random-effects models. Finally, we derived the regional prevalence and cases of RLS based on an associated factor-based model. Results: From 52 articles across 23 countries, the global RLS prevalence in 2019 was estimated to be 7.12% (95% confidence interval (CI) = 5.15-9.76) among adults 20-79 years of age, equating to 356.07 million (95% CI = 257.61-488.09) affected individuals. Prevalence was similar in H-SDI (7.29%; 95% CI = 5.04-10.41) and LM-SDI (7.10%; 95% CI = 5.16-9.70) regions, with the majority of cases in LM-SDI countries (323.06 million; 90.73%). Europe had the highest (7.60%; 95% CI = 5.44-10.52) and Africa the lowest regional prevalence (6.48%; 95% CI = 4.70-8.87). The Western Pacific Region, meanwhile, had the most cases (111.91 million; 95% CI = 80.93-153.42). Factors positively associated with RLS included advanced age (OR = 1.13; 95% CI = 1.04-1.24), smoking (OR = 1.46; 95% CI = 1.29-1.64), depression (OR = 1.71; 95% CI = 1.26-2.32), and diabetes (OR = 1.54; 95% CI = 1.19-1.97). Conclusions: A considerable global burden of RLS exists. Effective strategies are needed to increase awareness and optimise resource allocation to address this often-overlooked condition. High-quality epidemiological investigations employing standardised and rigorous criteria for RLS are essential for addressing RLS burden more effectively. Registration: PROSPERO: CRD42020161860.

Changes of college students' psychological stress during the COVID-19 pandemic in China: A two-wave repeated survey.

COVID-19 has posed unprecedented challenges to the mental health of college students worldwide. We examined the trends in students' stress levels during and after China's first wave of COVID-19 outbreaks by analyzing their demographics, behavior, mental health status, career confidence, and Chinese Perceived Stress Scale (CPSS) scores. Our findings indicate an increase in students' stress levels since the COVID-19 onset, with more students experiencing higher stress levels after the first outbreak than during it (OR = 2.03, 95% CI 1.79, 2.30). Several factors were identified as being associated with higher CPSS scores, including higher class levels, residence in rural or town areas, low family income, and lack of familiarity with COVID-19, among others. Our study highlighted the urgency of developing and implementing effective strategies to cope with students' stress during and after a global pandemic.

Boron nitride-alginate coordination interactions enabling hydrogels with enhanced mechanical strength and heat resistance.

Developing large-scale hydrogels with high tensile strength and robust mechanical properties is an intricate challenge of great industrial significance. In this study, we demonstrate an efficient method for producing nanocomposite hydrogels with extraordinary mechanical properties. Our approach involves a two-step process: an initial stage of pre-cross-linking boron nitride (BN)-enriched pre-gel sodium alginate, followed by cross-linking with metal ions. In stark contrast to conventional sodium alginate hydrogels (SA), our newly formulated 'BS hydrogel' exhibited an impressive tensile strength exceeding 41 MPa and improved thermal resistance. Moreover, the reconstituted BS hydrogel exhibited tensile strengths ranging from 47 to 96 MPa and elastic moduli ranging from 199 to 1184 MPa, depending on the cross-linking metal ions. These findings indicate the multifaceted potential of the BS hydrogel, which is poised to revolutionize many applications and represents a significant step forward in hydrogel technology for industrial applications.

DNMT3L inhibits hepatocellular carcinoma progression through DNA methylation of CDO1: insights from big data to basic research.

BACKGROUND: DNMT3L is a crucial DNA methylation regulatory factor, yet its function and mechanism in hepatocellular carcinoma (HCC) remain poorly understood. Bioinformatics-based big data analysis has increasingly gained significance in cancer research. Therefore, this study aims to elucidate the role of DNMT3L in HCC by integrating big data analysis with experimental validation. METHODS: Dozens of HCC datasets were collected to analyze the expression of DNMT3L and its relationship with prognostic indicators, and were used for molecular regulatory relationship evaluation. The effects of DNMT3L on the malignant phenotypes of hepatoma cells were confirmed in vitro and in vivo. The regulatory mechanisms of DNMT3L were explored through MSP, western blot, and dual-luciferase assays. RESULTS: DNMT3L was found to be downregulated in HCC tissues and associated with better prognosis. Overexpression of DNMT3L inhibits cell proliferation and metastasis. Additionally, CDO1 was identified as a target gene of DNMT3L and also exhibits anti-cancer effects. DNMT3L upregulates CDO1 expression by competitively inhibiting DNMT3A-mediated methylation of CDO1 promoter. CONCLUSIONS: Our study revealed the role and epi-transcriptomic regulatory mechanism of DNMT3L in HCC, and underscored the essential role and applicability of big data analysis in elucidating complex biological processes.

PM2.5 air quality and health gains in the quest for carbon peaking: A case study of Fujian Province, China.

China faces a dual challenge of improving air quality and reducing greenhouse gas (GHG) emissions. Stringent clean air actions gradually narrow the end-of-pipe (EOP) pollution control potential. Meanwhile, pursuing carbon peaking will reduce air pollution and health risks. However, the impact on air quality and health gains in individual Chinese provinces has not been assessed with a specific focus on local policies. Here, typical shared socio-economic pathways (SSPs) and local policies (i.e., business as usual, BAU; end-of-pipe controls, EOP; co-control mitigation, CCM) are combined to set three scenarios (i.e., BAU-SSP3, EOP-SSP4, CCM-SSP1). Under these three scenarios, we couple the Low Emissions Analysis Platform (LEAP) model, an air quality model and health risk assessment methodology to evaluate the characteristics of carbon peaking in Fujian Province. PM2.5 air quality and impacts on public health are assessed, using the metric of the deaths attributable to PM2.5 pollution (DAPP). The results show that energy-related CO2 emissions will only peak before 2030 in the CCM-SSP1 scenario. In this context, air pollutant emission pathways reveal that mitigation is limited under the EOP-SSP4 scenario, necessitating further mitigation under the CCM-SSP1 scenario. The annual average PM2.5 level is projected to be 16.5 µg·m-3 in 2035 with a corresponding decrease in DAPP of 297 (95 % confidence intervals: 217-308) compared with that of 2020. Despite the significant improvements in PM2.5 air quality and health gains under the CCM-SSP1 scenario, reaching the 5 µg·m-3 target of the World Health Organization (WHO) remains difficult. Furthermore, population aging will require stronger PM2.5 mitigation to enhance health gains. This study provides a valuable reference for other developing regions to co-control air pollution and GHGs.

The Regulation of Phosphorus Release by Penicillium chrysogenum in Different Phosphate via the TCA Cycle and Mycelial Morphology.

Phosphate-solubilizing fungi (PSF) efficiently dissolve insoluble phosphates through the production of organic acids. This study investigates the mechanisms of organic acid secretion by PSF, specifically Penicillium chrysogenum, under tricalcium phosphate (Ca3(PO4)2, Ca-P) and ferric phosphate (FePO4, Fe-P) conditions. Penicillium chrysogenum exhibited higher phosphorus (P) release efficiency from Ca-P (693.6 mg/L) than from Fe-P (162.6 mg/L). However, Fe-P significantly enhanced oxalic acid (1193.7 mg/L) and citric acid (227.7 mg/L) production by Penicillium chrysogenum compared with Ca-P (905.7 and 3.5 mg/L, respectively). The presence of Fe-P upregulated the expression of genes and activity of enzymes related to the tricarboxylic acid cycle, including pyruvate dehydrogenase and citrate synthase. Additionally, Fe-P upregulated the expression of chitinase and endoglucanase genes, inducing a transformation of Penicillium chrysogenum mycelial morphology from pellet to filamentous. The filamentous morphology exhibited higher efficiency in oxalic acid secretion and P release from Fe-P and Ca-P. Compared with pellet morphology, filamentous morphology enhanced P release capacity by > 40% and > 18% in Ca-P and Fe-P, respectively. This study explored the strategies employed by PSF to improve the dissolution of different insoluble phosphates.

The prevalence of vitamin A deficiency and its public health significance in children in low- and middle-income countries: A systematic review and modelling analysis.

Background: Vitamin A deficiency (VAD) is widely recognised as a major public health concern in low- and middle-income countries (LMICs). Despite various interventions implemented in many countries, a lack of reliable data is hindering progress. We aimed to consolidate available data and quantify estimates of the prevalence of VAD among children ≤18 years in LMICs. Methods: We searched PubMed, Medline and Embase for studies reported the prevalence of VAD or marginal (m)VAD among children. A multilevel mixed-effects meta-regression approach was applied to establish the regression models for VAD and mVAD prevalence. The total numbers of children affected by VAD and mVAD in LMICs in 2019 were separately calculated from the estimated age- and socio-demographic index (SDI)-specific prevalence with their corresponding United Nations Population Division populations projections. We estimated areas of significant public health concern in 165 LMICs using the lower confidence interval (CI) of VAD prevalence. Results: A total of 116 articles from 40 LMICs were retained. In 2019, VAD and mVAD affected 333.95 million (95% CI = 253.00-433.74) and 556.13 million (95% CI = 388.83-767.94) children and adolescents in 165 LMICs, respectively, corresponding to a prevalence of 14.73% (95% CI = 11.16-19.14) and 24.54% (95% CI = 17.15-33.88). The prevalence of both VAD and mVAD was the highest in children aged 0-5 years at 19.53% (95% CI = 15.03-24.91) and 28.22% (95% CI = 20.00-38.24), respectively, with both steadily decreasing to 10.09% (95% CI = 7.44-13.50) and 20.76% (95% CI = 14.16-29.50) in adolescents aged 13-18 years. The prevalence of VAD was significantly higher in the low SDI region at 29.67% (95% CI = 22.67-37.53) compared to 5.17% (95% CI = 3.14-8.43) estimated in the high-middle SDI region. 68 of the 165 LMICs (41.21%) were classified as areas of moderate to severe VAD public health significance. Conclusions: VAD continues to pose a significant public health concern in many low-income settings. Development in LMICs is a crucial factor for VAD, with a disproportionately higher burden in low SDI regions. Registration: This study protocol was registered with PROSPERO, CRD42020220654.

Assessing the Knowledge, Attitudes, and Vaccination Practices Towards COVID-19 Vaccination Among Mainland Chinese Nursing Students and Interns: A Multicenter Cross-Sectional Study.

Objective: This study investigated factors influencing the knowledge, attitudes, practice profiles, and vaccination intentions among Chinese nursing students and nursing interns toward the coronavirus disease (COVID-19) vaccination. Materials and Methods: The multicenter cross-sectional study was based on a self-reported questionnaire collecting information among nursing students and nursing interns from three major geographic regions of China, and the sample was selected by consecutive sampling. The questionnaire was developed by knowledge, attitudes, and practice (KAP) theory. Univariate and multivariate logistic regression were used for statistical analysis. Results: A total of 3180 nursing students and interns (effective rate: 99.8%) from six Chinese provinces were polled. The vaccine hesitation rate was 9.65% (307/3180), 2230 participants (70.1%) had gotten at least one dose of the vaccine, and 643 participants (67.7%) had indicated a readiness to be vaccinated. The results showed that older age, higher academic background, perfect vaccine management, others' recommendations, influenza vaccination history, epidemic under control, knowledge of vaccines or intervals, and vaccine knowledge training were associated with higher vaccination rates. Conversely, vaccine hesitancy was caused by a perceived lack of physical need, uncertainty about vaccination requirements, and fear of vaccination. Conclusion: This study provided population-based estimates of COVID-19 vaccine uptake intention among mainland Chinese nursing students and interns. Factors such as age, education, vaccine knowledge, and attitudes influence COVID-19 vaccine behaviour. Relevant authorities should understand the barriers to COVID-19 vaccination from knowledge, attitude and practice, which is significant for formulating effective response strategies in future global public health crises.

Polypyrrole-Modified Nanocellulose Exhibits Superior Performance for Hg(II) Adsorption.

Cellulose, a kind of polymer containing abundant functional groups, has widespread use in the adsorptive removal of environmental pollutants. An efficient and environmental friendly polypyrrole (PPy) coating approach is employed to modify the agricultural by-product straw derived cellulose nanocrystal (CNC) into excellent property adsorbents for removing the heavy metal ion of Hg(II). The FT-IR and SEM-EDS results demonstrated that PPy is formed on the surface of CNC. Consequently, the adsorption measurements proved that the obtained PPy-modified CNC (CNC@PPy) possesses a remarkably enhanced Hg(II) adsorption capacity of 1095 mg g-1, owing to a plentiful functional group of doped Cl element on the surface of CNC@PPy by forming Hg2Cl2 precipitate. The results of the study suggest that the Freundlich model is more effective than the Langmuir model at describing the isotherms, while the pseudo-second order kinetic model is better suited to correlating with the experimental data compared to the pseudo-first order model. Further, the CNC@PPy exhibits an outstanding reusability, capable of maintaining 82.3% of its original Hg(II) adsorption capacity after five successive adsorption cycles. The findings of this work reveal a method to convert the agricultural by-product into high performance environmental remediation materials.

Lead remediation is promoted by phosphate-solubilizing fungi and apatite via the enhanced production of organic acid.

Lead (Pb) is one of the most common heavy metal pollutants in the environment, which can indirectly or directly threaten human health. Lead immobilization by apatite can reduce the effectiveness of Pb cations via the formation of pyromorphite (Pyro). However, the formation of Pyro is always depending on the release of phosphorus (P) from apatite. Phosphate-solubilizing fungi (PSF) can secrete large amounts of organic acid to promote the release of P from apatite. Although the combination of PSF and apatite has shown a huge potential in Pb remediation, this pathway needs to be more attention, especially for organic acid secretion by PSF. This research mainly reviews the possible pathway to strengthen Pb immobilization by PSF and apatite. Meanwhile, the limitation of this approach is also reviewed, with the aim of a better stabilizing effect of Pb in the environment and promoting the development of these remediation technologies.

Synthesis of FeOOH-Loaded Aminated Polyacrylonitrile Fiber for Simultaneous Removal of Phenylphosphonic Acid and Phosphate from Aqueous Solution.

Phosphorus is one of the important metabolic elements for living organisms, but excess phosphorus in water can lead to eutrophication. At present, the removal of phosphorus in water bodies mainly focuses on inorganic phosphorus, while there is still a lack of research on the removal of organic phosphorus (OP). Therefore, the degradation of OP and synchronous recovery of the produced inorganic phosphorus has important significance for the reuse of OP resources and the prevention of water eutrophication. Herein, a novel FeOOH-loaded aminated polyacrylonitrile fiber (PANAF-FeOOH) was constructed to enhance the removal of OP and phosphate. Taking phenylphosphonic acid (PPOA) as an example, the results indicated that modification of the aminated fiber was beneficial to FeOOH fixation, and the PANAF-FeOOH prepared with 0.3 mol L-1 Fe(OH)3 colloid had the best performance for OP degradation. The PANAF-FeOOH efficiently activated peroxydisulfate (PDS) for the degradation of PPOA with a removal efficiency of 99%. Moreover, the PANAF-FeOOH maintained high removal capacity for OP over five cycles as well as strong anti-interference in a coexisting ion system. In addition, the removal mechanism of PPOA by the PANAF-FeOOH was mainly attributed to the enrichment effect of PPOA adsorption on the fiber surface's special microenvironment, which was more conducive to contact with SO4•- and •OH generated by PDS activation. Furthermore, the PANAF-FeOOH prepared with 0.2 mol L-1 Fe(OH)3 colloid possessed excellent phosphate removal capacity with a maximal adsorption quantity of 9.92 mg P g-1. The adsorption kinetics and isotherms of the PANAF-FeOOH for phosphate were best depicted by pseudo-quadratic kinetics and a Langmuir isotherm model, showing a monolayer chemisorption procedure. Additionally, the phosphate removal mechanism was mainly due to the strong binding force of iron and the electrostatic force of protonated amine on the PANAF-FeOOH. In conclusion, this study provides evidence for PANAF-FeOOH as a potential material for the degradation of OP and simultaneous recovery of phosphate.

Hyperglycaemia in pregnancy and offspring blood pressure: a systematic review and meta-analysis.

BACKGROUND: Hyperglycemia in pregnancy (HIP) is suggested to be a risk factor for elevated blood pressure (BP) in offspring. However, the empirical evidence was mixed. Thus, this systematic review and meta-analysis was conducted to synthesize current evidence assessing the association between HIP and BP in offspring. METHODS: We searched PubMed, MEDLINE, and Embase to identify articles published from inception until 9 February 2021. A random-effects meta-analysis was performed to calculate a pooled effect size and 95% confidence interval (CI). Furthermore, the effects were evaluated separately while grouping by the offspring's sex, region, economic level, published year, insulin treatment status, and BP measurement. Each article was independently reviewed for quality. RESULTS: Of 3385 citations identified, 23 studies involving 88695 offspring were included. The study found that the offspring of women with HIP had an increased level of both systolic blood pressure (SBP; mean difference 1.90, 95% CI 1.09 to 2.70 mmHg, P < 0.001) and diastolic blood pressure (DBP; mean difference 0.87 mmHg, 95% CI 0.11 to 1.17 mmHg, P = 0.02) compared with those whose mothers with normal blood glucose during pregnancy. According to subgroup analyses, gestational diabetes mellitus (GDM) appeared to have varied impacts on offspring BP by sex of offspring, region and economic level of family, published year, maternal insulin treatment status, and BP measurement. CONCLUSION: Current evidence showed that HIP was associated with an elevated BP in offspring. Prenatal interventions targated on reducing HIP might be beneficial for controlling for offspring BP.

Factors affecting acceptance of organ donation in mainland China: A national cross-sectional study.

AIMS AND OBJECTIVES: To explore the acceptances and associated influences of organ donation in mainland China. BACKGROUND: The shortage of organ donors has limited the development of organ transplantation in China. It is important to recognise the target population who has high intention to donate their organs may change the status. DESIGN: We conducted a cross-sectional, multi-stage sampling study collected demographic data and individuals' willingness to accept organ donation. METHODS: A stepwise linear regression analysis was adopted to evaluate the factors related to the attitudes toward organ donation. RESULTS: We collected 11,031 valid samples for the survey. The willingness to donate organs among Chinese residents averaged 56.93 points. To be specific, males (ß = -.03), religious believers (ß = -.01) and parents with a different number of children (all: ß = -.04) are less willing to donate their organs. Respondents who live in an urban area (ß = .03), have higher education level (High school or junior college ß = .04, Bachelor degree or above ß = .09), feel anxious (mild, moderate ß = .02), feel pressured (moderate, severe ß = .08), have higher scores of the Short-Form Health Literacy Instrument (HLS-SF12) (ß = .31), The Self-Management Scale (SHMS) (ß = .16), EuroQol Five Dimensions Questionnaire (EQ-5D) (ß = .04) and EuroQol Visual Analogue Scale (EQ-VAS) (ß = .24), are more positive to donate. CONCLUSIONS: This study firstly discusses the public acceptance of organ donation through a nationwide sample around China. In this study, we discovered that Chinese residents' acceptance level of organ donation and that gender, house, anxiety, pressure, social support and health literacy were the main influencing factors on residents' attitudes. RELEVANCE TO CLINICAL PRACTICE: To figure out the Chinese public acceptance and its influencing factors of organ donation can help nurse transplant coordinators to recognise the target population and the obstacles of organ donation. PATIENT OR PUBLIC CONTRIBUTION: At the phase of collecting data, participants were recruited to fill the questionnaires.

The Global and Regional Prevalence of Abdominal Aortic Aneurysms: A Systematic Review and Modeling Analysis.

OBJECTIVE: To estimate the global and regional prevalence and cases of abdominal aortic aneurysms (AAAs) in 2019 and to evaluate major associated factors. BACKGROUND: Understanding the global prevalence of AAA is essential for optimizing health services and reducing mortality from reputed AAA. METHODS: PubMed, MEDLINE, and Embase were searched for articles published until October 11, 2021. Population-based studies that reported AAA prevalence in the general population, defined AAA as an aortic diameter of 30 mm or greater with ultrasonography or computed tomography. A multilevel mixed-effects meta-regression approach was used to establish the relation between age and AAA prevalence for high-demographic sociodemographic index and low-and middle-sociodemographic index countries. Odds ratios of AAA associated factors were pooled using a random-effects method. RESULTS: We retained 54 articles across 19 countries. The global prevalence of AAA among persons aged 30 to 79 years was 0.92% (95% CI, 0.65-1.30), translating to a total of 35.12 million (95% CI, 24.94-49.80) AAA cases in 2019. Smoking, male sex, family history of AAA, advanced age, hypertension, hypercholesterolemia, obesity, cardiovascular disease, cerebrovascular disease, claudication, peripheral artery disease, pulmonary disease, and renal disease were associated with AAA. In 2019, the Western Pacific region had the highest AAA prevalence at 1.31% (95% CI, 0.94-1.85), whereas the African region had the lowest prevalence at 0.33% (95% CI, 0.23-0.48). CONCLUSIONS: A substantial proportion of people are affected by AAA. There is a need to optimize epidemiological studies to promptly respond to at-risk and identified cases to improve outcomes.

Substitution of manure for mineral P fertilizers increases P availability by enhancing microbial potential for organic P mineralization in greenhouse soil.

The shortage of phosphorus (P) as a resource represents a major challenge for the sustainable development of agriculture. Manure has a high P content and is a potential substitute for mineral P fertilizers. However, little is known about the effects on soil P availability and soil microbial P transformation of substituting manure for mineral P fertilizers. In this study, variations in soil P availability and bacterial P mobilization were evaluated under treatment with manure as compared to mineral P fertilizers. In the greenhouse fruit and vegetable production system that provided the setting for the study, substitution of manure for mineral P (PoR treatment) resulted in a similar level of soil total P and a similar fruit and vegetable yield as compared to traditional fertilization, but a significantly increased level of soil available P. In addition, PoR treatment enhanced bacterial organic P mineralization potential and decreased inorganic P dissolution potential. These results demonstrate that manure application increases the availability of soil P primarily by enhancing soil microbial Po mineralization, indicating the potential feasibility of applying manure instead of mineral P fertilizers in greenhouse farming.

Interventions to improve antiretroviral adherence in HIV-infected pregnant women: A systematic review and meta-analysis.

Background: Medication adherence in HIV-infected pregnant women remains suboptimal. This systematic review and meta-analysis aimed to evaluate the effectiveness of interventions on improving antiretroviral adherence targeting among HIV-infected pregnant women. Methods: Five databases were screened to identify quasi-experimental studies and randomized controlled trials. The risk ratios (RR) and confidential intervals (CI) were extracted to estimate the improvement in antiretroviral adherence after interventions compared with control conditions. This study was registered with PROSPERO, number CRD42021256317. Results: Nine studies were included in the review, totaling 2,900 participants. Three interventions had significance: enhanced standard of care (eSOC, RR 1.14, 95%CI 1.07-1.22, Z = 3.79, P < 0.01), eSOC with supporter (RR 1.12, 95%CI 1.04-1.20, Z = 2.97, P < 0.01) and device reminder (RR 1.33, 95%CI 1.04-1.72, Z = 2.23, P = 0.03). Discussion: The study supported the eSOC and the device reminder as effective intervention strategies for improving HIV medication adherence. Based on the current findings, the study called for more efforts to improve antiretroviral care for pregnant women through involving multicenter, large-sample, and high-quality research and combining the device reminder with other intervention methods. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021256317, identifier CRD42021256317.

Chinese famine exposure in early life and metabolic obesity phenotype in middle age: Results from the China health and retirement longitudinal study.

Objective: To assess the association between early life exposure to famine and the risk of metabolic obesity phenotypes among adults in middle age. Methods: The study selected two comparison groups. Comparison A consisted of a non-exposed group born between 1963-1965 from the China Health and Retirement Longitudinal Study (CHARLS) 2015 wave (N=862) and a fetal-exposed group born between 1959-1961 from the 2011 wave (N=507). Comparison B consisted of an early childhood-exposed group born between 1955-1957 from the 2011 wave (N=830) and a fetal-exposed group born between 1959-1961 from the 2015 wave (N=552). Multivariable logistic regressions were conducted to explore the associations between different periods of famine exposure and obesity, metabolic health status, and metabolic obesity phenotypes, with stratification by sex. Results: Compared with the non-exposed group, participants exposed to famine in the fetal period had a significantly lower risk of overweight/obesity (OR: 0.78, 95%CI: 0.63-0.97) and a higher risk of metabolically unhealthy status (OR: 1.73, 95%CI: 1.34-2.23) and metabolically unhealthy non-obesity (MUNO) (OR: 2.12, 95%CI: 1.46-3.08) at the age of 50-52 years. In the sex-stratified analysis, males exposed to famine in the fetal period had a significantly lower risk of overweight/obesity (OR: 0.59, 95%CI: 0.43-0.80) and metabolically healthy obesity (MHO) (OR: 0.56, 95%CI: 0.37-0.85), while such associations were not found in females. Compared with the early childhood exposure group, participants in the fetal exposure group had a significantly lower risk of metabolic unhealthy status (OR: 0.65, 95%CI: 0.51-0.85) and MUNO (OR: 0.50, 95%CI: 0.35-0.72). Those associations were observed in both males and females. Conclusion: Exposure to famine in early life increased the risk of metabolically unhealthy status in adulthood. Different metabolic subtypes should be identified at an early stage and followed by classification, intervention, and treatment.

What are the acceptances and associated influences of hospice care in Mainland China? A national cross-sectional study.

Background: China ranks 53rd out of 81 countries in the Quality of Death Index for 2021. Although hospice care demand is increasing, the progress remains slow. It is of great significance to explore the acceptances and associated influencing factors of hospice care. Methods: A cross-sectional survey by quota sampling was conducted in China from July 10th to September 15th, 2021. We collected demographic data and hospice care acceptance. A stepwise linear regression analysis was used. Results: This survey contained 11,031 valid questionnaire results to investigate the hospice care acceptance. It was found that individuals with undergraduate or above (ß = 0.04), more properties [2 (ß = 0.02), 3 (ß = 0.01)], and higher reimbursement types of medical insurance [employee health insurance and commercial health (ß = 0.03), government insurance (ß = 0.04)] had higher hospice acceptance willingness, while males (ß = -0.02) were less willing to accept than females. Psychological conditions [mild anxiety (ß = 0.03), moderate anxiety (ß = 0.01), moderate stress (ß = 0.05), and severe stress (ß = 0.06)] also played an important role. The Self-Management Scale (SHMS) (ß = 0.12), EuroQol Five Dimensions Questionnaire (EQ-5D) (ß = 0.05), EuroQol Visual Analog Scale (EQ-VAS) (ß = 0.21), Short-Form Family Health Scale (FHS-SF) (ß = 0.12), higher scores of the Short-Form Health Literacy Instrument (HLS-SF12) (ß = 0.16), and Perceived Social Support Scale (PSSS) (ß = 0.10) also contributed. Gender subgroup showed that in the male group, age, highest educational level, marital status, number of properties, whether having children, psychological conditions, the SHMS, EQ-5D, EQ-VAS, HLS-SF12, and PSSS showed significant difference. Urban and rural subgroups showed that age, highest educational level, number of properties, whether having chronic disease or psychological conditions, the SHMS, EQ-VAS, HLS-SF12, and PSSS were contributing factors in rural areas. Conclusion: The average score of acceptance of hospice care was 65.02 points. Gender, house, anxiety, pressure, social support, and health literacy were the main influencing factors on residents' attitudes.

Integrated Metabolomics and Lipidomics Approach for the Study of Metabolic Network and Early Diagnosis in Cerebral Infarction.

Cerebral infarction (CI) remains a major cause of high mortality and long-term disability worldwide. The exploration of biomarkers and pathogenesis is crucial for the early diagnosis of CI. Although the understanding of metabolic perturbations underlying CI has increased in recent years, the relationship between altered metabolites and disease pathogenesis has only been partially elucidated and requires further investigation. In this study, we performed an integrated metabolomics and lipidomics analysis on 59 healthy subjects and 47 CI patients. Ultimately, 49 metabolite and 68 lipid biomarkers were identified and enriched in 24 disturbed pathways. The metabolic network revealed a significant interaction between altered lipids and other metabolites. Using receiver operating characteristic curve (ROC) analysis, a panel of three polar metabolites and seven lipids was optimized in the training set, which included taurine, oleoylcarnitine, creatinine, PE(22:6/P-18:0), Cer 34:2, GlcCer(d18:0/18:0), DG 44:0, LysoPC(16:0), 22:6-OH/LysoPC, and TAG58:7-FA22:4. Subsequently, a support vector machine (SVM) model was constructed and validated, which showed excellent predictive ability in the validation set. Thereby, the integrated metabolomics and lipidomics approach could contribute to a comprehensive understanding of the metabolic dyshomeostasis associated with the pathogenesis of underlying CI. The present research may promote a deeper understanding and early diagnosis of CI in the clinic. All raw data were deposited in PRIDE (PXD036199).