Microring structure for flexible polymer waveguide-based optical pressure sensing.

Flexible pressure sensors provide a promising platform for artificial smart skins, and photonic devices provide a new technique to fabricate pressure sensors. Here, we present a flexible waveguide-based optical pressure sensor based on a microring structure. The waveguide-based optical pressure sensor is based on a five-cascade microring array structure with a size of 1500 µm × 500 µm and uses the change in output power to linearly characterize the change in pressure acting on the device. The results show that the device has a sensing range of 0-60 kPa with a sensitivity of 23.14 µW/kPa, as well as the ability to detect pulse signals, swallowing, hand gestures, etc. The waveguide-based pressure sensors offer the advantages of good output linearity, high integration density and easy-to-build arrays.

Fabrication and characterization of polymer optical waveguide Bragg grating for pulse signal sensing.

Polymer materials have the advantages of a low Young's modulus and low-cost preparation process. In this paper, a polymer-based optical waveguide pressure sensor based on a Bragg structure is proposed. The change in the Bragg wavelength in the output spectrum of the waveguide Bragg grating (WBG) is used to linearly characterize the change in pressure acting on the device. The polymer-based WBG was developed through a polymer film preparation process, and the experimental results show that the output signal of the device has a sensitivity of 1.275 nm/kPa with a measurement range of 0-12 kPa and an accuracy of 1 kPa. The experimental results indicate that the device already perfectly responds to a pulse signal. It has significant potential application value in medical diagnostics and health testing, such as blood pressure monitoring, sleep quality monitoring, and tactile sensing.

Seasonal to decadal spatiotemporal variations of the global ocean carbon sink.

The global ocean has absorbed approximately 30% of anthropogenic CO2  since the beginning of the industrial revolution. However, the spatiotemporal evolution of this important global carbon sink varies substantially on all timescales and has not yet been well evaluated. Here, based on a reconstructed observation-based product of surface ocean pCO2 and air-sea CO2  flux (the MPI-SOMFFN method), we investigated seasonal to decadal spatiotemporal variations of the ocean CO2  sink during the past three decades using an adaptive data analysis method. Two predominant variations are modulated annual cycles and decadal fluctuations, which account for approximately 46% and 25% of all extracted components, respectively. Although the whole summer to non-summer seasonal difference pattern is determined by the Southern Ocean, the non-summer CO2  sink at mid-latitudes in both hemispheres shows an increasing trend (a total increase of approximately 1.0 PgC during the period 1982-2019), while it is relatively stable in summer. On decadal timescales for the global ocean carbon sink, unlike the weakening decade (1990-1999) and the reinvigoration decade (2000-2009) in which the Southern Ocean plays the dominant role, the reinforcement decade (2010-2019) is mainly the result from the weakening source effect in the equatorial Pacific Ocean. Our results suggest that except for the Southern Ocean's role in the global ocean carbon sink, the strengthening non-summer's sink at mid-latitudes in both hemispheres and the decadal or longer timescales of equatorial Pacific Ocean dynamics should be fully considered in understanding the oceanic carbon cycle on a global scale.

Serum pepsinogen levels in different regions of China and its influencing factors: a multicenter cross-sectional study.

BACKGROUND: The aim of this study is to investigate the difference of serum pepsinogen (PG) baseline levels in different regions of China and its influencing factors. METHODS: From October 2016 to October 2018, asymptomatic health checkup people who underwent nasal endoscopy in nine health management centers in different regions of China were collected. Lifestyle questionnaires were conducted, and serum PG and gastroscopy were performed. The differences in PG levels in baseline population (OLGA-0 grade) were studied according to geographical subregions of China. SPSS software was used for statistical analysis. RESULTS: 1922 patients were included in the final analysis. Compared with the non-atrophy (OLGA-0) group, PGR levels in atrophy group (OLGA-I to IV) were significantly decreased with the atrophy degree (p < 0.05). A total of 1590 baseline people (OLGA-0) were included in the study, including 254 from South China, 574 from East China, 210 from Southwest China, 332 from Northeast China, and 220 from Central/Northern China. There were significant differences in baseline PGI levels among the five regions (p < 0.05). The PGII levels were also different among the five regions, except for Central/Northern versus Southern China. PGR (PGI/PGII ratio) levels in Southern China were higher than other four regions. Further studies were conducted on the related factors that might affect the baseline PG level, which was affected by nationality, dietary habits, smoking, Helicobacter pylori infection and other related factors. CONCLUSION: Influenced by many factors, the baseline PG levels are different in different regions of China. In the follow-up studies of PG cut-off value, different PG cut-off value based on region may be more effective in the screening of gastric cancer and precancerous lesions in China.

Controlled attenuation parameter by vibration-controlled transient elastography for steatosis assessment in members of the public undergoing regular health checkups with reference to magnetic resonance imaging-based proton density fat fraction.

AIM: Controlled attenuation parameter (CAP) measured by vibration-controlled transient elastography (FibroScan) allows repeatable and reliable assessment of liver steatosis for screening of patients at risk of non-alcoholic steatohepatitis development among asymptomatic individuals at a community level. However, this has never been compared with another quantitative method, such as magnetic resonance imaging-based proton density fat fraction, among the Chinese health checkup population. METHODS: A multicenter prospective study was conducted with Chinese individuals undergoing regular health checkups. Steatosis grading by magnetic resonance imaging-based proton density fat fraction was used as the reference to evaluate the diagnostic performance of CAP. RESULTS: A total of 173 individuals were included with mean age of 45 ± 11 years and body mass index of 25.8 ± 4.0 kg/m2 . A linear correlation was found between CAP and log10 -transformed magnetic resonance imaging-based proton density fat fraction results (Pearson's coefficient 0.772, P < 0.001). The areas under the receiver operating characteristic curve for distinguishing ≥S1 and ≥S2 steatosis were 0.88 (95% confidence interval 0.83-0.93) and 0.89 (95% confidence interval 0.83-0.95), respectively. When optimized for ≥90% sensitivity, the CAP cut-off for staging ≥S1 steatosis was 244 dB/m. CAP could classify patients with ≥S1 steatosis with similar performance as an ultrasound examination. CONCLUSIONS: As a non-invasive and quantitative method, CAP is highly adapted for population screening at a community level. With the integration of liver stiffness and CAP results in risk stratification scores for non-alcoholic steatohepatitis, vibration-controlled transient elastography can be useful in regular health checkups.

The potential value of serum pepsinogen for the diagnosis of atrophic gastritis among the health check-up populations in China: a diagnostic clinical research.

BACKGROUND: The aim of this study is to assess the validity of the measurement of pepsinogen as a screening test for chronic atrophic gastritis (AG) in health check-up populations in China. METHODS: Patients from consecutive regular health check-up were enrolled from January 2014 to June 2015. Endoscopy, combined with monitoring the Helicobacter pylori (Hp) infections, and measuring the serum pepsinogen (PG) were used to determine the diagnostic accuracy of PG for the screening of atrophic gastritis. Histopathology was assessed by the Operative Link on Gastritis Assessment (OLGA) system. Statistical analysis was performed using SPSS statistical software. RESULTS: The total Hp infection rate was 40%. Based on pathology, the 996 participants were divided into three groups: non-atrophic (NAG), mild-moderate atrophic (MAG): stage I and II of the OLGA classification, and severe atrophic (SAG): stage III and IV of the OLGA classification. Compared with NAG and MAG groups, PGR decreased significantly in SAG group (p < 0.05). PGI and PGII levels were significantly elevated in Hp-positive group, while the PGR was markedly decreased (p < 0.01). When MAG and SAG groups were combined and compared with NAG group, the best cutoff value for atrophy diagnosis was PGI ≤50.3 ng/ml; the cutoff value in Hp-negative group was absolutely higher than in Hp-positive group. When NAG and MAG groups were combined and compared with the SAG group, the best cutoff value for diagnosis of severe atrophy was at PGR ≤4.28. The cutoff values in Hp-negative and Hp-positive groups were calculated at PGR ≤6.28 and ≤4.28, respectively. CONCLUSIONS: Pepsinogens play an important role in the identification of patients with atrophic gastritis and severe AG. Use of different cutoff values of PG for Hp-negative and Hp-positive groups may offer greater efficacy in the diagnosis of AG.

Outdoor temperature and temperature maintenance associated with blood pressure in 438,811 Chinese adults.

OBJECTIVES: The association of temperature maintenance with blood pressure (BP) has not been studied and the association of temperature with season-related BP was not being well understood. The present study aims to be further aware of season-related BP variation in Chinese adults. METHODS: We used decoded data from adults who visited the hospital for health examination from January 2008 to November 2013. Multivariate regression models were used to analyses the association between outdoor temperature and BP. RESULTS: The analysis included 438,811 adults. Larger change of BP accompanied with unit change of average outdoor temperature among outpatient than inpatient patients. The association of temperature with BP was stronger in normotensives than that in hypertensives. Compared with temperature variation, the impact of temperature maintenance on BP was smaller. These associations were stronger in men, older individuals. CONCLUSIONS: Temperature was strongly inversely associated with BP in Chinese adults. Temperature maintenance was mildly associated with BP compared to temperature variance. Seasonal temperature variation should be considered when screening for hypertension.

Wave-turbulence interaction-induced vertical mixing and its effects in ocean and climate models.

Heated from above, the oceans are stably stratified. Therefore, the performance of general ocean circulation models and climate studies through coupled atmosphere-ocean models depends critically on vertical mixing of energy and momentum in the water column. Many of the traditional general circulation models are based on total kinetic energy (TKE), in which the roles of waves are averaged out. Although theoretical calculations suggest that waves could greatly enhance coexisting turbulence, no field measurements on turbulence have ever validated this mechanism directly. To address this problem, a specially designed field experiment has been conducted. The experimental results indicate that the wave-turbulence interaction-induced enhancement of the background turbulence is indeed the predominant mechanism for turbulence generation and enhancement. Based on this understanding, we propose a new parametrization for vertical mixing as an additive part to the traditional TKE approach. This new result reconfirmed the past theoretical model that had been tested and validated in numerical model experiments and field observations. It firmly establishes the critical role of wave-turbulence interaction effects in both general ocean circulation models and atmosphere-ocean coupled models, which could greatly improve the understanding of the sea surface temperature and water column properties distributions, and hence model-based climate forecasting capability.

Optimal cut-off values of BMI, waist circumference and waist:height ratio for defining obesity in Chinese adults.

It has not been established which specific measures of obesity might be most appropriate for predicting CVD risk in Asians. The objectives of the present study were to determine the associations of BMI, waist circumference (WC) and waist:height ratio (WHtR) with CVD risk factors and to evaluate the optimal cut-off values to define overweight or obesity in Chinese adults. Data collected from seven nationwide health examination centres during 2008 and 2009 were analysed. The BMI, WC and WHtR of 244 266 Chinese adults aged ≥ 20 years included in the study were measured. Logistic regression models were fit to evaluate the OR of each CVD risk factor according to various anthropometric indices. Receiver operating characteristic (ROC) analyses were conducted to assess the optimal cut-off values to predict the risk of diabetes, hypertension, dyslipidaemia and the metabolic syndrome. WHtR had the largest areas under the ROC curve for all CVD risk factors in both sexes, followed by WC and BMI. The optimal cut-off values were approximately 24·0 and 23·0 kg/m2 for BMI, 85·0 and 75·0 cm for WC, and 0·50 and 0·48 for WHtR for men and women, respectively. According to well-established cut-off values, BMI was found to be a more sensitive indicator of hypertension in both men and women, while WC and WHtR were found to be better indicators of diabetes and dyslipidaemia. A combination of BMI and central obesity measures was found to be associated with greater OR of CVD risk factors than either of them alone in both sexes. The present study demonstrated that WHtR and WC may be better indicators of CVD risk factors for Chinese people than BMI.

[The association between body mass index and non-alcoholic fatty liver disease].

OBJECTIVE: To investigate the association of body mass index (BMI) with alcoholic fatty liver disease (NAFLD). METHODS: A cohort of 725 adult subjects underwent general health check-up at our hospital in July 2008, then were followed up in 2011. The clinical data including body mass index(BMI), blood pressure, lab testing results and liver ultrasonic findings were retrospectively analyzed. The NAFLD was diagnosed according to the guidelines for management of nonalcoholic fatty liver disease: an updated and revised edition in 2010 based on liver ultrasound results. The risk factors for NAFLD were analyzed with multivariate logistic regression. RESULTS: One hundred and sixty two NAFLD cases and 563 non-NAFLD cases were found in 2008 check-up. Among 563 non-NAFLD subjects, NAFLD was developed in 132 (23.4%) at follow-up in 2011. The incidence of NAFLD was correlated with the baseline BMI (χ²=82.861，P<0.01). Multivariate logistic regression analysis showed that baseline BMI，systolic blood pressure, alanine aminotransferase and the increase of BMI were the independent risk factors, while high density lipoprotein-cholesterol (HDL-C) was the protective factor for the development of NAFLD. Among 162 NAFLD cases, 71 (43.8%) had no evidence of NAFLD at the second check-up in 2011. The remission of NAFLD was negatively correlated with baseline BMI (χ²=22.425，P<0.01). Multivariate logistic regression analysis showed that male sex, baseline BMI and the increase of BMI were negatively associated with remission of NAFLD, while the age was positively associated with the remission of NAFLD. CONCLUSION: The development and remission of NAFLD are frequently encountered in health check-up subjects, which are closely related to baseline BMI and changes of BMI during the follow-up．

Beneficial associations between outdoor visible greenness at the workplace and metabolic syndrome in Chinese adults.

BACKGROUND: Greenness surrounding residential places has been found to significantly reduce the risk of diseases such as hypertension, obesity, and metabolic syndrome (MetS). However, it is unclear whether visible greenness exposure at the workplace has any impact on the risk of MetS. METHODS: Visible greenness exposure was assessed using a Green View Index (GVI) based on street view images through a convolutional neural network model. We utilized logistic regression to examine the cross-sectional association between GVI and MetS as well as its components among 51,552 adults aged 18-60 in the city of Hangzhou, China, from January 2018 to December 2021. Stratified analyses were conducted by age and sex groups. Furthermore, a scenario analysis was conducted to investigate the risks of having MetS among adults in different GVI scenarios. RESULTS: The mean age of the participants was 40.1, and 38.5% were women. We found a statistically significant association between GVI and having MetS. Compared to the lowest quartile of GVI, participants in the highest quartile of GVI had a 17% (95% CI: 11-23%) lower odds of having MetS. The protective association was stronger in the males, but we did not observe such differences in different age groups. Furthermore, we found inverse associations between GVI and the odds of hypertension, low high-density lipoprotein cholesterol, obesity, and high levels of FPG. CONCLUSIONS: Higher exposure to outdoor visible greenness in the workplace environment might have a protective effect against MetS.

Study of an elevated carbohydrate antigen 19-9 concentration in a large health check-up cohort in China.

BACKGROUND: Carbohydrate antigen 19-9 (CA19-9) is frequently tested in cancer patients. However, elevated CA19-9 can be found in many benign diseases. We investigated the relationship between elevated CA19-9 and diseases, and presented suggestions for its utility in a health check-up cohort. METHODS: From June 2008 to December 2008, we enrolled consecutive health check-up individuals with elevated CA19-9 (>37 U/mL). They were divided into three groups: group A (malignant diseases), group B (decreasing concentrations), and group C (increasing concentrations) according to the following criteria: (i) CA19-9 was rechecked monthly in the first 3 months; (ii) follow-up was completed if malignancy was found or if CA19-9 concentration dropped to normal; (iii) if CA19-9 kept increasing, it was monitored every 3 months; (4) total duration was 1 year. RESULTS: Among 33,867 individuals, 572 (1.7%) individuals showed elevated CA19-9 concentration. A total of 509 (90.0%) individuals finished at 1-year follow-up. In total, nine (1.8%) individuals were diagnosed with malignancies. For 336 (66.0%) individuals CA19-9 concentrations dropped to normal, whereas for 164 (32.2%) individuals it kept rising. Interestingly, we did not find any differences in concentration levels between group A and group C. The main associated benign diseases included fatty liver (25.3%), cholecystolithiasis (13.9%), and chronic hepatitis B (13.9%). CONCLUSIONS: Dynamic monitoring of CA19-9 is recommended in asymptomatic populations with elevated CA19-9 concentrations.

Global 3-hourly wind-wave and swell data for wave climate and wave energy resource research from 1950 to 2100.

Ocean wave climate, including wind waves and swells, is essential to human marine activities and global or regional climate systems, and is highly related to harnessing wave energy resources. In this study, a global 3-hourly instantaneous wave dataset was established with the third-generation wave model MASNUM-WAM and wind forcings derived from the products of the First Institute of Oceanography-Earth System Model version 2.0, the climate model coupled with wave model, under the unified framework of the Coupled Model Intercomparison Project phase 6. This dataset contains 17 wave parameters, including the information associated with wave energy and spectral shape geometries, from one historical (1950-2014) simulation and three future (2015-2100) scenario experiments (ssp125, ssp245, and ssp585). Moreover, all the parameters can be accessed separately in the form of wind waves and swells. The historical results show that the simulated wave characteristics agree well with satellite observations and the ERA5 reanalysis products. This dataset can provide the community with a unique and informative data source for wave climate and wave energy resource research.

A quantitative analysis of marine heatwaves in response to rising sea surface temperature.

It has been proven that marine heatwaves (MHWs) have increased in frequency, duration, and intensity over the past few decades, and this trend will accelerate further under continued global warming. While more intense and frequent MHWs are an expected consequence of rising sea surface temperatures (SSTs) under continued global warming, it remains unclear to what degree per Celsius warming trend of SSTs contributes to the changes in the MHW metrics. Here, we focus on how the MHW metrics evolve with the SST warming trend by using an adaptive data analysis method based on observational datasets covering the past four decades. We find that the globally averaged increasing rates of the annual MHW frequency, duration, and maximum intensity are approximately 3.7 events, 7.5 days, and 2.2° Celsius per degree Celsius of SST rise, respectively. The increasing rates for the annual MHW days and the fraction of the spatial extents to the global ocean affected by MHWs are approximately 58.8 days and 13.9 % per degree Celsius of SST rise, respectively. Based on these observational-based increasing rates and the projected SST warming from the selected Coupled Model Intercomparison Project Phase 6 (CMIP6) models, the spatial distributions of changes in annual MHW days, frequency, and cumulative intensity are projected to exhibit 2-fold, 4-fold, and 6 to 8-fold increases under the three socioeconomic pathways (i.e., SSP126, SSP245, and SSP585), respectively. The globally averaged annual MHW days will increase to approximately 224.2 ± 26.9 days, and the largest changes are projected to occur in the northeast Pacific, the North Atlantic, the south Indian Oceans, and parts of the Southern Ocean, with approximately 14.8 ± 5.7 % of the global ocean reaching a permanent MHW state by the end of the twenty-first century under SSP585.

General practitioner residents' experiences and perceptions of outpatient training in primary care settings in China: a qualitative study.

OBJECTIVES: The implementation of outpatient training in primary care settings is an essential part of residency training for general practitioner (GP) residents. However, limited research exists on their experiences and perceptions of this training. This study aimed to explore the experiences and perceptions of GP residents regarding outpatient training in primary care settings in China and provide insights and recommendations to enhance training quality. DESIGN: A qualitative descriptive study employing in-depth interviews. SETTING: Two community healthcare centres (CHCs) that implement outpatient training programmes for GP residents in Zhejiang Province, China. PARTICIPANTS: In total, 20 GP residents affiliated with 14 CHCs and two hospitals across Zhejiang Province and Guizhou Province who had completed outpatient training in either CHC for over 1 month. RESULTS: Of the 20 participants in this study, 11 (55%) were women, and the mean age was 28 years. GP residents completed the process of consultation, physical examination and therapy independently; subsequently, the community preceptors provided feedback based on their clinical performance and modelled their clinical skills. The benefits perceived by GP residents included improved clinical skills and confidence in practice, and they learned approaches to maintaining good relationships with patients. They preferred dealing with complex cases, discussions with peers and the indirect supervision of community preceptors in the training session. Residents recommended that measures be taken to improve the training quality regarding patient selection and recruitment, clinical skills in the training session, and assessment of clinical performance. CONCLUSIONS: The outpatient training in primary care settings provides constructive opportunities for GP residents to improve their professional competencies. Although the current training sessions and the abilities of community preceptors largely satisfy the needs of GP residents, further research is needed to evaluate the effectiveness of training and explore approaches to improve its quality.

Association of fat mass and fat-free mass with all-cause and cause-specific mortality in Asian individuals: A prospective cohort study.

OBJECTIVE: The study's objective was to investigate the association of fat mass index (FMI) and fat-free mass index (FFMI) with all-cause mortality and cause-specific mortality in the Chinese population. METHODS: A total of 422,430 participants (48.1% men and 51.9% women) from the Taiwan MJ Cohort with an average follow-up of 9 years were included. RESULTS: The lowest (Q1) and highest (Q5) quintiles of FMI and FFMI were associated with increased all-cause mortality. Compared with those in the third quintile (Q3) group of FMI, participants in Q1 and Q5 groups of FMI had hazard ratios and 95% CI of 1.32 (1.24-1.40) and 1.13 (1.06-1.20), respectively. Similarly, compared with those in Q3 group of FFMI, people in Q1 and Q5 groups of FFMI had hazard ratios of 1.14 (1.06-1.23) and 1.16 (1.10-1.23), respectively. In the restricted cubic spline models, both FMI and FFMI showed a J-shaped association with all-cause mortality. People in Q5 group of FFMI had a hazard ratio of 0.72 (0.58-0.89) for respiratory disease. CONCLUSIONS: The mortality risk increases in those with excessively high or low FMI and FFMI, yet the associations between FMI, FFMI, and the risk of death varied across subgroups and causes of death.

6-Year trajectory of fasting plasma glucose (FPG) and mortality risk among individuals with normal FPG at baseline: a prospective cohort study.

BACKGROUND: Higher fasting plasma glucose (FPG) levels were associated with an increased risk of all-cause mortality; however, the associations between long-term FPG trajectory groups and mortality were unclear, especially among individuals with a normal FPG level at the beginning. The aims of this study were to examine the associations of FPG trajectories with the risk of mortality and identify modifiable lifestyle factors related to these trajectories. METHODS: We enrolled 50,919 individuals aged ≥ 20 years old, who were free of diabetes at baseline, in the prospective MJ cohort. All participants completed at least four FPG measurements within 6 years after enrollment and were followed until December 2011. FPG trajectories were identified by group-based trajectory modeling. We used Cox proportional hazards models to examine the associations of FPG trajectories with mortality, adjusting for age, sex, marital status, education level, occupation, smoking, drinking, physical activity, body mass index, baseline FPG, hypertension, dyslipidemia, cardiovascular disease or stroke, and cancer. Associations between baseline lifestyle factors and FPG trajectories were evaluated using multinomial logistic regression. RESULTS: We identified three FPG trajectories as stable (n = 32,481), low-increasing (n = 17,164), and high-increasing (n = 1274). Compared to the stable group, both the low-increasing and high-increasing groups had higher risks of all-cause mortality (hazard ratio (HR) = 1.18 (95% CI 0.99-1.40) and 1.52 (95% CI 1.09-2.13), respectively), especially among those with hypertension. Compared to participants with 0 to 1 healthy lifestyle factor, those with 6 healthy lifestyle factors were more likely to be in the stable group (ORlow-increasing = 0.61, 95% CI 0.51-0.73; ORhigh-increasing = 0.20, 95% CI 0.13-0.32). CONCLUSIONS: Individuals with longitudinally increasing FPG had a higher risk of mortality even if they had a normal FPG at baseline. Adopting healthy lifestyles may prevent individuals from transitioning into increasing trajectories.

Age- and gender-specific prevalence of carotid atherosclerosis and its association with metabolic syndrome in Hangzhou, China.

OBJECTIVE: Because of rapid alterations in lifestyle and the incidence of metabolic syndrome (MetS), the prevalence of carotid atherosclerosis (CA) and carotid plaque (CP) may increase in China. We aimed to evaluate the prevalence of CA and CP as well as its relation to MetS in an East Chinese population. METHODS: The study included 6142 subjects who underwent general health screening including carotid ultrasonography in 2009. Diagnoses of MetS were made according to the revised Adult Treatment Panel III criteria. RESULTS: The prevalence of CA and CP increased gradually with age. These conditions were more prevalent in men than in women (CA: 22.1%vs 12.0%, P < 0.001; CP: 12.6%vs 7.2%, P < 0.001). Multivariate logistic regression analysis showed that male gender, age, blood pressure, fasting blood glucose (FBG) and low-density lipoprotein cholesterol were risk factors for CA and CP, while high-density lipoprotein cholesterol was protective for CA. Age ≥ 50 years has the largest impact on CA and CP, followed by elevated blood pressure and elevated blood glucose. Individuals with MetS had a higher prevalence of CA (27.7%vs 20.0% in men, 24.0%vs 10.3% in women; P < 0.001 in both) and CP (16.6%vs 11.2% in men, P < 0.001; 11.8%vs 6.5% in women, P < 0.005) than those without MetS. The prevalence and odds ratios of CA and CP aggregated with an increasing number of MetS components, even in individuals exhibiting only one component. CONCLUSIONS: These results indicate that CA and CP have become a major public health problem in China. MetS and its components were associated with an increased prevalence of CA and CP.

Arctic Ocean Amplification in a warming climate in CMIP6 models.

Arctic near-surface air temperature warms much faster than the global average, a phenomenon known as Arctic Amplification. The change of the underlying Arctic Ocean could influence climate through its interaction with sea ice, atmosphere, and the global ocean, but it is less well understood. Here, we show that the upper 2000 m of the Arctic Ocean warms at 2.3 times the global mean rate within this depth range averaged over the 21st century in the Coupled Model Intercomparison Project Phase 6 Shared Socioeconomic Pathway 585 scenario. We call this phenomenon the "Arctic Ocean Amplification." The amplified Arctic Ocean warming can be attributed to a substantial increase in poleward ocean heat transport, which will continue outweighing sea surface heat loss in the future. Arctic Amplification of both the atmosphere and ocean indicates that the Arctic as a whole is one of Earth's regions most susceptible to climate change.

Spatiotemporal propagating decadal signal of ocean heat content and thermocline depth identified in the tropical Pacific.

Tropical Pacific decadal variability (TPDV) and its mechanisms are essential for understanding long-term variations in global climate. The spatiotemporal pattern of this decadal variation has yet to be clarified. Here, on the basis of observational data with the help of the adaptive data analysis method, we extracted and investigated the spatiotemporal evolution of the tropical Pacific decadal variability in upper ocean heat content (UOHC) and thermocline depth. The tropical decadal signal propagated eastward along the equator from the western Pacific to the eastern Pacific after the 1970s, with a speed of 4-5 cm s-1 yielding a decadal oscillation of approximately 11-13 years. This decadal variability of the thermocline fluctuations (UOHC) was proven to be closely correlated with western wind anomalies since the 1970s and may have been induced by the regime shift of the Pacific decadal oscillation. These peaks of decadal signals corresponded well with the strong El Niño-Southern Oscillation (ENSO) events, reflecting nonlinear rectification of ENSOs on TPDV. Moreover, the TPDV showed a modulating signal on moderate and weak ENSO events.