Distributed shape detection for an acoustic sensitive optical cable with DAS.

Acoustic sensitive optical cables (ASOCs) and their shape detection are vital in underwater acoustic monitoring, and a distributed ASOC shape detection method is demonstrated with distributed acoustic sensing (DAS) technology. The accurate three-dimensional (3D) position of each ASOC unit is obtained from DAS signals and the prior position information of auxiliary acoustic sources by using a proposed adaptive peak allocation algorithm. Preliminary work has demonstrated single-point 3D localization and distributed ASOC shape detection, and the error is 6.53 cm. To the best of our knowledge, it is the first time that distributed ASOC shape detection is achieved with DAS. This method will promote the development of ASOC applications, such as underwater target detection and towed array correction.

Association between urinary metals and prostate-specific antigen in aging population with depression: a cross-sectional study.

Objective: This study aims to investigate the impact of depression and urinary metals on Prostate-Specific Antigen (PSA). Methods: Analysis was conducted on 1901 samples collected from the National Health and Nutrition Examination Survey (NHANES) database between 2001 and 2010. Analytical methods included stepwise multiple linear regression (MLR) analysis of the overall population's urinary metals and PSA relationship, analysis of urinary metals and PSA relationship in older adults and BMI subgroups, analysis of urinary metals and PSA relationship in the depressed population, and restricted cubic spline (RCS) analysis. A significance level of p < 0.05 was considered statistically significant. Results: In the stepwise multiple linear regression, beryllium (Be) showed a dose-response association with PSA (third quartile: ß = 0.05, 95%CI (0.02, 0.09); fourth quartile: ß = 0.07, 95%CI (0.02, 0.12), p trend = 0.048). Subgroup analysis indicated that in individuals aged >60, Be at Q4 level [ß = 0.09, 95%CI (0.05, 0.21)] exhibited a dose-response correlation with PSA. In the population with 25 ≤ BMI < 30, Be might more significantly elevate PSA, with Q4 level having a pronounced impact on PSA levels [ß = 0.03, 95%CI (0.02, 1.27)]. In the depressed population, urinary cadmium (Cd) levels showed a significant positive dose-response relationship, with Q4 level of Cd having the maximum impact on PSA [ß = 0.3, 95%CI (0.09, 0.49)]. Conclusion: Individuals exposed to beryllium (Be), especially the older adults and overweight, should monitor their PSA levels. In depressed patients, cadmium (Cd) levels may further elevate PSA levels, necessitating increased monitoring of PSA levels among males.

Voiceprint and position information detection of non-cooperative ship with Φ-OTDR and suspended sensitized optical cable.

Target detection is significant in many fields, including oceanic security, marine ecology, etc. In this paper, phase sensitive optical time domain reflectometry (Φ-OTDR) is introduced for the non-cooperative ship detection, with large-scale diversity technology and suspended sensitized optical cable. In outfield experiments, the ship's voiceprint information is obtained in high fidelity, the ship's power spectrum is analyzed, and the over-top detection is achieved. Moreover, an array orientation method based on adaptive phase difference correction (APDC) is proposed to track the ship, suppressing the delay jitter influence of acoustic transmission underwater. This is the first time that voiceprint information of the non-cooperative ship is high-fidelity acquired and deeply analyzed with Φ-OTDR and suspended sensitized optical cable, which is conducive to the detection and identification of marine targets, and proves the potential of Φ-OTDR in hydroacoustic detection applications.

Associations of healthy eating index-2015 with osteoporosis and low bone mass density in postmenopausal women: a population-based study from NHANES 2007-2018.

Purpose: The current study aimed to explore the associations of diet quality assessed by healthy eating index-2015 (HEI-2015) with risks of osteoporosis and low bone mineral density (BMD) among American postmenopausal women aged 50 years and older. Methods: Postmenopausal women aged 50 years and older in the National Health and Nutrition Examination Survey from 2007 through 2018 were included in the final sample. Analysis of variance and Rao-Scott adjusted chi-square tests were used to compare the characteristics across tertiles of HEI-2015. Univariate and multivariate weighted logistic regression models were employed to explore the associations of HEI-2015 tertiles and continuous HEI-2015 with the risks of osteoporosis and low BMD. Nonlinear dose-response associations were evaluated using weighted restricted cubic spline analyses, and the contributions of various HEI-2015 components were assessed using weighted quantile sum regression models. Results: The final sample included 3,421 postmenopausal women aged 50 years and older representative for approximately 28.38 million non-institutionalized U.S. postmenopausal women. Osteoporosis prevalence decreased with HEI-2015 tertiles while the prevalence of low BMD showed no significant decrease. Compared with postmenopausal women in the first tertile of HEI-2015, those with the second (OR: 0.57, 95%CI: 0.38-0.84) and third (OR: 0.48, 95%CI: 0.29-0.78) HEI-2015 tertiles were associated with reduced osteoporosis risk after multivariate adjustments, but no significant association of HEI-2015 with the risk of BMD was identified. Furthermore, similar effects were confirmed in the sensitivity analyses and subgroup analyses and interaction effects. Moreover, significant nonlinear associations were observed between HEI-2015 with osteoporosis risk, and total vegetables, refined grains and greens and beans demonstrated the strongest protective effect among HEI-2015 components against osteoporosis. Conclusions: This study strongly suggests the significant negative associations of HEI-2015 with osteoporosis risk in American postmenopausal women. These findings highlight the importance of adherence to the dietary guidelines for Americans in reducing the risk of osteoporosis.

Possible non-linear relation between prostate specific antigen and vitamin D: a machine learning study based on cross-section data.

Objective: Due to inconsistent results in earlier investigations regarding the relationship between vitamin D and prostate-specific antigen (PSA), this study was conducted to gain a deeper understanding of the association between vitamin D and PSA. Methods: A total of 7174 male samples with 25(OH)D, PSA, and other variables were obtained from the National Health and Nutrition Examination Survey (NHANES) database. Three models, created through stepwise logistic regression, were employed to examine the dose-response association between PSA and 25(OH)D. Subsequently, restricted cubic spline analysis (RCS) was used to explore the nonlinear association between 25(OH)D and PSA. The study also compared the performance of four machine learning models in predicting PSA levels. Results: The dose-response relationship indicated a negative impact of high 25(OH)D levels on PSA (p for trend 0.05). The odds ratio (OR) of Q4 (7.73 with 95% CI (0.26, 15.76)) was significantly higher than Q1 (6.23 with 95% CI (0.24, 12.57)). OR values in Q2 and Q3 were less than 1 (Q2= 0.57 with 95% CI (-6.37, 8.04) and Q3= 0.26 with 95% CI (-5.94, 6.86)), suggesting a potential protective effect of 25(OH)D on PSA. RCS analysis revealed a U-shaped relationship between blood 25(OH)D levels and PSA, with serum 25(OH)D in the range of 20-134 ng/ml showing a potential decrease in PSA levels. Above this range, an increase in 25(OH)D might elevate PSA levels. Age (2.67 with 95% CI 2.24 to 3.1) and BMI (17.52 with 95% CI 7.65 to 26.32), along with the OR of obesity (10.36 with 95% CI 0.68 to 20.18), were identified as potential PSA risk factors. Among the machine learning models, the random forest algorithm performed the best in predicting PSA levels. Conclusion: This study revealed a U-shaped relationship between 25(OH)D and PSA, with PSA potentially declining when 25(OH)D is between 20 and 134 ng/mL and possibly rising above this range. The random forest method proved effective in both predicting PSA levels and guiding vitamin D dosage.

Global, regional, national trends of femur fracture and machine learning prediction: Comprehensive findings and questions from global burden of disease 1990-2019.

Background: Femur fracture is a type of fracture with high disability and mortality. There is no comprehensive analysis and prediction of the global distribution of femur fractures, so we conducted this study. Methods: Age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and years living with disability (YLDs) of femur fractures (excluding femoral neck) were downloaded from the Global burden of disease database. Trend analysis was performed, and 6 time-series machine learning algorithms were applied to predict the global ASIR, ASPR, and YLDs. Results: ASPR for femur fracture had been increasing in most countries worldwide from 1990 to 2019, with the highest in East Asia (AAPC = 1.25 95%Confidence Interval (1.2, 1.3)) and lowest in Central Latin America (AAPC = -0.74 95%CI (-0.81, -0.67)). However, ASIR showed a significant downward trend worldwide, with East Saharan Africa decreasing the most (AAPC = -4.04 95%CI (-5.56, -2.47)), and East Asia elevating the most (AAPC = 1.11 95%CI (0.87, 1.42)). YLDs were increasing over the world, with East Asia still elevating the most AAPC= (3.9 95%CI (3.85, 3.95)), with the only region of decrease being Eastern Europe (AAPC = -0.28 95%CI (-0.3, -0.26)). Both ASPR and ASIR were higher in women than in men in the >75 year group, whereas YLDs was lower in women than in men in the >60 year group. Globally, the ARIMA model was optimal in the prediction of ASPR, the PROPHET model effected in the prediction of ASIR, and the PROPHET WITH XGBOOST model was the best in the prediction of YLDs. The projections showed increase in both ASPR and YLDs, except for ASIR decreasing by 2030. Conclusions: Our study found a rise in femur fracture ASPR and ASIR from 1990 to 2019 in war conflict areas and East Asia, meanwhile, the YLDs of femur fracture increased in populous countries. In both 1990 and 2019, both ASPR and ASIR were higher in women over 75 years than that in men, but YLDs was higher in men over 60 years than that in women. In 2020-2030, while global femur fracture ASIR might decline, both ASPR and YLDs might rise. The Translational Potential of this article: Femur fracture is a high-energy injury due to direct violence, and in war, conflicting and underdeveloped regions such as East Asia. Accidental injuries may occur due to the rapid development of industry and the frequent traffic accidents. This study suggests that we should focus on elderly women (≥75 years) in the above regions in the future. For older men (>60 years old), more attention should be paid to post-fracture functional rehabilitation and early reintegration into society to reduce the disability rate and lower the socio-economic burden.

Association between serum 25-hydroxyvitamin D level and myopia in children and adolescents: a cross-sectional study.

Background: Prior reports have indicated an inconsistent relationship between vitamin D levels and myopia in children and adolescents with limited sample size. This study was undertaken to further clarify this relationship with a repeated cross-section study. Methods: The National Health and Nutrition Examination Survey (NHANES) database with samples <19 years old was utilized. Data on rates of myopia (spherical equivalent less than or equal to -1.0 D), serum 25-hydroxyvitamin D [25(OH)D] level (high performance liquid chromatography), and other key variables were extracted and analyzed. Three models were utilized to evaluate the dose response of vitamin D levels using stepwise logistic regression. Logistic regressions for sex subgroups and other covariates were also performed, and Forest plots were drawn. Results: Data were available from 6,814 children (49.5% girls; mean age: 14.9±1.85 years). The myopia and non-myopia differed in serum 25(OH)D level, gender, race, poverty income ratio (PIR), and body mass index (BMI). Serum 25(OH)D levels were negatively correlated with myopia [odds ratio (OR) =0.98, 95% confidence interval (CI): 0.77-0.99, P<0.05] regardless of sex. Although the relationship did not appear to be linear, there was a dose effect with higher serum 25(OH)D levels linked with lower rates of myopia. In addition, rates of myopia were increased in females compared with males (OR =1.12, 95% CI: 1.01-1.24, P=0.03), those with a high PIR (OR =1.08, 95% CI: 1.04-1.11, P<0.001), and those with high BMI (OR =1.19, 95% CI: 1.11-1.27, P<0.001). White ethnicity (OR =0.78, 95% CI: 0.68-0.90, P<0.001) and leisure-time exercise (OR =0.94, 95% CI: 0.92-0.97, P=0.02) were associated with lower rates of myopia. Conclusions: These findings indicate that higher serum 25(OH)D levels and increased amounts of leisure-time exercise are associated with lower rates of myopia in this group of children and adolescents. Meanwhile, female gender, high PIR level, and high BMI were associated with greater rates of myopia. The findings indicated that children and adolescents needed leisure-time exercise to lower the risk of myopia.

Self-renewing human naïve pluripotent stem cells dedifferentiate in 3D culture and form blastoids spontaneously.

Human naïve pluripotent stem cells (hnPSCs) can generate integrated models of blastocysts termed blastoids upon switch to inductive medium. However, the underlying mechanisms remain obscure. Here we report that self-renewing hnPSCs spontaneously and efficiently give rise to blastoids upon three dimensional (3D) suspension culture. The spontaneous blastoids mimic early stage human blastocysts in terms of structure, size, and transcriptome characteristics and are capable of progressing to post-implantation stages. This property is conferred by the glycogen synthase kinase-3 (GSK3) signalling inhibitor IM-12 present in 5iLAF self-renewing medium. IM-12 upregulates oxidative phosphorylation-associated genes that underly the capacity of hnPSCs to generate blastoids spontaneously. Starting from day one of self-organization, hnPSCs at the boundary of all 3D aggregates dedifferentiate into E5 embryo-like intermediates. Intermediates co-express SOX2/OCT4 and GATA6 and by day 3 specify trophoblast fate, which coincides with cavity and blastoid formation. In summary, spontaneous blastoid formation results from 3D culture triggering dedifferentiation of hnPSCs into earlier embryo-like intermediates which are then competent to segregate blastocyst fates.

ZNF217-activated Notch signaling mediates sulforaphane-suppressed stem cell properties in colorectal cancer.

Cancer stem cells (CSCs) are known to contribute to the progression of colorectal cancer (CRC). However, understanding of the molecular mechanisms and key factors involved in CRC is still insufficient to identify therapeutic targets against colorectal CSCs. In an effort to identify such mechanisms, we conducted bioinformatics analyses to evaluate the expression patterns in tumor and normal colorectal tissues, leading us to focus on the role of the ZNF217/Notch1 axis in mediating stem cell properties in CRC. Our findings revealed that ZNF217 overexpression activated self-renewal ability, expression of colorectal CSC markers, and Notch signaling in CRC. Dual-luciferase reporter assay suggested a role for ZNF217 in targeting Notch1 to activate Notch signaling. We observed that the promotional effects of Notch signaling, as well as CSC markers, under ZNF217 overexpression were attenuated after Notch1 knockdown. In addition to in vitro data, our in vivo results confirmed the inhibitory effect of sulforaphane on the tumorigenicity of CSCs, depicted the suppressive role of sulforaphane on colorectal CSCs mediated by the ZNF217/Notch1 axis, thereby providing new targetable vulnerabilities and therapeutic strategies for CRC.

Associations of oxidative balance score with total abdominal fat mass and visceral adipose tissue mass percentages among young and middle-aged adults: findings from NHANES 2011-2018.

Objective: This study aimed to explore the association of the oxidative balance score (OBS) with total abdominal fat mass (TAFM) and visceral adipose tissue mass (VATM) percentages among young and middle-aged U.S. adults. Methods: Young and middle-aged adults in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018 were included. Analysis of variance and Rao-Scott adjusted chi-square tests were used to compare the characteristics across quartiles of OBS. Univariate and multivariate weighted logistic regression models were employed to explore the relationship between OBS and the risks of high TAFM or high VATM percentage in the general population and subgroups, while the interaction effects were tested with a likelihood test. Weighted restricted cubic spline analyses were utilized to assess the non-linear association of OBS with TAFM and VATM percentages. Results: The final sample included 8,734 young and middle-aged non-institutionalized U.S. adults representing 134.7 million adults. Compared with adults in the first quartile of OBS, those with higher OBS were less likely to have a high TAFM percentage; the ORs and 95% CI for adults in the second, third, and highest quartiles of OBS were 0.70 (0.53-0.94), 0.49 (0.36-0.60), and 0.25 (0.18-0.36), respectively. Similar trends were observed in the association between OBS and VATM percentages. Moreover, similar effects were confirmed in the sensitivity analyses and subgroup analyses according to demographic characteristics. Regarding the OBS subclass, higher dietary OBS and lifestyle OBS were also correlated with decreased ORs of high TAFM and VATM percentages. Conclusion: This study strongly suggests that higher OBS, as well as higher dietary OBS and lifestyle OBS, are significantly correlated with lower risks of abdominal obesity and visceral fat accumulation. The findings highlight the importance of an antioxidant-rich diet and maintaining a healthy lifestyle in reducing the risks.

A network suspected infectious disease model for the development of syphilis transmission from 2015 to 2021 in Hubei province, China.

AIMS: Understanding the transmission mode of syphilis is essential to prevent and predict its future prevalence and to develop effective control measures. This study aimed to develop a network suspected infectious disease model to simulate the syphilis transmission. METHODS AND RESULTS: The number of syphilis cases in Wuhan's Fourth Hospital, Hubei province, China, from October 2015 to July 2021 was collected. The simulation was carried out by interpersonal network-SI (suspected infectious) model based on temporal exponential family random graph models. Late latent syphilis and tertiary syphilis are predicted by December 2025. The validity of simulated value and real data was tested, including determination coefficient (R2), root means square error (RMSE), and means relative error (MRE). Moreover, we developed an online app that can more easily predict the number of syphilis infections in different scenarios by setting different parameters. Results showed that R2, RMSE, and MRE were 0.995, 36.19, and 6.31, respectively. Speed from latent infection to primary syphilis, primary syphilis to secondary syphilis, and susceptible group to latent infection decreased rapidly. The speed of transformation from secondary syphilis to early incubation period and early latent to late latent experienced a process from increase to decreased. Late latent to tertiary syphilis patients increased steadily. The number of late latent patients, early latent, invisible infection, primary syphilis, and secondary syphilis all increased at first and turn to decreased. However, tertiary syphilis continuously kept rising in the whole process. To better make use of the transmission model, an online application was developed (https://alanwu.shinyapps.io/MD-shiny/). CONCLUSIONS: Based on the simulation that late latent and tertiary syphilis were steadily increasing, the prevention and treatment for syphilis were imperative.

The association of blood metals with latent tuberculosis infection among adults and adolescents.

Objective: We aimed to investigate the relationship of metal exposure and latent tuberculosis infection (LTBI) among US adults and adolescents. Methods: Participants from the National Health and Nutrition Examination Surveys (NHANES 2011 ~ 2012) were included. Multiple logistic regression models were used to explore the associations between metal exposure and LTBI. A total of 5,248 adults and 1,860 adolescents were included in the present analysis. Results: For adults, we only found a positive association between total mercury and LTBI (OR: 1.411; 95% CI: 1.164 ~ 1.710) when used as a continuous variable. Compared with Q1, Q4 increased the prevalence of LTBI (2.303; 1.455 ~ 3.644) when used as a quartile. The OR of total mercury and LTBI was higher among females (1.517; 1.009 ~ 2.279), individuals aged 45 ~ 64 (1.457; 1.060 ~ 2.002), and non-Hispanic White individuals (1.773; 1.316 ~ 2.388). A relationship was observed among only participants with obesity (1.553; 1.040 ~ 2.319) or underweight (1.380; 1.076 ~ 1.771), with college or above (1.645; 1.184 ~ 2.286), with PIR > 3.0 (1.701; 1.217 ~ 2.376), reported smoking (1.535; 1.235 ~ 1.907) and drinking (1.464; 1.232 ~ 1.739). For adolescents, blood manganese was positively associated with LTBI. The OR and 95% CIs for each one-unit increase in the log-transformed level of blood manganese with LTBI were 9.954 (1.389 ~ 71.344). Conclusion: Significant associations were observed in girls, aged ≥12 years and in the non-Hispanic white population. In conclusion, total mercury is associated with an increased prevalence of LTBI among adults and positive association between blood manganese and LTBI was observed among adolescents. Further studies should be conducted to verify the results and explore potential biological mechanisms.

In vitro generation of mouse morula-like cells.

Generating cells with the molecular and functional properties of embryo cells and with full developmental potential is an aim with fundamental biological significance. Here we report the in vitro generation of mouse transient morula-like cells (MLCs) via the manipulation of signaling pathways. MLCs are molecularly distinct from embryonic stem cells (ESCs) and cluster instead with embryo 8- to 16-cell stage cells. A single MLC can generate a blastoid, and the efficiency increases to 80% when 8-10 MLCs are used. MLCs make embryoids directly, efficiently, and within 4 days. Transcriptomic analysis shows that day 4-5 MLC-derived embryoids contain the cell types found in natural embryos at early gastrulation. Furthermore, MLCs introduced into morulae segregate into epiblast (EPI), primitive endoderm (PrE), and trophectoderm (TE) fates in blastocyst chimeras and have a molecular signature indistinguishable from that of host embryo cells. These findings represent the generation of cells that are molecularly and functionally similar to the precursors of the first three cell lineages of the embryo.

Absorption and Metabolism of Urolithin A and Ellagic Acid in Mice and Their Cytotoxicity in Human Colorectal Cancer Cells.

Background: Ellagic acid is a natural polyphenol compound found in pomegranates, walnuts, and many berries. It is not easily absorbed, but it could be metabolized to urolithins by the gut microbiota. Urolithin A, one of the ellagic acid metabolites, has been proved to prolong the lifespan of C. elegans and increases muscle function of mice. The purpose of this current study was to analyze the absorption and metabolites of urolithin A and ellagic acid in mice and the anticancer effects of urolithin A, urolithin B, and ellagic acid in colorectal cancer cells. Methods: Urolithin A and urolithin B were synthesized and analyzed by HPLC and NMR. A pharmacokinetic study of urolithin A was performed in mice by analyzing urolithin A and its metabolites in urines. Absorption and biotransformation of ellagic acid were also studied in mice by analyzing the plasma, liver, and feces. The cytotoxicity of urolithin A, urolithin B, and ellagic acid was assayed in SW480, SW620, HCT 116, and HT-29 cells. Results: Urolithin A and urolithin B were synthesized and purified to reach 98.1% and 99% purity, respectively, and the structures were identified by NMR. In urolithin A intake analysis, urolithin A was only detectable at 3 h, not at 6-24 h; it suggested that urolithin A was rapidly metabolized to some unknown metabolites. Using UPLC-MS/MS analysis, the metabolites might be urolithin A 3-O-glucuronide, urolithin A 3-sulfate, and urolithin A-sulfate glucuronide. After feeding mice with ellagic acid for consecutive 14 days, ellagic acid contents could be detected in the fecal samples, but not in plasma and liver, and urolithin A was not detected in all samples. It suggests that ellagic acid is not easily absorbed and that the biotransformation of ellagic acid to urolithin A by intestinal flora might be very low. From the cytotoxicity assay, it was found that there was anticancer effect in urolithin A and urolithin B but not in ellagic acid. In contrast, ellagic acid promoted the proliferation of SW480 and SW620 cells.

Burden and trends of stroke attributable to dietary risk factors from 1990 to 2019 in the Belt and Road Initiative countries: an analysis from the global burden of disease study 2019.

Objectives: This study aimed to compare the burden and trends of stroke attributed to dietary risk factors in the Belt and Road ("B&R") countries from 1990 to 2019. Methods: The 2019 Global Burden of Disease (GBD) Study was used to gather information on the burden of stroke attributable to dietary risk factors. Numbers and age-standardized rates (ASRs) of deaths, disability-adjusted life years (DALYs) were determined in 1990 and 2019 among the "B&R" countries. The average annual percent change (AAPC) was used to analyze the temporal trends of diet-induced stroke DALYs from 1990 to 2019 and in the final decade (2010-2019) by Joinpoint regression analysis. Results: In 2019, the absolute number of stroke deaths and DALYs attributable to dietary risk factors were 671,872 cases (95% UI 436,354-937,093) and 1.67 million cases (95% UI 1.15-2.24) in China. We found geographical differences in mortality and DALYs of diet-attributable stroke among member countries, with Bulgaria, Hungary and Serbia being the three highest countries in 1990, Bulgaria, North Macedonia and Montenegro in Central Asia in 2019. The ASRs of diet-induced stroke mortality and DALYs were generally declining in most member states from 1990 to 2019, however, the corresponding metrics in Mongolia remained high. The fastest decline in ASR of mortality and DALYs for diet-induced stroke was seen in Estonia, Eastern Europe, with AAPC values of -7.09% (95%CI: -7.72, -6.46%) and - 6.62% (95%CI: -7.20, -6.03%), respectively. We noted a substantial downward trend in ASR of mortality and DALYs from diet-induced stroke changes in the final decade (2010-2019) for most member states. The ASR of DALYs for diet-induced stroke decreased greater in females than in males. For those aged 50-74, the DALYs for stroke due to dietary risk factors in all other member countries of the "B&R" showed a decreasing trend, except for the Philippines, which rose (AAPC = 2.13, 95%CI: 1.40-2.87%) and Turkmenistan, which remained stable (AAPC = 0.05, 95%CI: -0.43-0.33%). Conclusion: The burden of diet-induced stroke varies substantially across "B&R" countries and threaten public health, relevant evidence-based policies and interventions should be adopted to address the future burden of stroke in "B&R" countries through extensive collaboration.

A Stable Triazole-Based Covalent Gel for Long-Term Cycling Zn Anode in Zinc-Ion Batteries.

In this work, a functional covalent gel material is developed to resolve the severe dendritic growth and hydrogen evolution reaction toward Zn/electrolyte interface in aqueous zinc-ion batteries (ZIBs). A covalent gel layer with superior durability forms homogeneously on the surface of Zn foil. The covalent gel with triazole functional groups can uniformize the transport of Zn2+ due to the interactions between Zn2+ ions and the triazole groups in the covalent gel. As a consequence, the symmetrical battery with triazole covalent gel maintains stable Zn plating/stripping for over 3000 h at 1 mA cm-2 and 1 mAh cm-2 , and the full cell combined with a V2 O5 cathode operates steadily and continuously for at least 1800 cycles at 5 A g-1 with a capacity retention rate of 67.0%. This work provides a train of thought to develop stable covalent gels for the protection of zinc anode toward high-performance ZIBs.

Investigating the factors affecting the competence of a traditional Chinese medicine practitioner using structural equation model.

Background: Compared with other medical sciences, Chinese medicine provides professional advantages in disease prevention and the diagnosis of chronic diseases. The training of Chinese medicine practitioners is worthy of investigation. The present study focused on how structural equation modelling (SEM) can be used to analyze the competencies of traditional Chinese medicine (TCM) practitioners to help training an eligible TCM doctor and select suitable staff for TCM hospital. Methods: Before the analysis of competence factors for TCM, we developed the scale, including literature review, expert consultation, item pool for the proposed competency model, pilot test of the item pool, and finalization of the scale items. We analyzed questionnaires from 400 TCM practitioners in Hangzhou, Guangzhou, and Wuhan, and then performed an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) to extract the valuable items for TCM practitioners. Finally, SEM was employed to develop a competency structure. Results: A total of 21 items in this study's questionnaire were identified as being closely related to the competencies of TCM practitioners, which were further categorized by principal component analysis into five categories: (I) professional values; (II) basic medical knowledge; (III) communication skills; (IV) clinical skills; and (V) information management. Subsequent analyzes showed that clinical skills were the most important competency metric for TCM practitioners; additionally, the mediating role of basic medical knowledge and communication skills could not be ignored in both theory and practice. Conclusions: This research presents a preliminary methodology for evaluating the competence of TCM practitioners and provides hospitals with criteria theoretical reference for training and finding TCM practitioners.

Burden and trend of cardiovascular diseases among people under 20 years in China, Western Pacific region, and the world: An analysis of the global burden of disease study in 2019.

Objectives: Cardiovascular disease (CVD) is a global public health concern, but its disease burden and trend have been poorly studied in people younger than 20 years. This study aimed to fill this gap by evaluating the CVD burden and trend in China, Western Pacific Region, and the world from 1990 to 2019. Methods: We applied the 2019 Global Burden of Diseases (GBD) analytical tools to compare the incidence, mortality, and prevalence of CVD, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs) among people younger than 20 years from 1990 to 2019 in China, the Western Pacific Region, and the world. The trends of disease burden between 1990 and 2019 evaluated using the average annual percent change (AAPC) and the 95% uncertainty interval (UI) were reported. Results: Globally, in 2019, there were 2.37 (95% UI: 1.82 to 3.05) million incidence of CVD, 16.85 (95% UI: 12.56 to 22.03) million prevalence of CVD, and 74386.73 (95% UI: 64543.82 to 86310.24) deaths due to CVD among people under 20 years of age. The trends for DALYs decreased among children and adolescents in China, Western Pacific Region, and the world (AAPC = -4.29, 95% CI: -4.38% to -4.20%; AAPC = -3.37, 95% CI: -3.48% to -3.26%; AAPC = -2.17, 95% CI: -2.24% to -2.09%; p < 0.001, respectively) between 1990 and 2019. With the increase in age, the AAPC values of mortality, YLLs, and DALYs showed a notable downward trend. The AAPC values of mortality, YLLs, and DALYs in female patients were significantly greater than those in male patients. For all subtypes of CVD, the AAPC values showed a downward trend, with the largest reduction observed for stroke. From 1990 to 2019, a decline in the DALY rate for all CVD risk factors was observed, with a significant decrease in environmental/occupational risk factors. Conclusion: Our study shows a decline in the burden and trend of CVD among people younger than 20 years, which reflects the success in reducing disability, premature death, and the early incidence of CVD. More effective and targeted preventive policies and interventions aimed at mitigating preventable CVD burden and addressing risk factors from childhood are urgently needed.

The Associations of Weekend Warrior Activity Patterns With the Visceral Adiposity Index in US Adults: Repeated Cross-sectional Study.

BACKGROUND: According to previous reports, obesity especially visceral fat has become an important public health problem, causing an estimation of 20.5 disability-adjusted life years per 1000 inhabitants. Those who exercised for 1 or 2 days per week and reached the recommended 150 minutes of moderate physical activity (PA) per week have been defined as "weekend warriors" (WWs). Although the benefits of PA in suppressing obesity have been widely studied, the association of WWs with the Visceral Adiposity Index (VAI) and the difference between WW activity and regular PA are yet to be explored. OBJECTIVE: This study aims to explore the association between WW activity and other PA patterns with VAI in US adults. METHODS: The National Health and Nutrition Examination Survey 2007-2016 data set was used, and the analytic sample was limited to adults 20 years and older who had complete information about VAI, PA patterns, and other covariates, including demographic characteristics, behavioral factors, and disease conditions. Participants' characteristics in different PA pattern groups were tested using the Rao and Scott adjusted χ2 test and ANOVA. Univariate and multivariate stepped linear regression models were then used to explore the association between the PA pattern and VAI. Finally, stratified analyses and interaction effects were conducted to investigate whether the association was stable among subgroups. RESULTS: The final sample included 9642 adults 20 years or older, which is representative of 158.1 million noninstitutionalized US adults, with 52.15% (n=5169) being male and 70.8% (n=4443) being non-Hispanic White. Gender, age group, race, education level, income level, marital status, smoking status, alcoholism, VAI, cardiovascular disease, and diabetes were all correlated with the PA pattern, but no relationship between hypertension and PA pattern was observed. After adjusting for demographic covariates, smoking status, alcoholism, cardiovascular disease, diabetes, and hypertension, WW and regularly active adults had a ß of .307 (95% CI -0.611 to -0.003) and .354 (95% CI -0.467 to -0.241), respectively, for reduced VAI when compared with inactive adults, but no significant effect of lowering VAI (ß=-.132, 95% CI -0.282 to 0.018) was observed in insufficiently active adults when compared with inactive adults. Besides, no significant difference was exhibited between WW adults and regularly active adults (ß=.047, 95% CI -0.258 to 0.352), suggesting WW adults had the same benefit of decreasing VAI as regularly active adults. Stratified analyses results exhibited that WW activity was related to reduced VAI in female adults aged 20-44 years who were non-Hispanic Black, other, or multiracial; high school or General Educational Development education; and never married, and the association between PA pattern and VAI remained stable in all demographic subgroups. CONCLUSIONS: Compared with inactive adults, WWs could reduce VAI, and there was no significant difference between WWs and regular active adults in decreasing VAI. Our study provides compelling evidence of the beneficial effect of WW activity on visceral obesity.

Sex- and region-specific associations of skeletal muscle mass with metabolic dysfunction-associated fatty liver disease.

Introduction: Metabolic dysfunction-associated fatty liver disease (MAFLD) is known to be the most common chronic liver disease worldwide, and accumulating evidence suggests that skeletal muscle might play an important role in metabolic health. However, the association between skeletal muscle and MAFLD is poorly understood so far. Therefore, we aimed to evaluate the associations of skeletal muscle with MAFLD and significant fibrosis. Methods: A cross-sectional analysis was conducted using data obtained from the 2017-2018 US National Health and Nutrition Examination Survey. The whole-body, appendicular, and trunk skeletal muscle mass index (SMI) were assessed by dual-energy x-ray absorptiometry. MAFLD and significant fibrosis were assessed by transient elastography. Survey-weight adjusted multivariable logistic regressions were used to determine the associations. The area under the receiver operating characteristic curve (AUC) and variable importance scores from the random forest and logistic regression model were calculated to assess the predictive capability of variables and models. Results: Of the 2065 participants, those with appendicular SMI in the highest quartile were associated with a lower risk for MAFLD in both sexes (male, OR[95%CI]: 0.46 [0.25~0.84]; female, OR[95%CI]: 0.32 [0.13~0.82]), but with a significantly different scale of the associations between sexes (P interaction = 0.037). However, females with trunk SMI in the highest quartile had an increased risk of significant fibrosis (OR[95%CI]: 7.82 [1.86~32.77]). Trunk SMI and appendicular SMI ranked the third contributor to MAFLD in random forest and logistic regression models, respectively. Taking appendicular and trunk SMI into consideration, the AUCs for MAFLD were 0.890 and 0.866 in random forest and logistic regression models, respectively. Discussion: The distribution of skeletal muscle mass differently affects MAFLD and significant fibrosis in the sex groups. Higher appendicular skeletal muscle mass was associated with a lower risk of MAFLD, while the risk of significant fibrosis in females was increased with the trunk skeletal muscle mass.