Role of sugars in the apical hook development of Arabidopsis etiolated seedlings.

KEY MESSAGE: The sugar supply in the medium affects the apical hook development of Arabidopsis etiolated seedlings. In addition, we provided the mechanism insights of this process. Dicotyledonous plants form an apical hook structure to shield their young cotyledons from mechanical damage as they emerge from the rough soil. Our findings indicate that sugar molecules, such as sucrose and glucose, are crucial for apical hook development. The presence of sucrose and glucose allows the apical hooks to be maintained for a longer period compared to those grown in sugar-free conditions, and this effect is dose-dependent. Key roles in apical hook development are played by several sugar metabolism pathways, including oxidative phosphorylation and glycolysis. RNA-seq data revealed an up-regulation of genes involved in starch and sucrose metabolism in plants grown in sugar-free conditions, while genes associated with phenylpropanoid metabolism were down-regulated. This study underscores the significant role of sugar metabolism in the apical hook development of etiolated Arabidopsis seedlings.

Ultrasensitive and label-free electrochemical immunosensor for the detection of the ovarian cancer biomarker CA125 based on CuCo-ONSs@AuNPs nanocomposites.

Cancer antigen 125 (CA125) is pivotal as a tumor marker in early ovarian cancer prevention and diagnosis. In this work, we introduced an ultrasensitive label-free electrochemical immunosensor tailored for CA125 detection, leveraging nanogold-functionalized copper-cobalt oxide nanosheets (CuCo-ONSs@AuNPs) as nanocomposites. For the inaugural application, copper-cobalt oxide nanosheets delivered the requisite DPV electrochemical response for the immunosensors. Their large specific surface area and commendable electrical conductivity amplify electron transfer and enable significant gold nanoparticle loading. Concurrently, AuNPs offer a plethora of active sites, facilitating easy immobilization of biomolecules via the bond between amino groups and AuNPs. We employed scanning electron microscopy, transmission electron microscopy, and x-ray photoelectron spectroscopy to characterize the nanomaterials' surface morphology and elemental composition. The electrochemical sensor response signals were ascertained using differential pulse voltammetry. Under optimal conditions, the immunosensor exhibited a linear detection range from 1×10-7 U/mL to 1×10-3 U/mL and a detection limit of 3.9×10-8 U/mL (S/N=3). The proposed label-free electrochemical immunosensor furnishes a straightforward, dependable, and sensitive approach for CA125 quantification and stands as a promising method for clinical detection of other tumor markers.

Meta-analysis of pulsed-field ablation versus cryoablation for atrial fibrillation.

PURPOSE: The available data on the treatment strategy of pulsed field ablation (PFA) for patients with atrial fibrillation (AF) is limited. This study aims to provide a comparative analysis of the efficacy, safety, and procedural efficiency between PFA and cryoballoon ablation (CBA) for AF. METHODS: We conducted a comprehensive search of the EMBASE, PubMed, Cochrane Library, and ClinicalTrials.gov databases to identify trials comparing PFA with CBA for AF from their inception until December 2023. The odds ratio (OR) and mean difference (MD), along with a 95% confidence interval (CI), were utilized as measures of treatment effect. RESULTS: The analysis included 15 eligible trials with a total enrollment of 1880 patients. No significant differences were found in recurrent atrial arrhythmia (OR 0.83, 95% CI 0.64, 1.07) or periprocedural complications (OR 0.78, 95% CI 0.46, 1.30) between the two ablation techniques examined in this study. However, the PFA technique demonstrated a significantly shorter procedure time (MD -7.17, 95% CI -13.60, -0.73), but a longer fluoroscopy time (MD 2.53, 95% CI 0.87, 4.19). Similarly, PFA was found to be significantly associated with a decreased incidence of phrenic nerve palsy (OR 0.20, 95% CI 0.07, 0.59), but an increased incidence of cardiac tamponade (OR 4.07, 95% CI 1.15, 14.39). Moreover, there was a significantly higher release of troponin with PFA compared to CBA (MD 470.28, 95% CI 18.89, 921.67), while the increase in S100 protein and heart rate was significantly lower with PFA than with CBA (MD -64.41, 95% CI -105.46, -17.36), (MD -8.76, 95% CI -15.12, -2.40). CONCLUSION: The utilization of PFA provides a safer, time-saving, and tissue-specific procedure compared to CBA, while maintaining comparable success rates. This has the potential to enhance procedural efficiency and optimize resource utilization in clinical practice. These findings underscore the feasibility and promise of PFA as an alternative technique for PVI in patients with AF.

[Research on fault diagnosis of patient monitor based on text mining].

The conventional fault diagnosis of patient monitors heavily relies on manual experience, resulting in low diagnostic efficiency and ineffective utilization of fault maintenance text data. To address these issues, this paper proposes an intelligent fault diagnosis method for patient monitors based on multi-feature text representation, improved bidirectional gate recurrent unit (BiGRU) and attention mechanism. Firstly, the fault text data was preprocessed, and the word vectors containing multiple linguistic features was generated by linguistically-motivated bidirectional encoder representation from Transformer. Then, the bidirectional fault features were extracted and weighted by the improved BiGRU and attention mechanism respectively. Finally, the weighted loss function is used to reduce the impact of class imbalance on the model. To validate the effectiveness of the proposed method, this paper uses the patient monitor fault dataset for verification, and the macro F1 value has achieved 91.11%. The results show that the model built in this study can realize the automatic classification of fault text, and may provide assistant decision support for the intelligent fault diagnosis of the patient monitor in the future.

Dietary carbohydrate types, genetic predisposition, and risk of adult-onset asthma: A longitudinal cohort study.

We aimed to investigate the longitudinal associations among carbohydrate intake types, genetic predisposition, and risk adult onset asthma (AOA). A dataset of 96,487 participants from UK Biobank was included with 1830 cases of incident AOA during an average follow-up of 9.68 years. Participants with the highest intake of total sugar, free sugar, and fiber intake, as compared to those with the lowest intake of total sugar, free sugar, and fiber intake, showed a 17 % and 22 % increased risk of incident AOA, and a 16 % decreased risk of AOA, respectively. Substitution of 5 % energy from free sugars with 5 % energy from non-free sugars was associated with a significantly lower risk of AOA (Hazard Ratio [HR] = 0.93, 95 % Confidence Interval [CI]: 0.88, 0.99). Participants with high genetic risk and the highest intake of free sugar showed a 112 % (HR = 2.12, 95%CI: 1.68, 2.68) increased risk of incident AOA. Participants with low genetic risk and highest intake of fiber showed a 50 % (HR = 0.50, 95%CI: 0.39, 0.64) reduced risk of AOA. This study highlights the critical role of carbohydrate types in AOA prevention, with an emphasis on reduced free sugar, moderate non-free sugar, and increased fiber intake.

Sandwich-type immunosensor based on aminated 3D-rGOF-NH2 and CMK-3-Fc-MgAl-LDH multilayer nanocomposites for detection of CA125.

Cancer antigen 125 (CA125)1 is the most important biological screening indicator used to monitor epithelial ovarian cancers, and it plays a vital role in distinguishing ovarian cancers from benign diseases. Biosensors show great potential in the analysis and detection of disease markers. In this study, we designed electrochemical sensors based on three-dimensional amino-functionalized reduced graphene oxide (3D-rGOF-NH2),2 MgAl layered double hydroxide nanocomposites containing ordered mesoporous carbon (CMK-3),3 and ferrocene carboxylic acids（Fc-COOH）4for the detection of CA125. 3D-rGOF-NH2 possesses good conductivity, a large surface area, and high porosity, enabling more immobilized nanoparticles to be deposited on its surface with excellent stability. CMK-3@Fc@MgAl-LDH nanocomposite was used as a carrier to enhance the immobilization of antibodies and the loading of Fc, conductors to enhance conductivity, and enhancers to gradually amplify the signal of Fc. The surface morphology, elemental composition, and surface groups of the materials were characterized using scanning electron microscopy (SEM),5 transmission electron microscopy (TEM),6 and X-ray diffraction (XRD)7 techniques. The response signal of the electrochemical sensor was measured by DPV. Under the optimal conditions, the electrochemical sensor obtained a linear detection range of 0.01 U/mL-100 U/mL with a detection limit of 0.00417 U/mL.

Life's Essential 8, genetic predisposition, and risk of incident adult-onset asthma: a prospective cohort study.

BACKGROUND: Adult-onset asthma (AOA) and cardiovascular diseases shared common risk factors and similar pathophysiologic resemblances. The American Heart Association (AHA) unveiled the life's essential 8 (LE8) to promote cardiovascular health (CVH). This study aimed to assess the overall impact of LE8 implementation on AOA prevention. METHODS: According to the guideline of AHA's Construct of CVH in 2022, LE8 score was calculated from 8 health status concerning diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. Cox proportional-hazards models were used to estimate effect sizes of associations between CVH, asthma genetic risk, and risk of incident AOA in participants selected from the UK Biobank study. RESULTS: A total of 6180 incident AOA cases occurred in 249,713 participants during an average of 11.60 y' follow-up. A higher LE8 score was associated with a lower risk of incident AOA with a significant linear trend (P < 0.0001). Every standard deviation increment of LE8 was associated with a 17% (HR: 0.83; 95% CI: 0.81, 0.85) lower risk of incident AOA. Compared with participants with low-CVH score, participants with moderate (HR: 0.72; 95% CI: 0.67, 0.78) and high CVH scores (HR: 0.52; 95% CI: 0.47, 0.58) were associated with a lower risk of incident AOA (P-trend < 0.0001). No significant multiplicative or additive interaction was found between LE8 score and genetic risks. Stratified analysis showed a consistent association between CVH and risk of incident AOA across different asthma polygenic risk score (PRS) levels. Compared with participants with high PRS and low CVH, participants with low PRS and high CVH experienced the lowest risk (HR: 0.28; 95% CI: 0.23, 0.34) of incident AOA. CONCLUSIONS: Our findings suggest that maintaining optimal CVH should be recommended as a preventive strategy for AOA, regardless of their asthma genetic risks.

Identifying interactions among air pollutant emissions on diabetes prevalence in Northeast China using a complex network.

BACKGROUND: Low air quality related to ambient air pollution is the largest environmental risk to health worldwide. Interactions between air pollution emissions may affect associations between air pollution exposure and chronic diseases. Therefore, this study aimed to quantify interactions among air pollution emissions and assess their effects on the association between air pollution and diabetes. METHODS: After constructing long-term emission networks for six air pollutants based on data collected from routine monitoring stations in Northeast China, a mutual information network was used to quantify interactions among air pollution emissions. Multiple linear regression analysis was then used to explore the influence of emission interactions on the association between air pollution exposure and the prevalence of diabetes based on data reported from the Northeast Natural Cohort Study in China. RESULTS: Complex network analysis detected three major emission sources in Northeast China located in Shenyang and Changchun. The effects of particulate matter (PM2.5 and PM10) and ground-level ozone (O3) emissions were limited to certain communities but could spread to other communities through emissions in Inner Mongolia. Emissions of sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) significantly influenced other communities. These results indicated that air pollutants in different geographic areas can interact directly or indirectly. Adjusting for interactions between emissions changed associations between air pollution emissions and diabetes prevalence, especially for PM2.5, NO2, and CO. CONCLUSIONS: Complex network analysis is suitable for quantifying interactions among air pollution emissions and suggests that the effects of PM2.5 and NO2 emissions on health outcomes may have been overestimated in previous population studies while those of CO may have been underestimated. Further studies examining associations between air pollution and chronic diseases should consider controlling for the effects of interactions among pollution emissions.

Precious metal clusters as fundamental agents in bioimaging usability.

Fluorescent nanomaterials (NMs) are widely used in imaging techniques in biomedical research. Especially in bioimaging systems, with the rapid development of imaging nanotechnology, precious metal clusters such as Au, Ag, and Cu NMs have emerged with different functional agents for biomedical applications. Compared with traditional fluorescent molecules, precious metal clusters have the advantages of high optical stability, easy regulation of shape and size, and multifunctionalization. In addition, NMs possess strong photoluminescent properties with good photostability, high release rate, and sub-nanometer size. They could be treated as fundamental agents in bioimaging usability. This review summarizes the recent advances in bioimaging utilization, it conveys that metal clusters refer to Au, Ag, and Cu fluorescent clusters and could provide a generalized overview of their full applications. It includes optical property measurement, precious metal clusters in bioimaging systems, and a rare earth element-doped heterogeneous structure illustrated in biomedical imaging with specific examples, that provide new and innovative ideas for fluorescent NMs in the field of bioimaging usability.

Adherence to healthy lifestyle was associated with an attenuation of the risk of chronic kidney disease from metabolic dysfunction-associated fatty liver disease: Results from two prospective cohorts.

AIMS: Non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) are important risk factors of chronic kidney disease (CKD). Whether adherence to a healthy lifestyle can modify these effects remain unknown. This study aimed to evaluate the modification effects of healthy lifestyle on the associations among NAFLD, MAFLD, and the risk of CKD, with taking into the effect of genetic risk. METHODS: The Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study (TCLSIH), the UK Biobank Study (UKB). The outcome was incident CKD. The exposures including NAFLD, MAFLD, healthy lifestyle, and a genetic risk score (GRS) for CKD. RESULTS: After 1,135,334 person-year follow-up, we documented 2975 incident CKD cases in the two cohorts. MAFLD and NAFLD were associated with a higher risk of CKD, particularly in patients with MAFLD. In the TCLSIH and UKB, the hazard ratios (95% confidence intervals) of incident CKD for MAFLD were 1.47 (1.30, 1.66) and 1.73 (1.57, 1.91), respectively. Adherence to a healthier lifestyle decreased the risk of CKD from MAFLD with significant interaction effects (TCLSIH: Pinteraction = 0.02; UKB: Pinteraction = 0.04). Participants with a lower CKD-GRS experienced a higher risk of CKD from MAFLD, but achieved two healthy lifestyles can significantly decreased the risk of CKD in patients with MAFLD. CONCLUSIONS: MAFLD and NAFLD are associated with a higher CKD risk, particularly MAFLD. Adherence to a healthier lifestyle was associated with a lower risk of CKD from MAFLD. These results highlight the important role of following a healthy lifestyle to prevent CKD.

Dietary patterns, uric acid levels, and hyperuricemia: a systematic review and meta-analysis.

Background: Studies investigating the effects of dietary intake on serum uric acid (SUA) and hyperuricemia have yielded inconsistent results. Therefore, we conducted a meta-analysis to assess the associations between various dietary patterns and SUA levels as well as hyperuricemia. Methods: We searched PubMed, Web of Science, and EMBASE databases for relevant articles examining the association between dietary intake and SUA levels and/or hyperuricemia published until March 2023. Dietary intake patterns were classified into plant-based, animal-based, and mixed dietary patterns based on predominant foods. The pooled effect sizes of eligible studies and their corresponding 95% confidence intervals (CIs) were estimated using random-effects models. Publication bias was assessed using Egger's test. Results: We included 41 studies, comprising 359 317 participants, that investigated the effects of dietary patterns on SUA levels (n = 25) and hyperuricemia (n = 19). Our findings suggested that a plant-based dietary pattern was associated with decreased SUA levels in both interventional (standard mean difference: -0.24 mg dL-1, 95% CI: -0.42, -0.06; I2 = 61.4%) and observational studies (odds ratio (OR): 0.92, 95% CI: 0.89, 0.95, I2 = 91.1%); this association was stronger in men (OR: 0.45, 95% CI: 0.35, 0.58; I2 = 0). We observed that plant- and animal-based dietary patterns were associated with a reduced risk (OR: 0.75; 95% CI: 0.67, 0.83, I2 = 93.3%) and an increased risk (OR: 1.38; 95% CI: 1.20, 1.59, I2 = 88.4%) of hyperuricemia, respectively. Conclusions: Collectively, a plant-based dietary pattern is negatively associated with SUA levels and hyperuricemia. Therefore, a plant-based dietary pattern should be recommended for the management of SUA levels and the prevention of hyperuricemia.

Internet accessibility and incident depressive symptoms in middle aged and older adults in China: A national longitudinal cohort study.

BACKGROUND: With the rapid development of the Internet over the past ten years, its widespread applications and accessibility may cause dynamic changes in the association between internet use and depressive symptoms. OBJECTIVE: We aim to explore the association between internet accessibility (including broadband connection, internet use, frequency, and devices for internet use), as well as its changes, and the risk of incident depressive symptoms for middle aged and older adults based on a cohort study. METHODS: 8772 participants with three repeat waves of follow-up (average 6.04 years) were included. Cox proportional hazards regressions were used to explore risk effects. Hazard ratios (HRs) and 95 % Confidence Intervals [CI] were presented. RESULTS: Incidence density for depressive symptoms was 53.89 for every 1000 person-years. The rate of internet usage by middle aged and older adults in China increased evidently from 2012 to 2018 (16.39 % vs 77.41 %). Broadband internet connection (BIC) (HR = 0.80, 95%CI: 0.71, 0.90) and moderate frequency of internet use (IU) (HR = 0.30, 95%CI: 0.10, 0.92) were associated with decreased risk of depressive symptoms. Participants who changed from no internet accessibility to internet accessibility were associated with a lower risk of depressive symptoms (BIC: HR = 0.46, 95%CI: 0.41, 0.51; IU: HR = 0.42, 95%CI: 0.34, 0.51). Using large screen devices (HR = 0.64, 95%CI: 0.45, 0.91) for internet access, instead of phones, was associated with lower risk of depressive symptoms. CONCLUSIONS: Older adults should be encouraged to use the Internet; online time, frequency, and devices for internet use should be considered simultaneously.

Dietary intake patterns during pregnancy and excessive gestational weight gain: a systematic review and meta-analysis.

Excessive gestational weight gain (EGWG) is associated with gestational complications and adverse birth outcomes. Dietary intake is closely related to EGWG; however, evidence of the association between different dietary patterns and EGWG is inconsistent. We conducted a meta-analysis to systematically evaluate this association using articles from PubMed, Embase, and Web of Science databases published up to March 1st 2023 and included observational studies revealing an association between EGWG and dietary patterns during pregnancy. Dietary patterns were categorized into three groups: healthy, unhealthy, and mixed. Summary odds ratio (OR) and 95% confidence interval (CI) were calculated using the fixed-effects (I2 < 50%) or random-effects model (I2 ≥ 50%). Fourteen studies from eleven countries, including a total of 77,550 participants, met the inclusion criteria. The overall effect of healthy dietary patterns on EGWG was non-significant. After excluding one result in overweight participants, a significant negative association between healthy dietary patterns and EGWG was found in studies with a priori defined healthy dietary patterns (OR = 0.97, 95% CI: 0.94-1.00, P = 0.047), with sample size <1000 (OR = 0.68, 95% CI: 0.48-0.97, P = 0.031), and cohort studies (OR = 0.97, 95% CI: 0.95-1.00, P = 0.043). Overall analysis revealed a significant association between unhealthy dietary patterns and EGWG (OR = 1.22, 95% CI: 1.02-1.45, P = 0.031), and the results were similar in sub-groups of cohort studies (OR = 1.23, 95% CI: 1.02-1.49, P = 0.009) and those with a sample size < 1000 (OR = 1.31, 95% CI: 1.07-1.61, P = 0.03). A healthy dietary pattern instead of an unhealthy dietary pattern is recommended for pregnant women to prevent EGWG. This meta-analysis was registered in PROSPERO as CRD42023404179.

Overcoming Multidrug Resistance by Base-Editing-Induced Codon Mutation.

Multidrug resistance (MDR) is the main obstacle in cancer chemotherapy. ATP binding cassette (ABC) transporters on the MDR cell membrane can transport a wide range of antitumor drugs out of cells, which is one of the main causes of MDR. Therefore, disturbing ABC transporters becomes the key to reversing MDR. In this study, we implement a cytosine base editor (CBE) system to knock out the gene encoding ABC transporters by base editing. When the CBE system works in MDR cells, the MDR cells are manipulated, and the genes encoding ABC transporters can be inactivated by precisely changing single in-frame nucleotides to induce stop (iSTOP) codons. In this way, the expression of ABC efflux transporters is reduced and intracellular drug retention is significantly increased in MDR cells. Ultimately, the drug shows considerable cytotoxicity to the MDR cancer cells. Moreover, the substantial downregulation of P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP) implies the successful application of the CBE system in the knockout of different ABC efflux transporters. The recovery of chemosensitivity of MDR cancer cells to the chemotherapeutic drugs revealed that the system has a satisfactory universality and applicability. We believe that the CBE system will provide valuable clues for the use of CRISPR technology to defeat the MDR of cancer cells.

Exposure to ambient air pollution and metabolic kidney diseases: evidence from the Northeast China Biobank.

BACKGROUND: At present, there is no epidemiological evidence of the association between metabolic kidney diseases (MKD) and exposure to air pollution. METHODS: We investigated the association between exposure to long-term air pollution and the risk of developing MKD using samples from the Northeast China Biobank. RESULTS: Data from 29 191 participants were analyzed. MKD prevalence was 3.23%. Every standard deviation increment in PM2.5 increased the risk of MKD [odds ratio (OR) = 1.37, 95% confidence interval (CI) 1.19-1.58), diabetic kidney disease (DKD) (OR = 2.03, 95% CI 1.52-2.73), hypertensive kidney disease (BKD) (OR = 1.31, 95% CI 1.11-1.56), hyperlipidemic kidney disease (PKD) (OR = 1.39, 95% CI 1.19-1.63) and obese kidney disease (OKD) (OR = 1.34, 95% CI 1.00-1.81). PM10 increased the risk of MKD (OR = 1.42, 95% CI 1.20-1.67), DKD (OR = 1.38, 95% CI 1.03-1.85), BKD (OR = 1.30, 95% CI 1.07-1.58) and PKD (OR = 1.50, 95% CI 1.26-1.80). Sulfur dioxide increased the risk of MKD (OR = 1.57, 95% CI 1.34-1.85), DKD (OR = 1.81, 95% CI 1.36-2.40), BKD (OR = 1.44, 95% CI 1.19-1.74) and PKD (OR = 1.72, 95% CI 1.44-2.04). Ozone decreased the risk of PKD (OR = 0.83, 95% CI 0.70-0.99). Age, ethnicity and air pollution interacted to affect the risk of MKD, BKD and PKD. Associations between air pollution and CKD or metabolic disease were weaker than those with MKD. The association between air pollution and MKD became stronger when compared with participants with non-metabolic disease. CONCLUSIONS: Air pollution may cause MKD or facilitate the progression from metabolic disease to renal failure.

Association between water source and chronic gastrointestinal diseases in Chinese: A cross-sectional and longitudinal study.

Background: Gastrointestinal health is closely associated with the quality of the water supply. However, long-term associations between the water supply type and chronic gastrointestinal disease (CGD) are unclear. Method: The water supply was categorized as "tap-water" or "non-tap water" use. Changes in water source use were categorized into four types: "non-tap water both at baseline and in follow-ups," "non-tap water at baseline and tap-water in follow-ups," "tap-water at baseline and non-tap water in follow-ups," or "tap-water at baseline and in follow-ups." We explored the association between tap-water use (and changes therein) and the risk of CGD in a cross-sectional and longitudinal population study based on national cohort data from 2011 to 2018. Results: After the inclusion and exclusion process, 13,332 and 9,688 participants were included in the cross-sectional and longitudinal analyses, respectively. Tap-water use was associated with fewer CGD cases at baseline (OR = 0.98, 95% CI: 0.90, 1.07). Tap-water use at baseline was associated with significantly lower incidence of CGD in follow-ups (HR = 0.70, 95% CI: 0.70, 0.90). Compared with consistent non-tap water use in both baseline and follow-ups, switching from non-tap water to tap-water use in follow-ups was associated with a lower risk of CGD (HR = 0.79, 95% CI: 0.64, 0.97), tap water use at both baseline and in follow-ups was associated with a lower risk of CGD (HR = 0.72, 95% CI: 0.59, 0.88). The decreased risk of CGD followed a linear trend (P fortrend < 0.01). Adjustment for indoor solid fuel use and outdoor air pollution exposure to PM2.5 did not change the association between tap water use and CGD. Conclusion: Tap water use was associated with a reduced risk of incident CGD. The results from this study should aid in effect assessment for water purification strategies and public decision support for gastrointestinal health management.

Household solid fuel use and stroke incidence: Evidence from a national cohort study.

Stroke is one of the leading causes of global mortality and disability. No specific study has focused on the association between household solid fuel use for different purposes and incident stroke. Therefore, we explored the associations between household solid fuel use purposes and switches and incident stroke based on a national prospective cohort study. There were 12,485 participants included in this study after exclusions. The incidence density of stroke was 8.29 for every 1,000 person-years. Household solid fuel use simultaneously for heating and cooking had the largest hazard effect on stroke occurrence [hazard ratio (HR), 1.35; 95% confidence interval (CI), 1.07, 1.70] with a significant linear trend (P < 0.01). Solid fuel use for cooking was significantly associated with increased risk of stroke occurrence (HR, 1.27; 95% CI, 1.06, 1.51). Persistent clean fuel use for both heating and cooking associated with a lower risk of stroke occurrence (HR, 0.79; 95% CI: 0.64, 0.99), and switching from solid fuel to clean-fuel use for cooking associated with a lower risk of stroke occurrence (HR, 0.89; 95% CI, 0.73, 1.09) compared with persistent solid fuel use. Effective measures to improve the household cooking environment may be necessary to prevent incident stroke.

Shape Memory Alloy Helical Microrobots with Transformable Capability towards Vascular Occlusion Treatment.

Practical implementation of minimally invasive biomedical applications has been a long-sought goal for microrobots. In this field, most previous studies only demonstrate microrobots with locomotion ability or performing a single task, unable to be functionalized effectively. Here, we propose a biocompatible shape memory alloy helical microrobot with regulative structure transformation, making it possible to adjust its motion behavior and mechanical properties precisely. Especially, towards vascular occlusion problem, these microrobots reveal a fundamental solution strategy in the mechanical capability using shape memory effect. Such shape-transformable microrobots can not only manipulate thrust and torque by structure to enhance the unclogging efficiency as a microdriller but also utilize the high work energy to apply the expandable helical tail as a self-propulsive stent. The strategy takes advantage of untethered manipulation to operate microsurgery without unnecessary damage. This study opens a route to functionalize microrobots via accurate tuning in structures, motions, and mechanical properties.

Bi-directional associations between depressive symptoms and asthma in middle-aged and elderly adults in China.

BACKGROUND: There is currently no evidence of an association between depressive symptoms and asthma among older adults in China. We explored the bi-directional associations between depressive symptoms and asthma, and their changes in middle-aged and elderly adults from a national cohort. METHODS: A longitudinal cohort study was conducted with a total of 17,708 individuals from 150 urban communities and 450 rural villages in 28 provinces in China. RESULTS: After making exclusions, 11,492 and 8604 participants were included for incident asthma and incident depressive symptoms analysis, respectively. The incidence density was 4.46 and 10.24 for every 1000 person-years, respectively. Baseline depressive symptoms were associated with a higher risk of incident asthma (Hazard ratio [HR] = 1.60, 95 % confidence interval [CI]: 1.27, 2.02). Decreased depressive symptoms during baseline or follow-ups or both baseline and follow-ups were associated with a lower risk of incident asthma (Pfor trend < 0.0001). Every 1-score increment of CES-D score was associated with a 4 % increase in asthma, with a non-linear association (P = 0.04) between CES-D score (break point = 7) and asthma. Asthma status increased the risk of participants with severe depressive symptoms (HR = 1.51, 95 % CI: 1.19, 1.92), especially in males (Pfor interaction = 0.02). LIMITATIONS: Depressive symptoms and asthma were assessed by validated questionnaires instead of clinical diagnosis. CONCLUSIONS: Bi-directional associations between asthma and depressive symptoms do exist. Effective measures should be taken to reduce depressive symptoms and the risk of incident asthma in middle aged and elderly adults in China.