Low voltage electric-double-layer transistor nonenzymic erythromycin sensors based on molecularly imprinted polymers.

Erythromycin (Ery) is a commonly used antibiotic that can be found ubiquitously in water bodies. The increasing apprehension over the adverse effects of antibiotic remnants in aquatic environments necessitates the prompt advancement of erythromycin detection techniques that are both highly sensitive and compact. Here, we propose a non-enzyme Ery sensor that integrates a mesoporous SiO2-based low-voltage oxide electric-double-layer transistor (EDLT) with a molecular imprinting technique, featuring a molecularly imprinted polymers (MIP) functionalized gate electrode. The mesoporous SiO2-based oxide transistor exhibits excellent electrical characteristics, including an operating voltage of small than 1.0 V, an on/off ratio exceeding 106 and a mobility of 14.95 cm2V-1s-1. At an ultra-low operating voltage within 0.5 V, the sensor exhibits a linear response to the concentration range of 1 nM-10 µM of Ery, with a detection limit of 0.22 nM and a sensitivity of 23.3 mV dec-1. Besides, the single-spike dynamic sensing mode effectively reduces the power consumption of the detection. The proposed sensor provides a rapid and convenient approach to detect Ery in aqueous environments, with benefits such as miniaturization, high sensitivity, and simplicity.

Industrial technology progress, digital finance development and corporate risk-taking: Evidence from China's listed firms.

Industrial technological progress, as an essential industrial-technological and institutional phenomenon, brings with it the possibility of high profits for firms but also implies new norms and rules of competition, which affect the willingness and propensity of firms to bear the costs of undertaking venture capital projects. This study empirically investigates the causal impact of industrial-technological progress on corporate risk-taking and the mechanism of digital financial growth on the relationship between the two, based on data from China's A-share listed businesses from 2011 to 2020. This paper finds that (1) industrial technological progress improves enterprise risk-taking levels. Moreover, digital financial development has an incentive effect on industrial technological progress and enterprise risk-taking levels. (2) Industrial technological progress under digital financial development generates financing constraint relaxation effects, input capital return enhancement effects, and innovation performance incentive effects, increasing enterprise risk-taking. (3) The positive moderating effect of digital financial development on the relationship between industrial technological progress and the risk-taking level of enterprises in the eastern regions and enterprises in the high-tech industry is more prominent. The study's findings provide a theoretical foundation and policy insights on the crucial elements of industrial-technological progress and enterprises' increased ability to take risks throughout the development of digital finance.

Sub-satisfactory stenting recanalization of severe vascular stenosis of the posterior circulation can significantly improve cerebral hemodynamic perfusion.

PURPOSE: To investigate the effect of sub-satisfactory stenting recanalization of severe vascular stenosis of the posterior circulation on cerebral hemodynamic perfusion. MATERIALS AND METHODS: Patients with severe vascular stenosis of the posterior circulation who had undergone three-dimensional cerebral angiography before and after stenting were retrospectively enrolled. Computational fluid dynamic (CFD) analysis of hemodynamic parameters at the stenosis, perforating branch, and normal arterial segments proximal and distal to the stenosis were performed. RESULTS: Sixty-two patients with basilar artery stenosis aged 60.9 ±â€¯9.6 years were enrolled, and stent angioplasty resulted in the reduction of stenosis degree from 85.3 ±â€¯7.2% before to 18.6 ±â€¯6.4% after stenting. After stenting, at the proximal normal artery, the total pressures had significantly (P < 0.05) decreased, whereas all the other parameters (WSS, cell Reynolds number, velocity, vorticity, turbulence intensity, turbulence kinetic energy and dissipation rate) had significantly (P < 0.05) increased. At the stenosis, all hemodynamic parameters had significantly decreased. At the stenosis perforating branch, the WSS, cell Reynolds number, velocity, and vorticity were all significantly decreased, and the total pressure, turbulence intensity, kinetic energy, and dissipation rate were all significantly increased. At the distal normal artery, the total flow pressure (perfusion pressure) and velocity were both significantly (P < 0.05) increased, and the total pressure, WSS, cell Reynolds number, vorticity, turbulence intensity, kinetic energy, and dissipation rate were all significantly (P < 0.05) decreased. The hemodynamic parameters after stenting were closer to those after virtual stenosis repair at all measurements. CONCLUSION: Sub-satisfactory recanalization has significantly restored the stenosis and improved the hemodynamic parameters near the stenosis and at the root of the perforating branch, thus significantly improving the cerebral perfusion, similar to the changes of hemodynamic status and cerebral perfusion after virtual removal of the vascular stenosis. This may indicate the good effect of sub-satisfactory stenting recanalization of the vascular stenosis at the posterior circulation.

Safety and efficacy of enterprise stenting for symptomatic atherosclerotic severe posterior circulation stenosis.

PURPOSE: To investigate the safety and efficacy of Enterprise stent angioplasty and risk factors for the prognoses in treating symptomatic severe posterior circulation atherosclerotic stenosis (SSPCAS). MATERIALS AND METHODS: Patients with SSPCAS who were treated with the Enterprise stent angioplasty were retrospectively enrolled. The clinical data, peri-procedural complications, postoperative residual stenosis, in-stent restenosis and recurrent stroke at follow-up were analyzed. RESULTS: 262 patients with 275 stenotic lesions treated with the Enterprise stent angioplasty were enrolled. The stenosis degree was reduced from 86.3 ± 6.2% before to 19.3 ± 5.4% after stenting. Complications occurred in 14 (5.3%) patients. Clinical follow-up was performed in 245 (93.51%) patients for 16.5 ± 7.3 months. During 1 year follow-up, 7 patients (2.9%) had recurrent symptoms, including 4 patients with stenting in the intracranial vertebral artery and 3 in the basilar artery. Imaging follow-up was conducted in 223 (85.11%) patients. In-stent restenosis was present in 35 patients (15.7%), with the restenosis rate of 26.4% (n = 23) in the intracranial vertebral artery, which was significantly (P < 0.001) greater than in the basilar artery (8.8%). Six patients (17.1%) with in-stent restenosis were symptomatic. The stenotic length was the only significant (P = 0.026 and 0.024, respectively) independent risk factor for 1 year stroke or death events and in-stent restenosis. CONCLUSION: The Enterprise stent can be safely and efficaciously applied in the treatment of symptomatic severe posterior circulation atherosclerotic stenosis, with a relatively low rate of in-stent restenosis and recurrent stroke within 1 year. The stenotic length was the only significant independent risk factor for 1 year stroke or death events and in-stent restenosis.

5.7 GHz Ultrasensitive Shear Horizontal-Surface Acoustic Wave Humidity Sensor Based on LiNbO3/SiO2/SiC Heterostructures with a Sensitive Layer of Polyethyleneimine-SiO2 Nanocomposites.

Humidity sensing and water molecule monitoring have become hot research topics attributed to their potential applications in monitoring breathing/physiological conditions of humans, air conditioning in greenhouses, and soil moisture in agriculture. However, there is a huge challenge for highly sensitive and precision humidity detection with wireless and fast responsive capabilities. In this work, a hybrid/synergistic strategy was proposed using a LiNbO3/SiO2/SiC heterostructure to generate shear-horizontal (SH) surface acoustic waves (SAWs) and using a nanocomposite of polyethylenimine-silicon dioxide nanoparticles (PEI-SiO2 NPs) to form a sensitive layer, thus achieving an ultrahigh sensitivity of SAW humidity sensors. Ultrahigh frequencies (1∼15 GHz) of SAW devices were obtained on a high-velocity heterostructure of LiNbO3/SiO2/SiC. Among the multimodal wave modes, we selected SH waves for humidity sensing and achieved a high mass-sensitivity of 5383 MHz · mm2 · µg-1. With the PEI-SiO2 NP composite as the sensitive layer, an ultrahigh sensitivity of 2.02 MHz/% RH was obtained, which is two orders of magnitude higher than those of the conventional SAW humidity sensors (∼202.5 MHz frequency) within a humidity range of 20-80% RH.

Hydrothermal deposition synthesis of dual-mode luminescent material GdVO4 :Eu3+ /carbon dots with optimal luminescence and its application in anti-counterfeiting.

To obtain optimal luminescence, 0.12 g of GdVO4 :3%Eu3+ nanocrystals (NCs) and different volumes of nitrogen-doped carbon dots (N-CDs) crude solution were used as precursors, and the composite synthesized using the hydrothermal deposition method showed optimal luminescence when 11 ml (2.45 mmol) crude solution was used. In addition, similar composites with the same molar ratio as GVE/cCDs(11) were also prepared with the hydrothermal and physical mixing processes. Based on the test results of XRD, XPS, and PL spectra, for the composite GVE/cCDs(11), the highest (lowest) peak intensity of the C-C/C=C (C=O/C=N) bond, which was 1.18 (0.75) times that of GVE/cCDs-m, indicated most N-CDs deposition and led to their highest emission intensity under 365 nm excitation, although nitrogen atoms in the composite were shed slightly during the deposition process. Finally, as can be seen from the patterns designed for security applications that the optimally luminescent composite is one of the most promising candidates in the anti-counterfeiting field.

Endovascular recanalization of symptomatic non-acute occlusion of the vertebrobasilar artery.

Purpose: The study aimed to investigate the safety, effect, and risk factors of endovascular recanalization of symptomatic non-acute occlusion of the vertebrobasilar artery (SNOVA). Materials and methods: Patients with SNOVA were retrospectively enrolled and treated with endovascular recanalization. The clinical data, endovascular treatment, peri-procedural complications, and follow-up outcomes were analyzed. Results: A total of 88 patients were enrolled, with an interval to recanalization of 2-89 days (median 23) and an mRS of 2-5 (median 3 and IQR 1). Occlusion was in the intracranial vertebral artery in 68 (77.27%) patients and basilar artery in 20 (22.73%), with an occlusion length of 4.5-43.7 mm (mean 18.3 ± 8.8). Endovascular recanalization was successful in 81 (92.0%) patients. Post-dilatation was performed in 23 (28.4%) patients. After stenting, the residual stenosis was 10%-40% (mean 20.2% ± 7.6%). Peri-procedural complications occurred in 17 (19.3%) patients, with a mortality rate of 5.7%. In total, 79 (95.18%) patients underwent follow-up 5-29 (mean 16.9 ± 5.5) months later, with an mRS score of 0-6 (median 1 and IQR 1) at follow-up, being significantly (p < 0.0001) better than that at discharge. Stroke occurred in 9 patients (11.4%) in 1 year. In-stent restenosis occurred in 19 (25.33%) patients. Significant (p < 0.05) independent risk factors were blunt occlusion for successful recanalization, duration to recanalization and blunt occlusion for peri-procedural complications, and post-dilatation for both in-stent restenosis and 1-year stroke or death events. Conclusion: Endovascular recanalization of symptomatic non-acute occlusion of the vertebrobasilar artery is feasible even for a long occlusion segment, with a high recanalization rate, a low complication rate, and a good prognosis. Blunt occlusion and duration from the onset to recanalization may affect successful recanalization and peri-procedural complications while post-dilatation may affect in-stent restenosis and prognosis.

MRI arterial spin labeling in evaluating hemorrhagic transformation following endovascular recanalization of subacute ischemic stroke.

Objective: To investigate the value of the MRI arterial spin labeling (ASL) in evaluating the blood-brain barrier permeability of anterior circulation ischemic lesions in subacute ischemic stroke (SIS) and the risk of hemorrhage transformation (HT) after endovascular recanalization. Materials and methods: Patients with anterior circulation SIS treated with endovascular recanalization were prospectively enrolled. The imaging presentations in the MRI ASL sequences, dynamic contrast-enhanced (DCE) sequence, and Xper CT were studied. The relative cerebral blood flow (rCBF), volume transfer constant (Ktrans), and the weighted Kappa coefficient (rKtrans) were analyzed. Results: Among 27 eligible patients, HT occurred in 7 patients (25.92%). Patients with HT had significantly higher rCBF value (1.56 ± 0.16 vs. 1.16 ± 0.16), Ktrans, (0.08 ± 0.03 min vs. 0.03 ± 0.01 min) and rKtrans (3.02 ± 0.89 vs. 1.89 ± 0.56). The ASL imaging sequence had a high consistency with the DCE sequence and Xper CT with a high weighted Kappa coefficient of 0.91 for the DCE sequence and 0.70 for the Xper CT imaging. The DCE sequence was also highly consistent with the Xper CT in imaging classification with a high weighted Kappa coefficient of 0.78. The rCBF value in the 21 patients with the subcortical and basal ganglia infarction was significantly lower than that in the other 6 patients with the cortical infarction (1.222 ± 0.221 vs. 1.413 ± 0.259, t = 1.795, P = 0.004). Conclusion: The MRI ASL sequence has an important role in evaluating the blood-brain barrier permeability and the risk of hemorrhagic transformation of anterior circulation SIS following endovascular recanalization.

Fabrication of Temperature Sensors with High-Performance Uniformity through Thermal Annealing.

It is considered to be of great significance to monitor human health and track the effect of drugs by measuring human temperature mapping through flexible temperature sensors. In this work, we found that the thermal annealing of flexible temperature sensors based on graphite-acrylate copolymer composites can not only improve the temperature coefficient of resistance (TCR) values of the devices, but also greatly improve the uniformity of the performance of the devices prepared in parallel. The best results were obtained when the devices were annealed at 100 °C, which is believed to be due to the rearrangement of graphite particles to generate more uniform and numerous conductive channels within the conductive composite. We believe this finding might promote the practical development of flexible temperature sensors in body temperature sensing for health maintenance and medical applications.

A Pseudocapacitor Diode Based on Ion-Selective Surface Redox Effect.

Supercapacitor diode (CAPode) is a novel device that integrates ion diode functionality into a conventional electrical double-layer capacitor and is expected to have great applications in emerging fields such as signal propagation, microcircuit rectification, logic operations, and neuromorphology. Here, a brand new pseudocapacitor diode is reported that has both high charge storage (50.2 C g-1 at 20 mV s-1 ) and high rectification (the rectification ratio of 0.79 at 200 mV s-1 ) properties, which is realized by the ion-selective surface redox reaction of spinel ZnCo2 O4 in aqueous alkaline electrolyte. Furthermore, an application of the integrated device is demonstrated in the logic gate of circuit system to realize the logic operations of "AND" and "OR". This work not only expands the types of CAPodes, but also provides a train of thought for constructing high-performance capacitive ionic diodes.

A new strategy to minimize humidity influences on acoustic wave ultraviolet sensors using ZnO nanowires wrapped with hydrophobic silica nanoparticles.

Surface acoustic wave (SAW) technology has been widely developed for ultraviolet (UV) detection due to its advantages of miniaturization, portability, potential to be integrated with microelectronics, and passive/wireless capabilities. To enhance UV sensitivity, nanowires (NWs), such as ZnO, are often applied to enhance SAW-based UV detection due to their highly porous and interconnected 3D network structures and good UV sensitivity. However, ZnO NWs are normally hydrophilic, and thus, changes in environmental parameters such as humidity will significantly influence the detection precision and sensitivity of SAW-based UV sensors. To solve this issue, in this work, we proposed a new strategy using ZnO NWs wrapped with hydrophobic silica nanoparticles as the effective sensing layer. Analysis of the distribution and chemical bonds of these hydrophobic silica nanoparticles showed that numerous C-F bonds (which are hydrophobic) were found on the surface of the sensitive layer, which effectively blocked the adsorption of water molecules onto the ZnO NWs. This new sensing layer design minimizes the influence of humidity on the ZnO NW-based UV sensor within the relative humidity range of 10-70%. The sensor showed a UV sensitivity of 9.53 ppm (mW/cm2)-1, with high linearity (R 2 value of 0.99904), small hysteresis (<1.65%) and good repeatability. This work solves the long-term dilemma of ZnO NW-based sensors, which are often sensitive to humidity changes.

Predictive Functional Linear Models with Diverging Number of Semiparametric Single-Index Interactions.

When predicting crop yield using both functional and multivariate predictors, the prediction performances benefit from the inclusion of the interactions between the two sets of predictors. We assume the interaction depends on a nonparametric, single-index structure of the multivariate predictor and reduce each functional predictor's dimension using functional principal component analysis (FPCA). Allowing the number of FPCA scores to diverge to infinity, we consider a sequence of semiparametric working models with a diverging number of predictors, which are FPCA scores with estimation errors. We show that the parametric component of the model is root-n consistent and asymptotically normal, the overall prediction error is dominated by the estimation of the nonparametric interaction function, and justify a CV-based procedure to select the tuning parameters.

Shotgun metagenomics reveals both taxonomic and tryptophan pathway differences of gut microbiota in major depressive disorder patients.

BACKGROUND: The microbiota-gut-brain axis, especially the microbial tryptophan (Trp) biosynthesis and metabolism pathway (MiTBamp), may play a critical role in the pathogenesis of major depressive disorder (MDD). However, studies on the MiTBamp in MDD are lacking. The aim of the present study was to analyze the gut microbiota composition and the MiTBamp in MDD patients. METHODS: We performed shotgun metagenomic sequencing of stool samples from 26 MDD patients and 29 healthy controls (HCs). In addition to the microbiota community and the MiTBamp analyses, we also built a classification based on the Random Forests (RF) and Boruta algorithm to identify the gut microbiota as biomarkers for MDD. RESULTS: The Bacteroidetes abundance was strongly reduced whereas that of Actinobacteria was significantly increased in the MDD patients compared with the abundance in the HCs. Most noteworthy, the MDD patients had increased levels of Bifidobacterium, which is commonly used as a probiotic. Four Kyoto Encyclopedia of Genes and Genomes (KEGG) orthologies (KOs) (K01817, K11358, K01626, K01667) abundances in the MiTBamp were significantly lower in the MDD group. Furthermore, we found a negative correlation between the K01626 abundance and the HAMD scores in the MDD group. Finally, RF classification at the genus level can achieve an area under the receiver operating characteristic curve of 0.890. CONCLUSIONS: The present findings enabled a better understanding of the changes in gut microbiota and the related Trp pathway in MDD. Alterations of the gut microbiota may have the potential as biomarkers for distinguishing MDD patients form HCs.

Shotgun metagenomics reveals both taxonomic and tryptophan pathway differences of gut microbiota in bipolar disorder with current major depressive episode patients.

BACKGROUND: The microbiome-gut-brain axis, especially the microbial tryptophan biosynthesis and metabolism pathway (MiTBamp), is closely connected to bipolar disorder with current major depressive episode (BPD). METHODS: We performed shotgun metagenomics sequencing (SMS) of faecal samples from 25 BPD patients and 28 healthy controls (HCs). Except for the microbiota taxa and MiTBamp analyses, we also built a classification model using the Random Forests (RF) and Boruta algorithm to find the microbial biomarkers for BPD. RESULTS: Compared to HCs, the phylum Bacteroidetes abundance was significantly reduced, whereas that of the Actinobacteria and Firmicutes were significantly increased in BPD patients. We also identified 38 species increased and 6 species decreased significantly in the BPD group. In the MiTBamp, we identified that two Kyoto Encyclopedia of Genes and Genomes (KEGG) orthologies (KOs) (K00658 and K00837) were significantly lower in the BPD, and five KOs (K01696, K00382, K00626, K01667, and K03781) were significantly higher in the BPD group. We also identified significant genera and species which were closely related to these KOs. Finally, RF classification based on gut microbiota at the genus level can achieve an area under the receiver operating characteristic curve of 0.997. LIMITATIONS: The features of cross-sectional design, limited sample size, the heterogeneity of bipolar disorders, and a lack of serum/plasma tryptophan concentration measurements. CONCLUSIONS: The present findings enable a better understanding of changes in gastrointestinal microbiome and MiTBamp in BPD. Alterations of microbes may have potential as biomarkers for distinguishing the BPD patients form HCs.

Bienenstock-Cooper-Munro Learning Rule Realized in Polysaccharide-Gated Synaptic Transistors with Tunable Threshold.

With reference to the organization of the human brain nervous system, a hardware-based approach that builds massively parallel neuromorphic circuits is of great significance to neuromorphic computing. The Bienenstock-Cooper-Munro (BCM) learning rule, which describes that the synaptic weight modulation exhibits frequency-dependent and tunable frequency threshold characteristics, is more compatible with the working principle of neuromorphic computing systems than spike-timing-dependent plasticity. Therefore, it is interesting to simulate the BCM learning rule on solid-state synaptic devices. Here, we have prepared λ-carrageenan (λ-car) electrolyte-gated oxide synaptic transistors, which exhibit good transistor performances, including a low subthreshold swing of 125 mV/dec, an on/off ratio larger than 106, and a mobility of 9.5 cm2 V-1 s-1. By modulating the initial channel current and spike frequency, the simulation of the BCM rule was successfully realized. The competitive relationship between the drift of protons under an electric field and the spontaneous diffusion of protons can explain this mechanism. The proposed λ-car-gated synaptic transistor has a great significance to neuromorphic computing.

Stretchable elastic synaptic transistors for neurologically integrated soft engineering systems.

Artificial synaptic devices that can be stretched similar to those appearing in soft-bodied animals, such as earthworms, could be seamlessly integrated onto soft machines toward enabled neurological functions. Here, we report a stretchable synaptic transistor fully based on elastomeric electronic materials, which exhibits a full set of synaptic characteristics. These characteristics retained even the rubbery synapse that is stretched by 50%. By implementing stretchable synaptic transistor with mechanoreceptor in an array format, we developed a deformable sensory skin, where the mechanoreceptors interface the external stimulations and generate presynaptic pulses and then the synaptic transistors render postsynaptic potentials. Furthermore, we demonstrated a soft adaptive neurorobot that is able to perform adaptive locomotion based on robotic memory in a programmable manner upon physically tapping the skin. Our rubbery synaptic transistor and neurologically integrated devices pave the way toward enabled neurological functions in soft machines and other applications.

A study on attentional bias and response inhibition of facial expressions in manic patients: evidence from eye movement.

Introduction: In recent years, evidence has accumulated to suggest that patients with bipolar disorder show altered processing of emotionally relevant information. However, only a few studies have examined manic patients' eye movements when processing facial expressions. Method: A free viewing task and anti-saccade task were used separately to investigate attentional bias and response inhibition while processing emotional stimuli. Data were drawn from matched samples of manic patients (n = 25) and healthy controls (n = 20). Results: The analyses of eye-movement data revealed that there was a significant difference between manic patients and healthy controls in the total duration of fixations but not in the orientation or duration of the first fixation. However, no significant differences between manic patients and healthy controls in response inhibition were detected. Conclusion: These results demonstrate that compared to healthy controls, manic patients show a deficiency in processing speed. The patients showed no attentional vigilance to happy or sad expressions but did showed avoidance of the sad expression and focused more on the happy expression in later emotion processing. There were no impairments of response inhibition detected in manic patients. Key points Abnormal processing of emotional information and having aberrant inner-experiences of emotion is a feature of bipolar disorders. Processing speed is slow in manic patients versus healthy controls. Manic patients focused lesser on sad expression than healthy controls, which suggesting an avoidance of sad expressions. The findings show that psychotherapies like CBT may be applicable to manic patients.

Similarly in depression, nuances of gut microbiota: Evidences from a shotgun metagenomics sequencing study on major depressive disorder versus bipolar disorder with current major depressive episode patients.

BACKGROUND: To probe the differences of gut microbiota among major depressive disorder (MDD), bipolar disorder with current major depressive episode (BPD) and health participants. METHODS: Thirty one MDD patients, thirty BPD patients, and thirty healthy controls (HCs) were recruited. All the faecal samples were analyzed by shotgun metagenomics sequencing. Except for routine analyses of alpha diversity, we specially designed a new indicator, the Gm coefficient, to evaluate the inequality of relative abundances of microbiota for each participant. RESULTS: The Gm coefficients are significant decreased in both MDD and BPD groups. The relative abundances of increased phyla Firmicutes and Actinobacteria and decreased Bacteroidetes were significantly in the MDD and BPD groups. At genus level, four of top five enriched genera (Bacteroides, Clostridium, Bifidobacterium, Oscillibacter and Streptococcus) were found increased significantly in the MDD and BPD groups compared with HCs. The genera Escherichia and Klebsiella showed significant changes in abundances only between the BPD and HC groups. At the species level, compared with BPD patients, MDD patients had a higher abundance of Prevotellaceae including Prevotella denticola F0289, Prevotella intermedia 17, Prevotella ruminicola, and Prevotella intermedia. Furthermore, the abundance of Fusobacteriaceae, Escherichia blattae DSM 4481 and Klebsiella oxytoca were significantly increased, whereas the Bifidobacterium longum subsp. infantis ATCC 15697 = JCM 1222 was significantly reduced in BPD group compared with MDD group. CONCLUSIONS: Our study suggested that gut microbiota may be involved in the pathogenesis of both MDD and BPD patients, and the nuances of bacteria may have the potentiality of being the biomarkers of MDD and BPD.

Associations of Resistance Exercise with Cardiovascular Disease Morbidity and Mortality.

PURPOSE: Resistance exercise (RE) can improve many cardiovascular disease (CVD) risk factors, but specific data on the effects on CVD events and mortality are lacking. We investigated the associations of RE with CVD and all-cause mortality and further examined the mediation effect of body mass index (BMI) between RE and CVD outcomes. METHODS: We included 12,591 participants (mean age, 47 yr) who received at least two clinical examinations 1987-2006. RE was assessed by a self-reported medical history questionnaire. RESULTS: During a mean follow-up of 5.4 and 10.5 yr, 205 total CVD events (morbidity and mortality combined) and 276 all-cause deaths occurred, respectively. Compared with no RE, weekly RE frequencies of one, two, three times or total amount of 1-59 min were associated with approximately 40%-70% decreased risk of total CVD events, independent of aerobic exercise (AE) (all P values <0.05). However, there was no significant risk reduction for higher weekly RE of more than four times or ≥60 min. Similar results were observed for CVD morbidity and all-cause mortality. In the stratified analyses by AE, weekly RE of one time or 1-59 min was associated with lower risks of total CVD events and CVD morbidity regardless of meeting the AE guidelines. Our mediation analysis showed that RE was associated with the risk of total CVD events in two ways: RE had a direct U-shaped association with CVD risk (P value for quadratic trend <0.001) and RE indirectly lowered CVD risk by decreasing BMI. CONCLUSION: Even one time or less than 1 h·wk of RE, independent of AE, is associated with reduced risks of CVD and all-cause mortality. BMI mediates the association of RE with total CVD events.