"Urological age" as a proxy of healthy longevity: analysis of prospective population-based cohorts in U.S. and China.

BACKGROUND: Assessing urinary symptoms poses a complex challenge for primary care practitioners. In evaluating urological function, our approach involves constructing an urological age through the analysis of laboratory parameters and indicators of the urinary system. METHODS: Based on the National Health and Nutrition Examination Survey (NHANES), urological laboratory tests and age-related symptoms were included in the development of urological age (UA) and urological age acceleration (UAA) through the Klemera Doubal method. In relation to mortality associated with UAA, the metric was categorized into grades (0, 1, 2) as a discrete variable. We investigated the correlation between UAA and its grades with mortality, conducted survival analysis based on UAA grades, and explored the correlation between multisystem ageing-related disorders and UAA grades based on the NHANES and the West China Natural Population Cohort Study. RESULTS: UA was related to age with the r to 0.85 in men and 0.84 in women. Each year the increase in UAA was related to higher 1% and 4% mortality for men and women. Those with UAA grades 1 and 2 were associated with more risk of mortality than individuals with UAA grade 0 (men 8% and 40%, women 24% and 157%). The advanced UAA grades kept pace with multisystem ageing. Healthy diets and lifestyle habits are associated with lower UAA. CONCLUSION: Urological age is related to multisystem ageing and increases mortality risk, and urological age can be used to screen high-risk individuals and inform precision clinical development for ageing intervention.

An Artificial Intelligence-Driven Approach for Automatic Evaluation of Right-to-Left Shunt Grades in Saline-Contrasted Transthoracic Echocardiography.

BACKGROUND: Intracardiac or pulmonary right-to-left shunt (RLS) is a common cardiac anomaly associated with an increased risk of neurological disorders, specifically cryptogenic stroke. Saline-contrasted transthoracic echocardiography (scTTE) is often used for RLS diagnosis. However, the identification of saline microbubbles in the left heart can be challenging for novice residents, potentially leading to a delay in diagnosis and treatment. In this study, we proposed an artificial intelligence (AI)-based algorithm designed to automatically detect microbubbles in scTTE images and evaluate right-to-left shunt grades. This tool aims to support residency training and decrease the workload of cardiologists. METHODS: A dataset of 23,665 scTTE images obtained from 174 individuals was included in this study. This dataset was partitioned into a training set (n = 20,475) and an internal validation set (n = 3,190) on a patient-level basis. An additional cohort of 33 patients diagnosed with cryptogenic ischemic stroke was enrolled as an external validation set. The proposed algorithm for right-to-left shunt degree classification employed the EfficientNet-b4 model, and the model's performance was evaluated using the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity, and compared to the performance of residents. RESULTS: Our AI model demonstrated robust performance with an accuracy of 0.926, sensitivity of 0.827, and specificity of 0.951 on the internal testing dataset. In the external validation set, our AI model exhibited diagnostic accuracy, sensitivity, and specificity of 0.864, 0.818, and 0.909, respectively. In comparison, residents achieved values of 0.727, 0.636, and 0.818, respectively. CONCLUSION: Our AI model provides a swift, precise, and easily deployable methodology for grading the degree of right-to-left shunt in scTTE, carrying substantial implications for routine clinical practice. Residents can benefit from our artificial intelligence-based algorithm, enhancing both the accuracy and efficiency of RLS diagnosis.

Associations between urinary concentrations of bisphenols and serum concentrations of sex hormones among US. Males.

BACKGROUND: Bisphenol A (BPA) exposure and its structural analogs (BPS and BPF) might cause endocrine alterations and adverse physiological effects. Few studies to date have directly explored the association between its structural analogs (BPS, BPF) and sex hormones in adult male participants. Therefore, we aimed to assess the associations between BPA, BPS, BPF, and sex hormones in American adult men. METHODS: We used data from the U.S. National Health and Nutrition Examination Survey 2011-2016. We excluded participants without data available on sex hormones and urinary bisphenols. Furthermore, participants consuming sex hormone medications were excluded. Multivariable regression models were performed to assess the association between bisphenols and sex hormones. RESULTS: In this study, 2367 participants were included. Of 2367, in 1575 participants, the data on BPS and BPF were available. We found that a per unit increase in BPF was associated with 0.575 ng/dL higher total testosterone (TT) (Model 2: 95% CI: 0.047, 1.103, P = 0.033). However, there was no significant association between BPA or BPS and TT. Furthermore, increased BPA and BPS levels were associated with higher levels of sex hormone-binding globulin (SHBG) (Model 2: ß = 0.364, 95% CI: 0.158, 0.571; ß = 0.25, 95% CI: 0.071, 0.429, respectively). Additionally, participants in the highest BPA exposure quartile (quartile 4) had 4.072 nmol/L higher levels of SHBG than those in quartile 1 (Model 2: 95% CI: 0.746, 7.397, P = 0.017; P for trend =0.005). Both BPA and BPS were negatively associated with free testosterone (FT, nmol/L) after full adjustment (Model 2, ß = - 0.01%, P = 0.0211, P = 0.0211; Model 2, ß = - 0.01%, P = 0.0258, respectively). However, BPF was positively associated with FT (Model 2, ß = 0.0029%, P = 0.0028). CONCLUSION: Our study indicated that exposure to both BPA and its substitutions could alter sex hormone levels. This finding supports the possibility that human exposure to bisphenols at environmental levels might affect the endogenous hormone balance.

Association of sleep quality with lower urinary tract symptoms/benign prostatic hyperplasia among men in China: A cross-sectional study.

Objective: As the population aged, voiding dysfunction has been steadily rising among males during the past decade. Increasing evidence showed that sleep disorders are associated with an increasing risk of various diseases, but the association between sleep disorders and lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) among Chinese males have not been well characterized. Materials and methods: We conducted a cross-sectional analysis of data from West China Natural Population Cohort Study (WCNPCS) 2019-2021. Sleep quality was assessed by Pittsburgh sleep quality index (PSQI) in Chinese version. LUTS/BPH as a dependent variable of a binary variable, assessed by a self-reported questionnaire. Multivariate logistic regression analysis were performed to evaluate the correlation between sleep disorders and the risk of LUTS/BPH after adjusting for confounding factors. Results: 11,824 eligible Chinese men participated in this cross-sectional survey. In multivariate logistic regression analysis, after adjusting for confounding variables, global PSQI score (OR: 1.257, 1.119-1.411, p < 0.001) and its six compounds (Subjective sleep quality: OR: 1.376, 1.004-1.886, p = 0.048; Sleep latency: OR: 0.656, 0.557-0.773, p < 0.001; Sleep duration: OR: 1.441, 1.189-1.745, p < 0.001; Habitual sleep efficiency: OR: 1.369, 1.193-1.570, p < 0.001; Daytime dysfunction: OR: 1.702, 1.278-2.267, p < 0.001) except the use of sleep drug subgroup were significantly positively correlated with LUTS/BPH prevalence. Significant interaction effects were observed in age subgroups (age-young group: age < 51; age-middle group: 51 ≤ age ≤ 61; age-older group: age > 61) (P < 0.05). Among older participants, sleep disorders were more significantly associated with the risk of LUTS/BPH. Conclusion: There was a significant association between poor sleep quality and increased prevalence of LUTS/BPH, especially among the elderly male population, suggesting an important role of healthy sleep in reducing prostate disease burden.

A single-sample mRNA molecular classification of bladder cancer predicting prognosis and response to immunotherapy.

Background: As an immunogenic cancer, crosstalk between cancer cells and immune cells has been gradually recognized in bladder cancer (BC). Several studies have emphasized the clinical significance of the molecular stratification of BC without highlighting the role of the immune microenvironment. Although immunotherapy acted as a prospective treatment, more precise molecular stratification should be established to select those sensitive to immunotherapy. Methods: To select specific immune genes forming subtypes indicating disparate prognoses, we performed bioinformatic analysis using BC transcriptomic profiles from six published datasets, with 408 BC samples in The Cancer Genome Atlas (TCGA) database and 295 individuals in International Cancer Genome Consortium (ICGC) database. Survival analyses were conducted using Kaplan-Meier curves, while Kruskal-Wallis tests were applied to test the differences among groups. Except for unsupervised clustering based on the differential expression of genes, we additionally performed binomial logistic regression, focusing on the mRNA level of a single sample. Results: Unsupervised clustering showed that 4 clusters captured the best segmentation. After validation with survival data and simplification using binomial logistic regression, we found that cluster B and cluster D showed worse survival outcomes (P=0.012). Considering the similar survival outcomes of these two clusters, we recombined and performed another survival analysis, which also showed significant survival differences (P=0.0041). Bonding with clinical data, a greater proportion of risk factors were assigned to the worse prognosis subtype, especially showing higher grades in the subtype (P<0.001). In addition, immune cell infiltration, single nucleotide polymorphism (SNP) and copy number variation (CNV) all showed differences between clusters, indicating changes in the immune microenvironment and mutation burden. Through phenotypical analysis, we found metabolism and proliferation phenotypes associated with the immune clusters and mutually exclusive in BC, of which proliferation contributed to worse outcomes. Using the tumor immune dysfunction and exclusion (TIDE) score, a worse immunotherapy benefit was predicted in clusters B&D, defined as the worse prognosis subtype. Conclusions: With this novel clustering criterion based on immune-related genes, we provide a better understanding of the immune microenvironment, further guiding the use of immunotherapy.

The associations between organophosphate esters and urinary incontinence in the general US population.

Organophosphate esters (OPEs) impact health in many ways. Since its relationship with urinary incontinence remains unknown, we aimed to explore their associations in the US general population. We combined the results of urine specimens test and self-reported urinary incontinence conditions from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 among 2666 participants and then conducted linear regression and logistic regression to analyse associations between log2-transformed OPE concentrations and urinary incontinence. We found that 0.92% of men and 15.74% of women complained of mixed urinary incontinence (MUI). The concentrations of diphenyl phosphate (DPHP) were significantly correlated to MUI among women when treated as a continuous variable (adjusted odds ratio (OR) = 1.15; 95% confidence interval (CI), 1.01-1.31; p = 0.0369) and as a categorical variable (adjusted OR = 1.24; 95% CI, 1.03-1.49; p for trend = 0.0245), whereas no positive correlation was found in males. There were no significant associations between the other three OPEs: bis(2-chloroethyl) phosphate (BCEP), bis(1,3-dichloro-2-propyl) phosphate (BDCPP) and dibutyl phosphate (DBUP). The association of DPHP with an increased prevalence OR of MUI in women is a public health concern; future prospective studies are needed to explore its potential mechanism.

Associations of exposure to polycyclic aromatic hydrocarbons and kidney stones in U.S. general population: results from the National Health and Nutrition Examination Survey 2007-2016.

PURPOSE: It has been reported that polycyclic aromatic hydrocarbons (PAHs) exposure was associated with the increasing risk of various diseases. Utilizing the data from the general population of the U.S., we tried to assess the association between PAHs exposure and KS. METHODS: The dataset was extracted from National Health and Nutrition Examination Survey (NHANES) 2007-2016. The hydroxylated metabolites of polycyclic aromatic hydrocarbons (OH-PAHs) were detected as representative of urinary PAHs. Ranking-based PAHs score was used to evaluate the total PAHs exposure burden. Multivariable logistic regression analyses were performed to assess the association between PAHs exposure and KS after adjusting a series of confounding factors. RESULTS: 8975 eligible participants were included. In multivariable logistic regression analyses, after adjusting confounding variables, 2-hydroxynaphthalene (OR 1.38, 1.16-1.65; p = 0.038) and 9-hydroxyfluorene (OR 1.39, 1.06-1.84, p = 0.019) were still observed to have significant positive correlations with the prevalence of KS, respectively. The incidence of KS increased significantly with the increase of total PAHs burden (p for trend = 0.011). Significant interaction effects were observed in the subgroup of gender (p for interaction < 0.05). Among female participants, PAHs exposure was more significantly correlated with KS. Higher 2-hydroxynaphthalene (OR 1.94, 1.39-2.70; p < 0.001), 1-hydroxyphenanthrene (OR 1.57, 1.07-2.30; p = 0.022) and 2-hydroxyphenanthrene (OR 1.85, 1.11-3.06; p = 0.018) were significantly associated with the increased incidence of KS in women. CONCLUSIONS: There is a significant association between a high level of PAHs exposure and increased prevalence of KS. In particular, in the female population, the relationship between PAHs exposure and KS is especially significant.

Interfacial Titanium Diffusion Self-Adapting Layer in Ultrathin Epitaxial MnO2/TiO2 Heterostructures.

The electrochemical performance of supercapacitors is suppressed by a large number of defects in the interface of heterostructure due to lattice mismatch. In this paper, the (001) oriented rutile MnO2 thin films with different thicknesses were grown on rutile TiO2 substrates. The lattice mismatch between film and substrate was minimized through a Ti diffusion self-adapting layer. The energy-dispersive spectroscopy mappings were used to measure the diffusion range of Ti. The results of high-resolution X-ray diffraction confirmed that the dependence of the out-of-plane lattice parameter on the thickness was consistent with the self-adapting interface model, indicating that Ti diffusion can indeed alleviate the lattice mismatch. In addition, the results of the synchrotron soft X-ray absorption spectrum indicated that the capacitance of the thin films with a large proportion of Ti diffusion increased with electrons involved in the reaction. Although the decrease of carrier density and conductivity of the thinner films depressed the electrochemical activity, it is worth mentioning that the film we designed still has considerable specific capacitance even when it is very thin, which can provide a new idea for the development of thinner and larger capacity potential micro-supercapacitors.

Deployment of check-in nodes in complex networks.

In many real complex networks such as the city road networks and highway networks, vehicles often have to pass through some specially functioned nodes to receive check-in like services such as gas supplement at gas stations. Based on existing network structures, to guarantee every shortest path including at least a check-in node, the location selection of all check-in nodes is very essential and important to make vehicles to easily visit these check-in nodes, and it is still remains an open problem in complex network studies. In this work, we aim to find possible solutions for this problem. We first convert it into a set cover problem which is NP-complete and propose to employ the greedy algorithm to achieve an approximate result. Inspired by heuristic information of network structure, we discuss other four check-in node location deployment methods including high betweenness first (HBF), high degree first (HDF), random and low degree first (LDF). Finally, we compose extensive simulations in classical scale-free networks, random networks and real network models, and the results can well confirm the effectiveness of the greedy algorithm. This work has potential applications into many real networks.

IRLT: Integrating Reputation and Local Trust for Trustworthy Service Recommendation in Service-Oriented Social Networks.

With the prevalence of Social Networks (SNs) and services, plenty of trust models for Trustworthy Service Recommendation (TSR) in Service-oriented SNs (S-SNs) have been proposed. The reputation-based schemes usually do not contain user preferences and are vulnerable to unfair rating attacks. Meanwhile, the local trust-based schemes generally have low reliability or even fail to work when the trust path is too long or does not exist. Thus it is beneficial to integrate them for TSR in S-SNs. This work improves the state-of-the-art Combining Global and Local Trust (CGLT) scheme and proposes a novel Integrating Reputation and Local Trust (IRLT) model which mainly includes four modules, namely Service Recommendation Interface (SRI) module, Local Trust-based Trust Evaluation (LTTE) module, Reputation-based Trust Evaluation (RTE) module and Aggregation Trust Evaluation (ATE) module. Besides, a synthetic S-SN based on the famous Advogato dataset is deployed and the well-known Discount Cumulative Gain (DCG) metric is employed to measure the service recommendation performance of our IRLT model with comparing to that of the excellent CGLT model. The results illustrate that our IRLT model is slightly superior to the CGLT model in honest environment and significantly outperforms the CGLT model in terms of the robustness against unfair rating attacks.

[Planktonic Algae's Distribution and Correlation with Dissolved Organic Matters' Fluorescence in the End of the Three Gorges Reservoir's Back Water Zone].

For researching the community structure, composition, and distribution of the planktonic algae in the Three Gorges Reservoir (TRG), especially, within TRG water levels' fluctuating, mpacting to water quality with the algae's growing, 6 sampling cites in the end of the TGR's back water zone, from Chaotianmen to Taihonggang Town, are chosen to monitor, at the sensitive stages time of algal bloom between March to May 2012, namely, water levels lowing from the highest impounding. The community's structure, composition, and distribution of the planktonic algae in the TGR, and the correlation of water quality parameters and DOM's fluorescence features with algae density, are obtained. According to the experimental results, blue algae fibre, chlorella, melosira, navicula are the dominated algae in the end of the TGR's back water zone, from Chaotianmen to Taihonggang Town, algae density are 0.40~0.56 × 10(6), 1.9~0.8 × 10(6), 0.36~0.25 × 10(6), 0.42~0.15 × 10(6) cells · L(-1) respectively. Besides, anabaena, phormidium, cladophora, feather, ovate algae are existing in only limited 2 sections. The fitting results reveal obvious linear correlation of the EEM characteristics of DOM with the 4 kinds of dominated algal density, which could be useful conference for the algae bloom monitor, conveniently and effectively.

Dynamic source routing strategy for two-level flows on scale-free networks.

Packets transmitting in real communication networks such as the Internet can be classified as time-sensitive or time-insensitive. To better support the real-time and time-insensitive applications, we propose a two-level flow traffic model in which packets are labeled as level-1 or level-2, and those with level-1 have higher priority to be transmitted. In order to enhance the traffic capacity of the two-level flow traffic model, we expand the global dynamic routing strategy and propose a new dynamic source routing which supports no routing-flaps, high traffic capacity, and diverse traffic flows. As shown in this paper, the proposed dynamic source routing can significantly enhance the traffic capacity and quality of time-sensitive applications compared with the global shortest path routing strategy.