Exploring the comprehensive link between climatic factors and vegetation productivity in China.

Understanding the influence of climatic factors on vegetation dynamics and cumulative effects is critical for global sustainable development. However, the response of vegetation to climate and the underlying mechanisms in different climatic zones remains unclear. In this study, we analyzed the response of vegetation gross primary productivity (GPP) to climatic factors and the cumulative effects across various vegetation types and climatic zones, utilizing data on precipitation (Pr), temperature (Ta), and the standardized precipitation evapotranspiration index (SPEI). The results showed that: (1) GPP showed significant differences among the seven climatic zones, with the highest value observed in zone VII, reaching 1860.07 gC·m- 2, and the lowest in zone I, at 126.03 gC·m- 2. (2) GPP was significantly and positively correlated with temperature in climatic zones I, IV, V, and VI and with precipitation in climatic zones I, II, and IV. Additionally, a significant positive correlated was found between SPEI and GPP in climatic zones I, II, and IV. (3) Drought exerted a cumulative effect on GPP in 45.10% of the regions within China, with an average cumulative duration of 5 months. These effects persisted for 6-8 months in zones I, II, and VII, and for 2-4 months in zones III, IV and VI. Among different vegetation types, forests experienced longest cumulative effect time of 6 months, followed by grasslands (5 months), croplands (4 months), and shrublands (4 months). The cumulative time scale decreased with increasing annual SPEI. The varying responses and accumulation of GPP to drought among different vegetation types in various climatic zones underscore the complexity of vegetation-climate interactions the response and accumulation of GPP to drought.

Cumulative effects of fish disturbance and vegetative propagules reduce the growth advantage of Vallisneria natans.

Benthivorous fish disturbance and density-dependent competition from adjacent macrophytes are two important biotic factors that significantly impact the growth of submerged macrophyte pioneer species, which is crucial for the success of eutrophication lake restoration. We conducted an outdoor mesocosm experiment to explore the individual and combined effects of these two factors on water quality and the growth of Vallisneria natans. The experiment involved two levels of fish (Misgurnus anguillicaudatus) disturbance crossed with two levels of Hydrilla verticillata vegetative propagule (shoot) intensity. The results showed that fish disturbance significantly increased the water column total nitrogen (TN), ammonia nitrogen (N-NH4), total phosphorus (TP), and phosphate­phosphorus (P-PO4). V. natans exhibited restricted plant height elongation and decreased soluble carbohydrate (SC) and starch concentration in fish treatments. Fish disturbance inhibited the growth advantage of V. natans by increasing the extinction coefficient of the water column. There was no statistical significance in total biomass between the two macrophytes in increased vegetative propagule and fish treatments. H. verticillata exhibited a higher relative growth rate (RGR) and summed dominance ratio (SDR3) than V. natans in four treatments and the treatment with three shoots of H. verticillata and one M anguillicaudatus, respectively. Fish disturbance and vegetative propagules showed cumulative effects that negatively affected the RGR_V.H (V. natans relative to H. verticillata). Our findings indicated that benthivorous fish disturbance and vegetative propagules could individually and cumulatively reduce the growth advantage of the pioneer species, V. natans. Our study sheds light on the accumulated effects of multiple disturbances that simultaneously occur in lakes, which holds theoretical and practical importance for lake restoration efforts.

Bidirectional relationship between C-reactive protein and depressive symptoms considering cumulative effect among Chinese middle-aged and older adults.

Introduction: Research examining the bidirectional relationship between C-reactive protein (CRP) and depressive symptoms, while accounting for cumulative effect of repeated episodes of CRP or depressive symptoms, is currently deficient in non-Western populations. Methods: A nationally representative population-based cohort data from the Chinese Health and Retirement Longitudinal Study (CHARLS) was utilized. In bi-directional analysis, we considered both single determinations and two successive determinations of CRP or depressive symptoms. Multivariate logistic regression assessed the association between elevated CRP levels at baseline or repeated episodes of CRP elevations over two successive determinations and subsequent elevated depressive symptoms, and vice versa. Results: Although single determinations of CRP or depressive symptoms yielded non-significant results in both directions, full multivariate models, adjusting for baseline depressive symptoms, socio-demographic characteristics, health-related behaviors, metabolic measures, and health status, revealed a significantly positive association based on two successive determinations of CRP or depressive symptoms. This significant association was observed between cumulative effects of sustained CRP elevations over two successive determinations (2 vs. 0) and subsequent elevated depressive symptoms (OR=1.58; 95% CI: 1.15 to 2.17) and between cumulative effect of repeated episodes of depression (2 vs. 0) and later elevated CRP (OR=1.26; 95% CI: 1.02 to 1.56). Furthermore, sex-stratified analyses confirmed the robustness of these relationships. Conclusion: There are bidirectional associations between depressive symptoms and CRP, driven by the cumulative effect of repeated episodes of CRP or depressive symptoms among middle-aged and older Chinese adults. These findings hold significant clinical implications, highlighting the potential of both anti-inflammatory and anti-depression approaches.

Dynamics of solar-induced chlorophyll fluorescence (SIF) and its response to meteorological drought in the Yellow River Basin.

Solar-induced chlorophyll fluorescence (SIF) has been used since its discovery to characterize vegetation photosynthesis and is an effective tool for monitoring vegetation dynamics. Its response to meteorological drought enhances our comprehension of the ecological consequences and adaptive mechanisms of plants facing water scarcity, informing more efficient resource management and efforts in mitigating climate change. This study investigates the spatial and temporal patterns of SIF and examines how vegetation SIF in the Yellow River Basin (YRB) responds to meteorological drought. The findings reveal a gradual southeast-to-northwest decline in SIF across the Yellow River Basin, with an overall increase-from 0.1083 W m-2µm-1sr-1 in 2001 to 0.1468 W m-2µm-1sr-1 in 2019. Approximately 96% of the YRB manifests an upward SIF trend, with 75% of these areas reaching statistical significance. The Standardized Precipitation Evapotranspiration Index (SPEI) at a time scale of 4 months (The SPEI-4), based on the Liang-Kleeman information flow method, is identified as the most suitable drought index, adeptly characterizing the causal relationship influencing SIF variations. As drought intensified, the SPEI-4 index markedly deviated from the baseline, resulting in a decrease in SIF values to their lowest value; subsequently, as drought lessened, it gravitated towards the baseline, and SIF values began to gradually increase, eventually recovering to near their annual maximum. The key finding is that the variability of SIF with SPEI is relatively pronounced in the early growing season, with forests demonstrating superior resilience compared to grasslands and croplands. The responsiveness of vegetation SIF to SPEI can facilitate the establishment of effective drought early warning systems and promote the rational planning of water resources, thereby mitigating the impacts of climate change.

Dynamic process of ecosystem water use efficiency and response to drought in the Yellow River Basin, China.

Ecosystem water use efficiency (WUE) is a crucial indicator of the impact of climate change on terrestrial ecosystems, reflecting the balance between biological processes (photosynthesis and transpiration) and physical processes (evapotranspiration). However, the response mechanisms and driving processes of WUE to drought remain to be further understood. In this study, we analyzed the spatial and temporal dynamics and response mechanisms of WUE in the Yellow River Basin (YRB) using data on Gross Primary Productivity (GPP), Evapotranspiration (ET) and Standardized Precipitation Evapotranspiration Index (SPEI), which revealed the cumulative effect of drought on WUE and assessed the ecosystem's resilience. The study results showed that (1) GPP, ET and WUE in the YRB exhibited a significant increasing trend, with 63.04 % of the area showing a marked increase in WUE. (2) GPP was the dominant factor influencing WUE in 65.36 % of the area, particularly in cropland and grassland, while ET was more influential in forested areas. Vapor pressure deficit (VPD) was identified as the principal driver affecting vegetation GPP in semi-arid and semi-humid regions of the YRB. In contrast, soil moisture (SM) was the limiting factor in arid areas. (3) 71.00 % of the WUE in the basin was affected by drought cumulative effects, with an average cumulative duration of 4.5 months. Arid regions experienced the most extended duration of 7.29 months, compared to 3.05 months in semi-humid regions. (4) 74.85 % of the regional ecosystems exhibited ecological resilience to drought, particularly in the source areas of the western basin of the YRB. Shrublands have the highest drought resilience among vegetation types, while grasslands have the lowest. The resilience of each climatic zone was in the order of semi-humid, semi-arid, and arid order. This study comprehensively analyzed of the spatial and temporal dynamics and response mechanisms of WUE in the YRB, offering a new perspective and scientific basis for understanding and predicting the ecosystem response to climate change.

The Effects of Rainfall Events on the Composition and Diversity of Microplastics on Beaches in Xiamen City on a Short-Term Scale.

Coastal beaches are vulnerable to microplastic pollution originating primarily from terrestrial and marine sources or the in situ weathering of plastic waste. The present study investigates the effects of rainfall events on the composition and diversity of microplastics on beaches in Xiamen City on a short-term scale. In the results, the quantity of microplastics in beach sediments was 245.83 ± 11.61 items·kg-1 (mean ± standard error). The abundance of microplastics did not differ after each rainfall event but significantly decreased after multiple rainfall events. When the diversity of microplastics in the coastal area was evaluated, the Shannon-Wiener index and Pielou's index also decreased from 3.12 and 0.64 to 2.99 and 0.62, respectively, after multiple rainfall events. Rainfall had varying effects on microplastics depending on their size and shape, with particles smaller than 500 µm experiencing pronounced reductions. There was a significant negative correlation between the abundance of microplastics and the grain size of sand, but a positive correlation with sediment moisture content. We encourage the consideration of the potential impact of rainfall events during sample collection to ensure the reliability of the data. We also recommend using diversity indexes to help in understanding the influence of physical processes on microplastic distribution and their mechanisms.

Changes in vegetation-water response in the Sahel-Sudan during recent decades.

Study region: The Africa Sahel-Sudan region, defined by annual rainfall between 150 and 1200 mm. Study focus: Understanding the mechanism of vegetation response to water availability could help mitigate the potential adverse effects of climate change on global dryland ecosystems. In the Sahel-Sudan region, spatio-temporal changes and drivers of the vegetation-water response remain unclear. This study employs long-term satellite water and vegetation products as proxies of water availability and vegetation productivity to analyze changes in vegetation-water sensitivity and the cumulative effect duration (CED) representing a measure of the legacy effect of the impact of water constraints on vegetation. A random forest model was subsequently used to analyze potential climatic drivers of the observed vegetation response. New hydrological insights for the region: During 1982-2016 we found a significant decrease (p < 0.05) in the sensitivity of vegetation productivity to water constraints in 26% of the Sahel-Sudan region, while 9% of the area showed a significantly increased sensitivity, mainly in the sub-humid zone. We further showed that CED significantly increased and decreased, respectively in around 9% of the study area in both cases. Our climatic driver attribution analysis suggested the existence of varying underlying mechanisms governing vegetation productivity in response to water deficit across the Sahel-Sudan dryland ecosystems. Our findings emphasize the need for diverse strategies in sustainable ecosystem management to effectively address these varying mechanisms.

Cumulative effects of excess high-normal alanine aminotransferase levels in relation to new-onset metabolic dysfunction-associated fatty liver disease in China.

BACKGROUND: Within the normal range, elevated alanine aminotransferase (ALT) levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease (MAFLD). AIM: To investigate the associations between repeated high-normal ALT measurements and the risk of new-onset MAFLD prospectively. METHODS: A cohort of 3553 participants followed for four consecutive health examinations over 4 years was selected. The incidence rate, cumulative times, and equally and unequally weighted cumulative effects of excess high-normal ALT levels (ehALT) were measured. Cox proportional hazards regression was used to analyse the association between the cumulative effects of ehALT and the risk of new-onset MAFLD. RESULTS: A total of 83.13% of participants with MAFLD had normal ALT levels. The incidence rate of MAFLD showed a linear increasing trend in the cumulative ehALT group. Compared with those in the low-normal ALT group, the multivariate adjusted hazard ratios of the equally and unequally weighted cumulative effects of ehALT were 1.651 [95% confidence interval (CI): 1.199-2.273] and 1.535 (95%CI: 1.119-2.106) in the third quartile and 1.616 (95%CI: 1.162-2.246) and 1.580 (95%CI: 1.155-2.162) in the fourth quartile, respectively. CONCLUSION: Most participants with MAFLD had normal ALT levels. Long-term high-normal ALT levels were associated with a cumulative increased risk of new-onset MAFLD.

Spatial and temporal variations of ecosystem water use efficiency and its response to soil moisture drought in a water-limited watershed of northern China.

Drought synchronously affects the water cycle and interferes with the carbon cycle in terrestrial ecosystems. Ecosystem water use efficiency (WUE), serving as a vital metric for assessing the interplay between water and carbon cycles, has found extensively use in exploring how ecosystems responses to drought. However, the effects of soil moisture drought on WUE are still poorly recognized. Taking Ziya River Basin as an example, the spatial-temporal variations of WUE from 2001 to 2020 were estimated by the Penman-Monteith-Leuning Version 2 (PML-V2) data. Based on the Standardized Soil Moisture Index (SSI) calculated from Soil Moisture of China by in situ data, version 1.0 (SMCI1.0) data, the sensitivity and thresholds of different vegetation WUE to drought magnitudes were investigated, and the influences of both lagged and cumulative effects of drought on WUE were further analyzed. Results showed that the annual mean WUE was 2.160 ± 0.975 g C kg-1 H2O-1 in the Ziya River Basin, with a significant increasing trend of 0.037 g C kg-1 H2O-1 yr-1 (p < 0.05). For all the vegetation types, the WUE reached the maximum value at a certain drought threshold (SSI = -1.5 ± 0.1). The dominant factor controlling WUE sensitivity to drought changed from evapotranspiration (ET) to gross primary production (GPP) when severe drought transformed into extreme drought. Significant lagged and cumulative effects were found in the response of WUE to drought in nearly 58.64 % (72.94 %) of the study area, with an average time scale of 6.65 and 2.11 months (p < 0.05) respectively. Drought resistance in descending order was: forest > shrub > grassland > cropland. Our findings enrich the understanding of the coupled carbon and water cycle processes in terrestrial ecosystems and their response to soil moisture drought in the context of global climate change.

"Cumulative effect" of second harmonic Lamb waves in a lossy plate.

The second harmonic Lamb waves have high sensitivity to microstructural defects in materials and are therefore promising for incipient damage detection and monitoring of thin-walled structures. Existing studies have shown that the second harmonic Lamb waves can be cumulative with increasing propagation distance under the internal resonance conditions, which is conducive to nonlinear wave measurements in view of structural health monitoring. However, when propagating in a lossy structure with damping, the cumulative properties of the second harmonic Lamb waves are affected by energy dissipation and thus need to be re-examined. In this paper, a method for predicting the cumulative characteristics of second harmonic Lamb waves in damped plates is proposed. Instead of using material damping parameters which are difficult to obtain in practice, the proposed method relies on the attenuation patterns of Lamb waves at fundamental and double frequencies while taking into account the influence of the wave beam divergence. The proposed methodology is validated by finite element simulations and experiments. The results show that the cumulative second harmonic Lamb waves in the damped plate tend to increase and then decrease, and a "sweet" zone of relatively large amplitude can be predicted using the proposed method. The elucidation of the cumulative characteristics of the second harmonic Lamb waves provides guidance for effective system design for structural damage detection and monitoring applications.

Satellite monitoring reveals short-term cumulative and time-lag effect of drought and heat on autumn photosynthetic phenology in subtropical vegetation.

Comparing with the effect of the average climate change on vegetation phenology, the impacts of extreme climate events remain unclear, especially considering their characteristic cumulative and time-lag effects. Using solar-induced chlorophyll fluorescence (SIF) satellite records, we investigated the cumulative and time-lag effects of drought and heat events on photosynthesis, particularly for the end date of autumn photosynthesis (EOP), in subtropical vegetation in China. Our results showed a negative effect of drought on the delay of EOP, with the cumulative effect on 30.12% (maximum continuous dry days, CDD), 34.82% (dry days, DRD), and 26.14% (dry period, DSDI) of the study area and the general time-lag effect on 50.73% (maximum continuous dry days), 56.61% (dry days), and 47.55% (dry period) of the study area. The cumulative and lagged time were 1-3 months and 2-3 months, respectively. In contrast, the cumulative effect of heat on EOP was observed in 16.27% (warm nights, TN90P), 23.66% (moderate heat days, TX50P), and 19.19% (heavy heat days, TX90P) of the study area, with cumulative time of 1-3 months. The lagged time was 3-4 months, detected in 31.02% (warm nights), 45.86% (moderate heat days), and 36.52% (heavy heat days) of the study area. At the vegetation community level, drought and heat had relatively rapid impacts on EOP in the deciduous broadleaved forest, whereas evergreen forests and bushes responded to heat slowly and took a longer time. Our results revealed that drought and heat have short-term cumulative and time-lag effects on the EOP of subtropical vegetation in China, with varying effects among different vegetation types. These findings provide new insights into the effect of drought and heat on subtropical vegetation and confirm the need to consider these effects in the development of prediction models of autumn phenology for subtropical vegetation.

Mortality and Cumulative Kidney Score are Associated with Transient and Persistent Acute Kidney Injury in Septic Patients: A Retrospective Study Based on MIMIC-IV.

BACKGROUND: Acute kidney injury (AKI) is frequently caused by sepsis. Recently, the Acute Disease Quality Initiative (ADQI) workgroup further classified AKI as transient or persistent. Oliguria and increased serum creatinine represent two different kinds of renal impairment. The aim of the study was to assess mortality and cumulative AKI score associated with transient and persistent AKI in septic patients. METHODS: Septic patients were stratified according to the presence and AKI development (considered persistent when remaining >48 h) were included. An adjusted logistic regression model was used to determine hospital mortality. In addition, we calculated an AKI score by combining both Kidney Disease: Improving Global Outcomes (KDIGO) criteria of urine output and creatinine AKI stages. The relationship between the cumulative AKI score and persistent AKI was further examined using the logistic regression model and receiver operating characteristic (ROC) curve analysis. RESULTS: 12928 septic patients were enrolled in the study. AKI occurred in 73.7% of septic patients, in 39.5% was transient and in 60.5% was persistent. Patients with persistent AKI had higher severity scores and more severe renal dysfunction upon admission. Persistent AKI, but not transient AKI, was associated with increased intensive care units (ICUs) and hospital mortality. Then we found that the cumulative AKI score was associated with an increased risk of persistent AKI. This association was consistent across three original KDIGO severity stages and subgroup analyses. CONCLUSIONS: It was found that persistent AKI was independently associated with mortality in septic patients. Furthermore, serum creatinine and urine output criteria had cumulative effects on KDIGO AKI staging and provided more information about the relationship between AKI and outcomes.

Mortality and Cumulative Kidney Score are Associated with Transient and Persistent Acute Kidney Injury in Septic Patients: A Retrospective Study Based on MIMIC-IV

Background: Acute kidney injury (AKI) is frequently caused by sepsis. Recently, the Acute Disease Quality Initiative (ADQI) workgroup further classified AKI as transient or persistent. Oliguria and increased serum creatinine represent two different kinds of renal impairment. The aim of the study was to assess mortality and cumulative AKI score associated with transient and persistent AKI in septic patients. Methods: Septic patients were stratified according to the presence and AKI development (considered persistent when remaining >48 h) were included. An adjusted logistic regression model was used to determine hospital mortality. In addition, we calculated an AKI score by combining both Kidney Disease: Improving Global Outcomes (KDIGO) criteria of urine output and creatinine AKI stages. The relationship between the cumulative AKI score and persistent AKI was further examined using the logistic regression model and receiver operating characteristic (ROC) curve analysis. Results: 12928 septic patients were enrolled in the study. AKI occurred in 73.7% of septic patients, in 39.5% was transient and in 60.5% was persistent. Patients with persistent AKI had higher severity scores and more severe renal dysfunction upon admission. Persistent AKI, but not transient AKI, was associated with increased intensive care units (ICUs) and hospital mortality. Then we found that the cumulative AKI score was associated with an increased risk of persistent AKI. This association was consistent across three original KDIGO severity stages and subgroup analyses. Conclusions: It was found that persistent AKI was independently associated with mortality in septic patients. Furthermore, serum creatinine and urine output criteria had cumulative effects on KDIGO AKI staging and provided more information about the relationship between AKI and outcomes (AU)

The effects of long-term cumulative HbA1c exposure on the development and onset time of dementia in the patients with type 2 diabetes mellitus: Hospital based retrospective study (2005-2021).

AIMS: We examined cumulative effects of long-term glycemic exposure in patients with type 2 diabetes mellitus (T2DM) on the development of dementia. METHODS: The study involved 20,487 records of patients with T2DM identified in the electronic medical record at Severance Hospital, Korea. Cumulative HbA1c (AUCHbA1c) and mean HbA1c over time (HbA1cavg) as measures of long-term glycemic exposure were compared for the development of dementia and the time to dementia. RESULTS: AUCHbA1c and HbA1cavg were significantly higher in patients who later developed dementia than in those who did not (AUCHbA1c: 56.2 ± 26.4 vs. 52.1 ± 26.1 %Year; HbA1cavg: 7.3 ± 1.0 vs. 7.0 ± 1.0%). Odds ratio of dementia increased when HbA1cavg was 7.2% (55 mmol/mol) or above, and when AUCHbA1c was 42 %Year (e.g., HbA1c 7.0% maintained for 6 years) or above. Among those who developed dementia, as HbA1cavg increased, the time to dementia onset decreased (ß = -380.6 days, 95% confidence interval [CI]: -416.2 to -345.0). CONCLUSIONS: Our results indicate poorly controlled T2DM was associated with an increased risk of developing dementia, as measured by AUCHbA1c and HbA1cavg. Higher cumulative glycemic exposure may lead to developing dementia in a shorter time.

Association of long-term triglyceride-glucose index level and change with the risk of cardiometabolic diseases.

Objective: The triglyceride-glucose (TyG) index is considered as a pivotal factor for various metabolic, cardiovascular, and cerebrovascular diseases. However, there is currently a paucity of relevant studies on the association between long-term level and change of TyG-index and cardiometabolic diseases (CMDs) risk. We aimed to explore the risk of CMDs in relation to the long-term level and change of TyG-index. Methods: Based on the prospective cohort study, a total of 36359 subjects who were free of CMDs, had complete data of triglyceride (TG) and fasting blood glucose (FBG) and underwent four health check-ups from 2006 to 2012 consecutively were followed up for CMDs until 2021. The associations between long-term level and change of TyG-index and CMDs risk were assessed by Cox proportional hazards regression models to compute hazard ratios (HRs) and 95% confidence intervals (CIs). The TyG-index was calculated as ln [TG, mg/dL) × FBG, mg/dL)/2]. Results: During the median observation period of 8 years, 4685 subjects were newly diagnosed with CMDs. In multivariable-adjusted models, a graded positive association was observed between CMDs and long-term TyG-index. Compared with the Q1 group, subjects with the Q2-Q4 group had increased progressively risk of CMDs, with corresponding HRs of 1.64(1.47-1.83), 2.36(2.13-2.62), 3.15(2.84-3.49), respectively. The association was marginally attenuated, after further adjustment for the baseline TyG level. In addition, compared with stable TyG level, both loss and gain in TyG level were associated with increased CMDs risk. Conclusions: Long-term elevated level and change of TyG-index are risk factors for the incident CMDs. Elevated TyG-index in the early stage remains to exert cumulative effects on the occurrence of CMDs even after accounting for the baseline TyG-index.

Research on the prediction model of agricultural drought hazard considering the time-delayed cumulative effect and system development characteristics.

Agricultural drought hazard is a complex time-delayed system affected by multiple hazard factors. The ability to estimate agricultural drought hazard accurately is crucial for guaranteeing food security. A TDMGM(1,m,N) prediction model coupling the time-delayed cumulative driving effect of multi-factor and the development characteristics of multi-system is constructed by introducing the time-delayed driving term and simultaneous formula with the goal of solving the problem of multivariate time-delayed prediction modeling of agricultural drought hazard. The definition form and derivation form of the TDMGM(1,m,N) model are given under the two cases of small and large variations of relevant variables, and the nonlinear solutions of the optimal delay parameters are given by using the fmincon function in Matlab. The solution method for model parameter estimation is also provided. It is proved that GM(1,1), GM(1,N), time-delayed GM(1,N), MGM(1,m) and MGM(1,m,N) are all special forms of TDMGM(1,m,N) model. The effect of multiplier transformation on model parameters, simulation prediction value, and model accuracy is also investigated. Finally, the TDMGM(1,m,N) model is applied to predict agricultural drought hazard in Henan Province. The findings demonstrate that the model can address the prediction problem of multiple system characteristic variables when multiple relevant variables exhibit time-delayed properties with good fitting and prediction accuracy.

Combined effects of high sensitivity C-reactive protein and triglyceride-glucose index on risk of cardiovascular disease among middle-aged and older Chinese: Evidence from the China Health and Retirement Longitudinal Study.

BACKGROUND AND AIMS: High sensitivity C-reactive protein (hsCRP) and triglyceride glucose (TyG) index were proved to be independent risk factors of cardiovascular disease (CVD). However, individual hsCRP or TyG index might not provide sufficient predictive value on CVD risk. The current study aimed to evaluate the cumulative effect of hsCRP and TyG index on CVD risk prospectively. METHODS AND RESULTS: A total of 9626 participants were enrolled in the analysis. The TyG index was calculated as ln(triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The primary outcome was new-onset CVD events (cardiac events or stroke), and the secondary outcomes were new-onset cardiac events and stroke, separately. Participants were divided into 4 groups through the median of hsCRP and TyG index. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportion hazard models. From 2013 to 2018, 1730 participants experienced CVD (570 stroke and 1306 cardiac events). Linear associations were found between hsCRP, TyG index, hsCRP/TyG ratio and CVD (all p < 0.05). Compared to participants with low hsCRP/low TyG index, multivariable adjusted HRs (95% CIs) for those with high hsCRP/high TyG index were 1.17 (1.03-1.37) for CVD. No interaction of hsCRP and TyG index was found on CVD (p-interaction ≥0.05). Furthermore, adding hsCRP and TyG index simultaneously to conventional risk model improved risk reclassification for CVD, stroke and cardiac events (all p < 0.05). CONCLUSION: The present study suggested combination of hsCRP and TyG index might better improved the ability for risk stratification of CVD among middle-aged and older Chinese.

Critical window for the association between early electronic screen exposure and hyperactive behaviors in preschool children.

Electronic screens have become an integral part of modern life, accompanied with growing concerns for children's neuropsychological development. This study aimed to evaluate the associations between measures of early life screen exposure and hyperactive behaviors among preschool children. The study also aimed to investigate their cumulative effects and the critical window for these associations. A cross-sectional survey was conducted among 52 625 mother-child dyads at preschools in LongHua District of Shenzhen, China. A self-administered structured questionnaire was used to assess socio-demographic characteristics, duration of children's electronic screen exposure in each of the first 3 years following birth and the presence of current hyperactive behaviors. A series of logistic regression models were used to examine the relationship between previous screen time and current hyperactive behaviors. A crossover analysis was used to explore the critical window for a significant relationship between screen time and hyperactive behaviors. We found that exposure to electronic screens in the first 3 years of life was associated with hyperactive behaviors in preschool children. A cumulative effect was shown in children with an average daily screen time less than 60 min, with adjusted ORs increasing from 1.262 to 1.989 as screen exposure years increased from 1 to 3 years. A critical window was identified in that children in the first 2 years after birth were vulnerable to electronic screen exposure. Exposure to televisions, mobile phones, and computers were all related to elevated risks for hyperactive behaviors. In conclusion, early screen exposure appears to increase the risk for hyperactive behaviors in preschool children with the presence of a cumulative effect, a critical window and different electronic screens having similar effects.

The more developmental assets, the less internet gaming disorder? Testing the cumulative effect and longitudinal mechanism during the COVID-19 pandemic.

The COVID-19 pandemic has triggered the dramatical development and prosperity of online games, while worldwide people are suffering from it. Considering the high prevalence, serious impacts, and huge development potential of internet gaming disorder (IGD), it is extremely necessary to develop a protective model to prevent and intervene with it among young people. Based on the developmental assets theory, the present study adopted a two-wave longitudinal design to evaluate the cumulative effects of developmental assets on IGD, as well as the underlying mechanisms during this specific period. Data were collected from a sample of 1023 adolescents in Hubei province, Central China through self-report questionnaires. The results indicated that (1) developmental assets were negatively associated with adolescents' IGD concurrently and longitudinally; (2) the overall developmental assets had cumulative effects in linear patterns on adolescents' IGD, concurrently and longitudinally; and (3) internal developmental assets mediated the relationship between external developmental assets and adolescents' IGD longitudinally. Theoretically, the present study supports the developmental assets theory and expands the literature about developmental assets and IGD in younger generations. Practically, the present study provides guidance for prevention and intervention of IGD among adolescents during and after the COVID-19 pandemic. Comprehensive measures should be taken to assist in developing positive internal and external resources to promote youth thriving.