Interacting and joint effects of triglyceride-glucose index (TyG) and body mass index on stroke risk and the mediating role of TyG in middle-aged and older Chinese adults: a nationwide prospective cohort study.

BACKGROUND: Individuals who are overweight or obese often develop insulin resistance, mediation of the association between body mass index (BMI) and stroke risk through the triglyceride-glucose index (TyG) seems plausible but has not been investigated. This study aims to examine whether TyG mediates associations of BMI with stroke risk and the extent of interaction or joint relations of TyG and BMI with stroke outcome. METHODS: The China Health and Retirement Longitudinal Study, initiated in 2011, is a nationally representative, ongoing prospective cohort study involving 8 231 middle-aged and older Chinese adults without a stroke history at baseline. Exposures examined include BMI and the TyG, the latter being the logarithmized product of fasting triglyceride and glucose concentrations. The primary study outcome is stroke incidence, as determined through self-reports, with a follow-up period extending from June 1, 2011, to June 30, 2018. RESULTS: Of the 8 231 participants, 3 815 (46.3%) were men; mean (SD) age was 59.23 (9.32) years. During a median follow-up of 7.1 years, 585 (7.1%) participants developed stroke. The TyG was found to mediate the association between BMI and incident stroke, proportions mediated were 16.3% for BMI in the 24.0-27.9 kg/m2 group and 53.8% for BMI ≥ 28.0 kg/m2 group. No significant multiplicative and additive interactions were found between BMI and TyG on incident stroke (Additive: RERI = 1.78, 95% CI - 1.29-4.86; Multiplicative, HR = 1.40, 95% CI 0.86-2.27). HRs for individuals with BMI ≥ 28.0 kg/m2 and quartile 4 of TyG compared with those with BMI < 24.0 kg/m2 and quartile 1 of TyG were 2.05 (95% CI 1.37-3.06) for incident stroke. Combining BMI and TyG enhanced predictive performance for stroke when compared to their individual (AUCBMI+TyG vs AUCBMI vs AUCTyG, 0.602 vs 0.581 vs 0.583). CONCLUSIONS: TyG appeared to be associated with stroke risk and mediates more than 50% of the total association between BMI and stroke in middle-aged and older Chinese adults. Public health efforts aiming at the reduction of body weight might decrease the stroke risk due to insulin resistance and the burden of stroke.

Dual-mode sensing chip for photoelectrochemical and electrochromic visual determination of deoxynivalenol mycotoxin.

The successful development of a dual-mode sensing chip for deoxynivalenol (DON) detection using photoelectrochemical (PEC) and electrochromic visualization techniques is reported. By laser etching technology, different functional areas, including the photoanode, the cathode, and the electrochromic area, are fabricated on indium tin oxide (ITO) glass. Then, these three areas are further respectively modified with PEC active materials, platinum nanoparticles, and Prussian blue. Under light illumination, photocurrents generate between the photoanode and the cathode due to the separation of photo-induced electrons and holes in the TiO2/3DNGH material. Meanwhile, the photo-induced electrons are transferred to Prussian blue on the visualization area, which will be reduced to colorless Prussian white. The binding of DON molecules and aptamers can promote electron transfer and reduce the recombination of electrons and holes, allowing for simultaneous quantitative detection of DON using either the photocurrent or color change. The sensor chip has a broad detection range of DON concentrations of 1 fg⋅mL-1 to 100 pg⋅mL-1 in the PEC mode with the limit of detection of 0.37 fg⋅mL-1, and 1 to 250 ng⋅mL-1 in the visualization mode with the limit of detection of 0.51 ng⋅mL-1. This portable dual-mode sensor chip can be used in both laboratory and field settings without the need for specialized instruments, making it a powerful tool for ensuring food safety. At the same time, the analysis of the standard addition method of the actual sample by using the sensor chip shows that, in the PEC mode, the recoveries of the dual-mode aptasensor chip were 91.3 to 99.0% with RSD values of 1.73~2.55%, and in visualization mode, the recoveries of the dual-mode aptasensor chip were 99.2 to 102.0% with RSD values of 1.00~6.21%, which indicate good accuracy and reproducibility.

Hierarchical Regulation of LaMnO3 Dual-Pathway Strategy for Excellent Room-Temperature Organocatalytic Oxidation Performance.

The performance-enhancing strategy of a single pathway for perovskite has been widely studied. In this work, the dual-pathway strategy of A-site Ce substitution and nitric acid selective dissolution was proposed. The catalytic oxidation performance of LaMnO3 exhibits the characteristic of hierarchical regulation, that is, a steplike improvement, which avoids the limitation of performance improvement of the single pathway. The B-site Mn with catalytic activity was in situ reconstituted on the surface to build a Mn-rich surface. The obtained sdLa0.7Ce0.3MnO3 has the advantages of good oxygen mobility, high Mn4+/Mn3+ molar ratio, and large specific surface area, and this material showed excellent catalytic oxidation performance for organics, which can realize colorimetric chemical oxygen demand detection at room temperature. Here, Ce substitution improved the oxidation capacity by improving the oxygen mobility and the ratio of Mn4+/Mn3+, and further nitric acid treatment not only accelerated the in situ reconstruction of B-site Mn but also increased the specific surface area.

Rapid Potentiometric Detection of Chemical Oxygen Demand Using a Portable Self-Powered Sensor Chip.

Chemical oxygen demand (COD) is an important indicator of organic pollutants in water bodies. Most of the present testing methods have the disadvantages of having complicated steps, being time-consuming, and using toxic and hazardous substances. In this work, rapid potentiometric detection of chemical oxygen demand (COD) using a portable self-powered sensor chip was successfully developed. The indium tin oxide (ITO) electrode was etched by laser, and the photocatalytic materials TiO2/CuS and Pt were modified onto the photoanode and the cathode to prepare the sensor chip. Based on the principle of photocatalytic degradation, organic pollutants can be oxidized by TiO2/CuS, and the concentration will affect the generated voltage. The quantitative detection of COD in the range of 0.05-50 mg/L can be rapidly achieved within 5 min by a miniature device. Besides good portability and sensitivity, the proposed sensor also has the advantages of environmental friendliness and ease of use, which is an ideal choice for the on-site detection of water pollution.

High-Throughput Detection of Multiple Contaminants Based on Portable Photoelectrochromic Sensor Chip.

With the increasing concerns about the environment and food safety, it is necessary to develop portable, low-cost, and high-throughput biosensors for the simultaneous detection of multiple contaminates. However, traditional photoelectrochemical (PEC) biosensors lack the ability of multiplexed assays due to the inherent mechanism limitation. Also, specialized instruments are necessary for most PEC biosensors. In this work, a portable high-throughput sensor chip has been successfully developed. By introducing electrochromic materials, the detection is based on color change instead of electric signals, which reduces the limitation of instruments. This designed sensor chip is composed of three parallel sensing channels fabricated by laser etching. Each channel is modified with TiO2/3D-g-C3N4 composites with excellent PEC activity and electrochromic material Prussian blue (PB). Under light illumination, photoinduced electrons generated by TiO2/3D-g-C3N4 are injected into PB, and blue PB is reduced to colorless Prussian white. Three organic contaminates, ochratoxin A, lincomycin, and edifenphos, can be simultaneously detected because the binding of these molecules with aptamers affects the electron transfer and the corresponding color changes. This portable and high-throughput sensor chip provides a convenient choice for multiplexed assays with good sensitivity and accuracy.

Portable Photoelectrochromic Visualization Sensor for Detection of Chemical Oxygen Demand.

Chemical oxygen demand (COD) is an important parameter to estimate water quality, and many methods have been developed to measure COD. However, these methods are not satisfying because of the use of hazardous materials, the interference of chloride, and complicated operations. Meanwhile, the development of portable sensors for field testing COD is still at an early stage. In this work, we propose a new portable COD sensor based on the photoelectrochromic principle. The whole detection can be conducted with a small indium tin oxide (ITO) electrode modified with photocatalytic material TiO2/g-C3N4 and the electrochromic material Prussian blue. Under light illumination, organic pollution can be photocatalytically oxidized by TiO2/g-C3N4 and photogenerated electrons are transferred to Prussian blue, which will be reduced to colorless Prussian white. So the COD value can be obtained through the color change of the ITO electrode. By adjusting the electrode size, the detection range is flexible from 0.025 to 750 mg/L, and this sensor has a good repeatability and stability. Meanwhile, this portable visualization PEC sensor has been successfully applied in actual wastewater sample detection, which has a good prospect in COD monitoring.

A potential-controlled electrochromic visual biosensor based on distance readout for zearalenone detection.

In this work, a potential-controlled electrochromic visual biosensor was developed for detecting zearalenone (ZEN) using a distance readout strategy. The sensor chip includes a square detection area and a folded signal output area created with laser etching technology. The detection area is modified with graphene oxide and ZEN aptamer, while Prussian blue (PB) is electrodeposited onto the signal output channel. When an appropriate voltage is applied, PB in the signal output area is reduced to colorless Prussian white (PW). The target ZEN molecules have the capability to release aptamers from graphene oxide (GO) surface in the detection area, resulting in a subsequent change in the potential of the visual signal output channel. This change determines the length of the channel that changes from blue to colorless, with the color change distance being proportional to the ZEN concentration. Using this distance readout strategy, ZEN detection within the range of 1 ng/mL to 300 ng/mL was achieved, with a detection limit of 0.29 ng/mL.

Evaluation of a medical education policy with compulsory rural service in China.

Background: Since 2010, China has implemented a national programme to train general practitioners for rural areas. The programme enrolled medical students with a rural background who signed a contract for 6 years' compulsory rural service after graduation. China is transitioning its national COVID-19 strategies in view of the features of coronavirus Omicron variant, the vaccination coverage, and the need for socioeconomic development. Strengthening primary health care, especially the health workforce in rural areas, should be an important consideration during the policy transition. This study aims to evaluate the implementation process of enrolling medical students in the programme, their willingness to work in the rural settings and their actual job choice after graduation. Methods: The study chose four medical universities in central and western China. A total of 2,041 medical graduates who have signed a contract for compulsory rural service and 1,576 medical graduates enrolled "as usual" (no compulsory rural service) were recruited in five campaigns-every June from 2015 to 2019. A survey was conducted 1 week before their graduation ceremony. Results: The top three reasons for choosing this programme were: a recommendation of a family member or teacher, a guaranteed job after graduation and the waiver of the tuition fee. 23.0-29.7% of the study participants were not familiar with the policy details. 39.1% of the medical students signed a contract with a county other than that of their hometown. Medical graduates on the compulsory rural service programme had very low willingness (1.9%) to work in rural areas but 86.1% of them actually worked at township health centers. In contrast, the willingness to work at township health centers was 0.2% for the comparison group (medical graduates without the contract), and their actual job choice at township health centers was 0%. Conclusions: Although the well-trained medical graduates on the compulsory rural service programme have low willingness to work in the township health centers, 86.1% of them choose to do so following their contract. This programme will strengthen the primary health workforce to deal with the increasing disease burden as China is transitioning its national COVID-19 strategies.

Nanoparticles-doped induced defective ZIF-8 as the novel cathodic luminophore for fabricating high-performance electrochemiluminescence aptasensor for detection of omethoate.

Although the use of omethoate (OMT) for pests control is enormously economically beneficial for agricultural production, the high toxicity of OMT to nontarget organisms has resulted in the contamination of soil, river water, and food materials. Developing sensitive and convenient techniques to detect OMT residues is vital to society. Electrochemiluminescence (ECL) is a powerful analytical tool and has been widely applied in biosensors. To boost the co-reaction efficiency and ECL intensity, we introduced defective ZIF-8 as the novel cathodic luminophore. At the same time, defect generated by the doping of MoTe2 nanoparticles into ZIF-8 could easily electrocatalytic reduce the co-reactor S2O82- to SO4•-. Hence, based on the catalysis of defective ZIF-8, the ECL intensity of MoTe2/ZIF-8 nanocomposites is much higher than both ZIF-8 and MoTe2 nanoparticles. By integration of as-prepared materials with specificity omethoate aptamer, the ECL sensor showed a broad linear range (10-10 g L-1 and 10-5 g L-1) and a comparatively low detection limit (3.3 × 10-11 g L-1). Besides, the ECL aptasensor appeared a good practical performance to detect potato and spinach extraction samples, which proposed a promising guideline for developing ECL aptasensors with high efficiency.

Early outcomes of a rural-oriented physician education programme against rural physician shortages in Guangxi province: a prospective cohort study.

OBJECTIVES: This study aimed to investigate early outcomes of one of the first medical undergraduate education programmes with a goal of mitigating severe rural physician shortages in China, which was developed by Guangxi Medical University (GXMU) and was called the Rural-oriented Free Tuition Medical Education (RTME)-GXMU programme. DESIGN: A prospective cohort study comprising a baseline investigation and follow-up research was conducted to dynamically observe the evolution of the RTME-GXMU programme that began since 2010. PARTICIPANTS: 380 RTME-GXMU graduates and 383 non-RTME-GXMU graduates from GXMU who completed trainings between 2015 and 2018 were recruited in the baseline investigation. Among them, 285 RTME-GXMU and 283 non-RTME-GXMU graduates responded to the follow-up research. MAIN OUTCOME MEASURES: Graduate practice location, registered specialty, passing rate of the National Medical Licensing Examination (NMLE), specialty of residency programme and contract compliance for the RTME-GXMU graduates. RESULTS: By the end of 2018, 100% of the 2015 RTME-GXMU graduates enrolled in this study practised in rural township health centres and registered themselves as general practitioners (GPs). All the RTME-GXMU graduates had completed or were attending residency programmes of general practice (GP). The above data stood in stark contrast to that of the non-RTME-GXMU graduates among whom as few as 1.06% worked in rural areas, 2.13% registered as GPs and less than 3% chose GP residency programmes. No significant differences were detected on passing rates of the NMLE between the two groups. Only one RTME-GXMU graduate broke the contract and dropped off the programme. CONCLUSIONS: The RTME-GXMU programme has achieved encouraging early outcomes. Reduced entry score and proper usage of urban primary care institutions are two key approaches contributing to these positive early results.

Role of PCK1 gene on oil tea-induced glucose homeostasis and type 2 diabetes: an animal experiment and a case-control study.

BACKGROUND: Oil tea is a type of traditional tea beverage used for treating various ailments in minority population in Guangxi, China. Our previous study showed oil tea improved glucose and lipid levels in type 2 diabetic mice. Yet, the underling molecular mechanisms are still not understood. This study aimed at assessing the effect of oil tea on glucose homeostasis and elucidating the molecular mechanisms underlying the oil tea-induced antidiabetic effects. METHODS: Twenty seven db/db mice were gavaged with saline, metformin and oil tea for 8 weeks with measurement of biochemical profiles. A real-time2 (RT2) profiler polymerase chain reaction (PCR) array comprising 84 genes involved in glucose metabolism was measured and validated by quantitative PCR (qPCR). The association between the candidate genes and type 2 diabetes were further analyzed in a case-control study in the Chinese minority population. RESULTS: Oil tea treatment facilitated glucose homeostasis by decreasing fasting blood glucose and total cholesterol, and improving glucose tolerance. Suppressing phosphoenolpyruvate carboxykinase 1 (PCK1) expression was observed in the oil tea treatment group and the expression was significantly correlated with fasting blood glucose levels. Target prediction and functional annotation by WEB-based GEne SeT AnaLysis Toolkit (WebGestalt) revealed that PCK1 mainly involved in the glycolysis/gluconeogenesis pathway among the top Kyoto Encyclopedia of Genes and Genomes (KEGG) database pathways. Both rs707555 and rs2071023 in PCK1 were significantly associated with type 2 diabetes in the minority population of Guangxi. CONCLUSION: Our findings indicated oil tea improved glucose homeostasis via down-regulation of PCK1 and PCK1 may be a genetic marker for the treatment of type 2 diabetes.