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Fluoroquinolone antibiotics are pseudo-persistence in aquatic environments as emerging contaminants. In this study, the Shitoukoumen Reservoir and its four inflow rivers were selected as a typical river-reservoir system. The factors, including river input, rainfall, flow regulation, population, antibiotic half-life, and antibiotic emission path were investigated to find out the reasons for antibiotic variations in the river-reservoir system during the reservoir discharge and filling periods. The results showed that ofloxacin was the most prevalent antibiotic in both the reservoir and inflow-river water, with median concentrations of 18.6 ± 2.4 and 39.7 ± 6.2 ng L−1, respectively. The concentrations of enrofloxacin, norfloxacin, and ofloxacin in the reservoir fluctuated during the reservoir discharge and filling periods. Enrofloxacin was only detected in the reservoir during the discharge period due to its input from the inflow rivers. Artificial reservoir discharge decreased the dissolved concentrations of norfloxacin and ofloxacin in the reservoir, whereas reservoir filling increased their accumulation. The Shuangyang, Yinma, and Chalu Rivers contributed relatively high individual antibiotic mass loads to the reservoir, ranging from 66.7% to 100%. Antibiotic-containing waste runoff during rainfall events increased input contributions of antibiotics from the Shuangyang and Chalu Rivers. The risk assessments indicated that norfloxacin posed a high risk to the most sensitive algae and therefore required greater attention. The study provides a comprehensive insight into fluoroquinolone antibiotic residues in the river-reservoir system during the periods of reservoir discharge and filling, and is of importance for their future monitoring and management.

The treadmill exercise test (TET) serves as a non-invasive method for the diagnosis of coronary artery disease (CAD). Despite its widespread use, TET reports are susceptible to external influences, heightening the risk of misdiagnosis and underdiagnosis. In this paper, we propose a novel automatic CAD diagnosis approach. The proposed approach introduces a customized preprocessing method to obtain clear electrocardiograms (ECGs) from individual TET reports. Additionally, it presents TETDiaNet, a novel neural network designed to explore the temporal relationships within TET ECGs. Central to TETDiaNet is the TETDia block, which mimics clinicians’ diagnostic processes to extract essential diagnostic information. This block encompasses an intra-state contextual learning module and an inter-state contextual learning module, modeling the temporal relationships within a single state and between states, respectively. These two modules help the TETDia block to capture effective diagnosis information by exploring the temporal relationships within TET ECGs. Furthermore, we establish a new TET dataset named TET4CAD for CAD diagnosis. It contains simplified TET reports for 192 CAD patients and 224 non-CAD patients, and each patient undergoes coronary angiography for labeling. Experimental results on TET4CAD underscore the superior performance of the proposed approach, highlighting the discriminative value of the temporal relationships within TET ECGs for CAD diagnosis.

The controlling of robotic arms based on brain–computer interface (BCI) can revolutionize the quality of life and living conditions for individuals with physical disabilities. Invasive electroencephalography (EEG)-based BCI has been able to control multiple degrees of freedom (DOFs) robotic arms in three dimensions. However, it is still hard to control a multi-DOF robotic arm to reach and grasp the desired target accurately in complex three-dimensional (3D) space by a noninvasive system mainly due to the limitation of EEG decoding performance. In this study, we propose a noninvasive EEG-based BCI for a robotic arm control system that enables users to complete multitarget reach and grasp tasks and avoid obstacles by hybrid control. The results obtained from seven subjects demonstrated that motor imagery (MI) training could modulate brain rhythms, and six of them completed the online tasks using the hybrid-control-based robotic arm system. The proposed system shows effective performance due to the combination of MI-based EEG, computer vision, gaze detection, and partially autonomous guidance, which drastically improve the accuracy of online tasks and reduce the brain burden caused by long-term mental activities.

Obesity is a significant risk factor for atrial fibrillation (AF), which is the most common sustained arrhythmia with increased mortality and morbidity. High‐fat diet (HFD)‐induced obesity is associated with the activation of endoplasmic reticulum stress (ERS). However, the role of ERS in HFD‐induced AF remains elusive. Human atrium samples were examined for the ERS activation test. C57BL/6J mice were divided into four groups, including the control group, the HFD group, the 4‐phenylbutyric acid (4‐PBA) group, and the HFD + 4‐PBA group. At the age of 4 weeks, the HFD group and the HFD + 4‐PBA group were given HFD to construct the obesity model, while the other two groups were given a normal diet (ND). Transesophageal programmed electrical stimulation was conducted to evaluate the AF inducibility and duration. Atrial fibrosis and ERS activation were also investigated.We found that CHOP and GRP‐78 protein were significantly higher in overweight patients than the controls (both P < 0.05). AF inducibility and duration of the HFD group were significantly higher than the other groups (both P < 0.05), while there was no difference between those groups (P > 0.05). The mice of the HFD group had significantly higher collagen volume fraction (CVF%) than the other groups (P < 0.05). ERS marker protein of GRP78, p‐PERK, ATF6 and CHOP protein expression level was increased in the HFD group, which were significantly mitigated in the HFD + 4‐PBA group. In summary, HFD‐induced ERS activation facilitates atrial fibrosis and AF. The inhibition of ERS might alleviate atrial fibrosis and reduce the incidence of AF‐associated obesity.

Background The 15-item Geriatric Depression Scale (GDS-15) shows good performance in detecting depression among older persons, but its applicability has not been well studied in non-Western oldest-old adults and centenarians. This study aimed to evaluate the psychometric property of the GDS-15 and a simplified version among a large representative longevous population in China. Methods A total of 1624 individuals (786 oldest-old persons aged from 80 to 99 years; 838 centenarians aged 100+ years) participated in this study. Home interviews with structured questionnaires were conducted to collect sociodemographic data. Depressive symptoms were measured using the Chinese GDS-15 version. We implemented mixed methods for the psychometric evaluation of the GDS-15. Cronbach’s α coefficient and item-total correlation coefficients were used to evaluate the internal consistency. A standard expert consultation was conducted to test the content validity of each item. Multiple factor analyses were used to explore the optimal factor structure and measurement invariance. Results The α coefficient of the GDS-15 was 0.745, while two items impaired the overall consistency reliability. Nineteen experts rated the applicability for each item and provided removal suggestion. Five items with less validity were removed, and a simplified 10-item GDS model with three-factor structure was proposed as an optimal solution. The GDS-10 model showed factorial equivalence across age, sex, residence, and education in multi-group confirmatory factor analyses. Conclusions The original GDS-15 has acceptable internal reliability, known-group validity, and concurrent validity among Chinese community-dwelling oldest-old and centenarians; however we provided preliminary evidence indicating that individual items related to somatic function or social activities may not be applicable for this population. The modified GDS-10 can be proposed as a potentially more practical and comprehensible instrument for depression screening.

Background Social frailty has not been comprehensively studied in China. Our objective is to investigate the prevalence of social frailty among the older population in China, as well as identify relevant factors and urban-rural differences. Methods We obtained data from the Fourth Sample Survey of the Aged Population in Urban and Rural China (SSAPUR) database. The study employed a multistage, stratified, cluster-sampling method, recruiting a total of 224,142 adults aged 60 years or older. Participants were interviewed to gather demographic data and information on family, health and medical conditions, health care service status, living environment conditions, social participation, protected rights status, spiritual and cultural life, and health. Social frailty was assessed using the HALFE Social Frailty Index. A score of three or above indicated social frailty. Results We analyzed a total of 222,179 cases, and the overall prevalence of social frailty was found to be 15.2%. The highest prevalence was observed among participants aged 75–79 years (18.0%). The prevalence of social frailty was higher in rural older populations compared to urban older populations (19.9% in rural vs. 10.9% in urban, P < 0.0001). In urban areas, women had a higher prevalence than men (11.7% in women vs. 9.9% in men, P < 0.0001), while in rural areas, men had a higher prevalence than women (20.6% in men vs. 19.2% in women, P < 0.0001). Multivariate regression analysis revealed that living in a rural/urban environment (OR 1.789, 95% CI 1.742–1.837), absence of a spouse/spousal presence (OR 4.874, 95% CI 4.743–5.009), self-assessed unhealthy/health status (OR 1.696, 95% CI 1.633–1.761), and housing dissatisfaction/satisfaction (OR 2.303, 95% CI 2.233–2.376) were all significantly associated with social frailty. Conclusions Using the HALFE social frailty index, we found a prevalence of 15.2% among older people in China, with the highest prevalence observed in the 75–79 age group. Social frailty was more prevalent in rural areas than in urban areas. Various factors, including spousal presence, housing satisfaction, health status, and urban-rural residential differences, were significantly associated with social frailty. These findings highlight the modifiable and non-modifiable factors that contribute to social frailty among older individuals in China.

In-hospital mortality rates decreased in the US over 2020. Most of the included studies in our systematic review were carried out in early stage of the global pandemic (i.e., up to June 2020) in hospital setting with inpatients, thus we were unable to make inference across time. Response: We suggest to look at the impact of this from the angles of in-hospital mortality and mortality in community settings.

Background Chronic diseases, such as heart disease, cancer, and diabetes, are the leading causes of death and disability. Loneliness is linked to a greater risk of chronic disease. However, the lack of loneliness may change this relationship. Methods The 4th Survey of the Aged Population in Urban and Rural China (SSAPUR) was performed. 222,179 people over 60 years old were recruited. Chronic disease was defined by self-reported tumble incidents using the fourth SSAPUR questionnaire. We found that the residuals were well normally distributed. Subsequently, we analyzed the association between each studied factor and chronic disease by univariate logistic regression analysis. Finally, we stratified the population by age, gender, and urban and rural. Results 77,448 individuals experienced loneliness, while 137,593 did not. Loneliness correlated significantly with urban-rural classification, age, and gender ( P  < 0.001). There was a significant association between chronic diseases and loneliness ( P  < 0.05). Compared to lonely individuals, those with low level of loneliness had a lower incidence of gastric diseases (OR = 0.752, 95% CI, 0.736–0.769, P  < 0.001), osteoarthritis (OR = 0.685, 95% CI, 0.673–0.697, P  < 0.001), chronic obstructive pulmonary disease (COPD) (OR = 0.678, 95% CI, 0.659–0.698, P  < 0.001), asthma (OR = 0.608, 95% CI, 0.583–0.633, P  < 0.001), malignant tumors (OR = 0.892, 95% CI, 0.822–0.968, P  = 0.006), and reproductive system diseases (OR = 0.871, 95% CI, 0.826–0.918, P  < 0.001). Conclusion In summary, loneliness is an important risk factor in the occurrence and development of chronic diseases in the elderly in China, and it has adverse effects on hypertension, stomach disease, cataract or glaucoma, osteoarthrosis, chronic lung disease, asthma, malignant tumor, and reproductive system diseases.

Various associations between adipose tissue and atherosclerosis (AS) have been revealed. This study aims to identify biomarkers in the epididymal adipose tissue of AS mice and to explore their effects on adipose tissue inflammation and adipogenesis. The gene expression profiles of epididymal adipose tissue (GSE57659 and GSE76812) were downloaded from the Gene Expression Omnibus database. Differentially expressed genes (DEG) screened by Limma R package and genes searched by weighted gene correlation network analysis (WGCNA) were performed to classify common genes associated with AS. The Protein-Protein interaction (PPI) network was constructed by Cytoscape software, and hub genes were eventually determined by the Cytohubba plugin. Finally, one of these hub genes was selected. The cell proliferation ability was assessed using the CCK8 assay. Oil Red O staining and Western blot were employed to evaluate the lipid content in adipocytes. The extent of the inflammatory response in adipocytes was determined by Enzyme-Linked Immunosorbent Assay (ELISA). A total of 125 DEGs were identified between the control group and the atherosclerosis group. Among these, 34 genes were selected based on two key modules identified through WGCNA. Subsequently, five key nodes were identified, namely , , , , and . was selected as the primary gene of interest for further investigation. Following the transfection of 3T3-L1 cells with lentivirus, was overexpressed. Capping actin protein, gelsolin like (CAPG) significantly enhanced preadipocyte proliferation, as demonstrated by CCK-8 and upregulated expression of the Cyclin D1. Furthermore, Oil Red O staining revealed a marked elevation in intracellular lipid accumulation upon CAPG overexpression. Western blot analysis showed increased protein levels of PPAR γ and adiponectin. Furthermore, CAPG in 3T3-L1 cells resulted in a marked upregulation of IL-6 and MCP-1. CAPG promotes the proliferation and differentiation of adipocyte precursor cells. Additionally, CAPG enhances the inflammatory response in adipocytes, potentially serving as a key molecule mediating obesity-related atherosclerosis.

Background. The association between lipoprotein-associated phospholipase A2 (Lp-PLA2) and stroke risk is inconsistent. We conducted a meta-analysis to determine whether elevated Lp-PLA2 is a risk factor for stroke. Methods. Studies were included if they reported Lp-PLA2 mass and/or activity levels and adjusted risk estimates of stroke. The primary outcome was overall stroke incidence. The combined results were shown as relative risks (RRs) with 95% confidence intervals (CI) for per 1 standard deviation (SD) higher value of Lp-PLA2 and the highest versus lowest Lp-PLA2 category. Results. Twenty-two studies involving 157,693 participants were included for analysis. After adjusting for conventional risk factors, the RRs for overall stroke with 1 SD higher Lp-PLA2 activity and mass were 1.07 (95% CI 1.02–1.13) and 1.11 (95% CI 1.04–1.19), respectively. The RRs of ischemic stroke with 1 SD higher Lp-PLA2 activity and mass were 1.08 (95% CI 1.01–1.15) and 1.11 (95% CI 1.02–1.22), respectively. When comparing the highest and lowest levels of Lp-PLA2, the RRs of stroke for Lp-PLA2 activity and mass were 1.26 (95% CI 1.03–1.54) and 1.56 (95% CI 1.21–2.00), respectively. Finally, when comparing the highest and lowest levels of Lp-PLA2, the pooled RRs of ischemic stroke for Lp-PLA2 activity and mass were 1.29 (95% CI 1.07–1.56) and 1.68 (95% CI 1.12–2.53), respectively. Conclusions. Elevated baseline Lp-PLA2 levels, detected either by activity or mass, are associated with increased stroke risk.